Abstract

BackgroundMalaria parasites and their products can activate a specific immune response by stimulating cytokine production in the host’s immune cells. Transcription nuclear factor kappa B (NF-κB) is an important regulator for the control of many pro-inflammatory genes, such as interleukin-1 (IL-1) and tumor necrosis factor (TNF). The activation and expression of NF-κB p65 in peripheral blood mononuclear cells (PBMCs) of malaria patients were investigated and correlated with the levels of IL-10 and TNF to study the nature of NF-κB p65 and its linkage to inflammatory cytokines.MethodsThe sample group comprised 33 patients admitted with malaria caused by Plasmodium vivax (n = 11), uncomplicated Plasmodium falciparum (n = 11), and complicated Plasmodium falciparum (n = 11). Peripheral blood was collected at admission and on day 7 for PBMC isolation. Healthy subjects were used as a control group. The expressions of NF-κB p65 in the PBMCs from malaria patients and the plasma levels of IL-10 and TNF were measured by using enzyme-linked immunosorbent assay (ELISA). The immunofluorescence technique was used to determine NF-κB nuclear translocation.ResultsAt admission, patients with P. vivax and uncomplicated P. falciparum had significantly elevated phospho-NF-κB p65 levels in the PBMCs compared with those of healthy controls. However, patients with complicated P. falciparum malaria had decreased levels of phospho-NF-κB p65. On day 7 post-treatment, significantly increased phospho-NF-κB p65 was found in the PBMCs of patients with complicated P. falciparum, compared with healthy controls. The plasma level of IL-10 was elevated in day 0 in patients with complicated P. falciparum malaria and was found to be negatively correlated with phospho-NF-κB p65 level (rs = −0.630, p = 0.038). However, there was no correlation between phospho-NF-κB p65 expression and TNF level in patients with complicated P. falciparum malaria.ConclusionsThis is the first report demonstrating alterations in NF-κB p65 activity in the PBMCs of malaria patients. The altered lower features of NF-κB p65 in the PBMCs of patients with complicated P. falciparum at admission could be due to a suppressive effect of high IL-10 associated with complicated P. falciparum malaria.

Highlights

  • Malaria parasites and their products can activate a specific immune response by stimulating cytokine production in the host’s immune cells

  • Patients diagnosed with P. vivax malaria were administered chloroquine and primaquine, whereas patients with P. falciparum malaria were treated with artesunate and mefloquine

  • Phospho-NF-κB p65 levels were significantly elevated in the peripheral blood mononuclear cells (PBMCs) of patients with P. vivax (0.182 ± 0.04, p < 0.001) and uncomplicated P. falciparum malaria (0.250 ± 0.10, p < 0.001), compared to the healthy controls (0.104 ± 0.04)

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Summary

Introduction

Malaria parasites and their products can activate a specific immune response by stimulating cytokine production in the host’s immune cells. Transcription nuclear factor kappa B (NF-κB) is an important regulator for the control of many pro-inflammatory genes, such as interleukin-1 (IL-1) and tumor necrosis factor (TNF). Nuclear factor kappa B (NF-κB) plays a crucial role in immune and inflammatory responses, through the regulation of various genes involved in pro-inflammatory cytokines, adhesion molecules, chemokines, inducible enzymes, and apoptosis [1]. Mammals express five NFκB protein members: NF-κB-1 (p50), NF-κB-2 (p52), Rel A (p65), Rel B, and c-Rel [2]. These proteins have a structurally conserved amino-terminal (300 amino-acid) region, containing dimerization, nuclear localization and DNA binding domains. Activated NF-κB translocates into the nucleus, where it binds to the DNA regulatory site to regulate specific gene expressions [2,3]

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