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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Immunology 1/2014

Cytokine profiles amongst Sudanese patients with visceral leishmaniasis and malaria co-infections

Zeitschrift:
BMC Immunology > Ausgabe 1/2014
Autoren:
Erika van den Bogaart, Al-Badawi A Talha, Masja Straetemans, Pètra F Mens, Emily R Adams, Martin P Grobusch, Bakri Y M Nour, Henk D F H Schallig
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2172-15-16) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contribution

EvdB designed the study, carried out the cytokine measurement and drafted the manuscript. AT recruited the study participants, performed collection of data and samples and participated to the sample analysis. MS performed the statistical analysis of the data. PM and EM conceived of the study, participated in its design, contributed to the sample analysis and helped to draft the manuscript. MG revised the critical content of the manuscript. BN participated to the study design and coordinated the work in the field. HS conceived of the study, participated in its design and coordination, contributed to the sample analysis and helped to draft the manuscript. All authors read and approved the final manuscript.

Abstract

Background

The immune system plays a critical role in the development of co-infections, promoting or preventing establishment of multiple infections and shaping the outcome of pathogen-host interactions. Its ability to mediate the interplay between visceral leishmaniasis (VL) and malaria has been suggested, but poorly documented. The present study investigated whether concomitant infection with Leishmania donovani complex and Plasmodium falciparum in naturally co-infected patients altered the immunological response elicited by the two pathogens individually.

Results

Circulating levels of interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12p70, IL-13, IL-17A and tumor necrosis factor (TNF) were assessed in sera of patients infected with active VL and/or malaria and healthy individuals from Gedarif State, Sudan. Comparative analysis of cytokine profiles from co- and mono-infected patients highlighted significant differences in the immune response mounted upon co-infection, confirming the ability of L. donovani and P. falciparum to mutually interact at the immunological level. Progressive polarization towards type-1 and pro-inflammatory cytokine patterns characterized the co-infected patients, whose response partly reflected the effect elicited by VL (IFN-γ, TNF) and malaria (IL-2, IL-13), and partly resulted from a synergistic interaction of the two diseases upon each other (IL-17A). Significantly reduced levels of P. falciparum parasitaemia (P <0.01) were detected in the co-infected group as opposed to the malaria-only patients, suggesting either a protective or a non-detrimental effect of the co-infection against P. falciparum infection.

Conclusions

These findings suggest that a new immunological scenario may occur when L. donovani and P. falciparum co-infect the same patient, with potential implications on the course and resolution of these diseases.
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