Abstract
OBJECTIVE: To determine if prolonged immune activation may be associated with the persistence of anaemia after treatment for severe malaria, we measured serum concentrations of neopterin and interleukin-4 during one week of antimalarial therapy and determined haemoglobin levels one month later. Neopterin is a clinically valuable marker for monitoring activation of macrophages by gamma-interferon and thus reflects the TH-1 immune response. Interleukin-4 is a major cytokine that tends to be inhibited by TH-1 activity. METHOD: The study population consisted of 26 Zambian children <6 years of age who presented with cerebral malaria to a rural hospital in 1994 and who were treated with quinine for seven days. Six children (23%) were anaemic (haemoglobin < 11 g/dl) one month after completing antimalarial therapy. RESULTS: On admission, concentrations of neopterin were markedly elevated in all patients. During the seven days of anti-malarial therapy, neopterin levels remained elevated in the 6 children who proved to have persistent anaemia one month after finishing treatment but declined significantly (P = 0.008) in the 2.0 children who corrected their haemoglobin levels by that time. Conversely, interleukin-4 levels declined in the children with persistent anaemia (P = 0.043) but not in the other children. CONCLUSION: Persistence of the TH-1 mediated immune response and associated activation of macrophages may be involved in the pathogenesis of lingering anaemia after treatment of malaria.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 60-65 |
| Number of pages | 6 |
| Journal | Tropical Medicine and International Health |
| Volume | 3 |
| Issue number | 1 |
| DOIs | |
| State | Published - 1998 |
| Externally published | Yes |
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Keywords
- Anaemia
- Interleukin-4
- Malaria
- Neopterin
- Zambia
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Infectious Diseases
- Parasitology
- Immunology
Cite this
Prolonged macrophage activation and persistent anaemia in children with complicated malaria. / Biemba, G.; Gordeuk, V. R.; Thuma, Philip E; Mabeza, G. F.; Weiss, G.
In: Tropical Medicine and International Health, Vol. 3, No. 1, 1998, p. 60-65.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prolonged macrophage activation and persistent anaemia in children with complicated malaria
AU - Biemba, G.
AU - Gordeuk, V. R.
AU - Thuma, Philip E
AU - Mabeza, G. F.
AU - Weiss, G.
PY - 1998
Y1 - 1998
N2 - OBJECTIVE: To determine if prolonged immune activation may be associated with the persistence of anaemia after treatment for severe malaria, we measured serum concentrations of neopterin and interleukin-4 during one week of antimalarial therapy and determined haemoglobin levels one month later. Neopterin is a clinically valuable marker for monitoring activation of macrophages by gamma-interferon and thus reflects the TH-1 immune response. Interleukin-4 is a major cytokine that tends to be inhibited by TH-1 activity. METHOD: The study population consisted of 26 Zambian children <6 years of age who presented with cerebral malaria to a rural hospital in 1994 and who were treated with quinine for seven days. Six children (23%) were anaemic (haemoglobin < 11 g/dl) one month after completing antimalarial therapy. RESULTS: On admission, concentrations of neopterin were markedly elevated in all patients. During the seven days of anti-malarial therapy, neopterin levels remained elevated in the 6 children who proved to have persistent anaemia one month after finishing treatment but declined significantly (P = 0.008) in the 2.0 children who corrected their haemoglobin levels by that time. Conversely, interleukin-4 levels declined in the children with persistent anaemia (P = 0.043) but not in the other children. CONCLUSION: Persistence of the TH-1 mediated immune response and associated activation of macrophages may be involved in the pathogenesis of lingering anaemia after treatment of malaria.
AB - OBJECTIVE: To determine if prolonged immune activation may be associated with the persistence of anaemia after treatment for severe malaria, we measured serum concentrations of neopterin and interleukin-4 during one week of antimalarial therapy and determined haemoglobin levels one month later. Neopterin is a clinically valuable marker for monitoring activation of macrophages by gamma-interferon and thus reflects the TH-1 immune response. Interleukin-4 is a major cytokine that tends to be inhibited by TH-1 activity. METHOD: The study population consisted of 26 Zambian children <6 years of age who presented with cerebral malaria to a rural hospital in 1994 and who were treated with quinine for seven days. Six children (23%) were anaemic (haemoglobin < 11 g/dl) one month after completing antimalarial therapy. RESULTS: On admission, concentrations of neopterin were markedly elevated in all patients. During the seven days of anti-malarial therapy, neopterin levels remained elevated in the 6 children who proved to have persistent anaemia one month after finishing treatment but declined significantly (P = 0.008) in the 2.0 children who corrected their haemoglobin levels by that time. Conversely, interleukin-4 levels declined in the children with persistent anaemia (P = 0.043) but not in the other children. CONCLUSION: Persistence of the TH-1 mediated immune response and associated activation of macrophages may be involved in the pathogenesis of lingering anaemia after treatment of malaria.
KW - Anaemia
KW - Interleukin-4
KW - Malaria
KW - Neopterin
KW - Zambia
UR - http://www.scopus.com/inward/record.url?scp=0031891205&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031891205&partnerID=8YFLogxK
U2 - 10.1046/j.1365-3156.1998.00168.x
DO - 10.1046/j.1365-3156.1998.00168.x
M3 - Article
VL - 3
SP - 60
EP - 65
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
SN - 1360-2276
IS - 1
ER -