Infammatory cytokines as potential biomarkers for early diagnosis of severe malaria in children in Ghana

Abstract

Background Severe malaria (SM) is a fatal multi-system disease which accounted for an estimated 619,000 deaths in 2021. Less than 30% of children presenting with SM are diagnosed and treated promptly, resulting in increased mortality and neurologic impairments in survivors. Studies have identifed cytokine profles that diferentiate the vari‑ ous clinical manifestations of malaria (severe and uncomplicated). However, the diagnostic capability of these cytokines in diferentiating between the disease states in terms of cut-of values has not yet been determined. Methods The plasma levels of 22 pro-infammatory cytokines (Eotaxin/CCL 11, interferon-gamma (IFN-γ), interleukin (IL)- 2, IL-6, IL-1β, IL-12p40/p70, IL-17A, RANTES, MCP-1, IL-15, IL-5, IL-1RA, IL-2R, IFN-α, IP-10, TNF, MIG, MIP-1α, MIP-1β, IL-7, IL-8 and Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF), and 3 anti-infammatory cytokines (IL-4, IL-13 and IL-10) in patients with SM, uncomplicated malaria (UM) and other febrile conditions, were measured and compared using the Human Cytokine Magnetic 25-Plex Panel. The receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of these cytokines. Results The level of the pro-infammatory cytokine, IL-17A, was signifcantly higher in the SM group as compared to the UM group. Levels of the anti-infammatory cytokines however did not difer signifcantly among the SM and UM groups. Only IL-1β and IL-17A showed good diagnostic potential after ROC curve analysis. Conclusion The data show that levels of pro-infammatory cytokines correlate with malaria disease severity. IL-1β and IL-17A showed good diagnostic potentials and can be considered for use in clinical practice to target treatment.

Description

Research Article

Keywords

Severe malaria, Uncomplicated malaria, Biomarker, Pro-infammatory cytokines, Anti-infammatory cytokines

Citation