Abstract
BACKGROUND Thrombocytopenia in malaria involves platelet destruction and consumption; however, the cellular response underlying this phenomenon has still not been elucidated.OBJECTIVE To find associations between platelet indices and unbalanced Th1/Th2/Th17 cytokines as a response to thrombocytopenia in Plasmodium vivax infected (Pv-MAL) patients.METHODS Platelet counts and quantification of Th1/Th2/Th17 cytokine levels were compared in 77 patients with uncomplicated P. vivax malaria and 37 healthy donors from the same area (endemic control group - ENCG).FINDINGS Thrombocytopenia was the main manifestation in 55 patients, but was not associated with parasitaemia. The Pv-MAL patients showed increases in the mean platelet volume (MPV), which may be consistent with larger or megaplatelets. Contrary to the findings regarding the endemic control group, MPV and platelet distribution width (PDW) did not show an inverse correlation, due the increase in the heterogeneity of platelet width. In addition, the Pv-MAL patients presented increased IL-1β and reduced IL-12p70 and IL-2 serum concentrations. Furthermore, the reduction of these cytokines was associated with PDW values.MAIN CONCLUSIONS Our data demonstrate that an increase in MPV and the association between reductions of IL-2 and IL-12 and PDW values may be an immune response to thrombocytopenia in uncomplicated P. vivax malaria.
Highlights
Thrombocytopenia in malaria involves platelet destruction and consumption; the cellular response underlying this phenomenon has still not been elucidated
The linear regression showed that the levels of IL-1β, IL-2 and IL-12 were associated with altered platelet distribution width (PDW) in Plasmodium vivax malaria (Pv-MAL) patients, and they may be predictors of the medullar response to thrombocytopenia caused by vivax malaria
Thrombocytopenia is the most common haematological disorder in patients with malaria and one of the major concerns when accompanied by multiple organ failures.[5,6] In our study, thrombocytopenia was the main manifestation among patients with vivax malaria, though the reduction in platelet count was not associated with parasitaemia
Summary
Thrombocytopenia in malaria involves platelet destruction and consumption; the cellular response underlying this phenomenon has still not been elucidated. OBJECTIVE To find associations between platelet indices and unbalanced Th1/Th2/Th17 cytokines as a response to thrombocytopenia in Plasmodium vivax infected (Pv-MAL) patients. METHODS Platelet counts and quantification of Th1/Th2/Th17 cytokine levels were compared in 77 patients with uncomplicated P. vivax malaria and 37 healthy donors from the same area (endemic control group - ENCG).
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