Elevated Plasma Levels of TNF-Alpha, Inf-Gamma, Il-10 and TGF-Beta in Malaria Patients From Two Malaria Non-Endemic Regions in Karnataka, India

Abstract

Purpose: In India, Plasmodium vivax malaria is endemic and accounts for 50-55% of the total malaria burden in the country. There has been limited sero-epidemiological data available from malaria non-endemic regions in Karnataka state. In this study, we aimed to evaluate the plasma levels of Tumor necrosis factor-α (TNF-α), Interferon-γ (IFN-γ), Interleukin-10 (IL-10), and Transforming growth factor-β (TGF-β) and correlate with malaria parasitaemia and infection type in vivax and falciparum malaria cases reported from two study centres. Methods: This hospital-based cross sectional observational study was conducted at BLDEU SHRI B.M. Patil during 2016 to 2019. A total number of 45 microscopy positive and molecularly confirmed malaria cases were included in the study. Plasma samples were analyzed for the concentrations of four cytokines by Enzyme-linked immunosorbent assay (ELISA). 20 uninfected healthy volunteers were used as controls. Correlation of cytokines and parasitemia was done using Pearson correlation analysis. Results: The results show an overall significant elevation of plasma TNF-α (p<0.05), IFN-γ (p<0.005), IL-10 (p<0.001), and TGF-β (p<0.001) in malaria patients compared to healthy controls. Except TNF-α (p<0.001), there was no significant difference in infection type specific immune responses. No significant correlation was seen among all the four cytokines with parasite load. A Receiver operating curve (ROC) was generated and showed that TNF-α, IL-10, and IFN-γ were the best individual predictors of malaria. Conclusions:We conclude that significantly elevated plasma concentrations of TNF-α-, IL-10, IFN-γ and TGF-β in both P. vivax and P. falciparum cases suggest their active involvement in mounting defensive immune response against malaria infection.