Elevated serum levels of IL-1ra in children with P. falciparum malaria are associated with increased severity of disease

• Published in: Cytokine (Philadelphia, Pa.) Pa.), 2008-02, Vol.41 (3), p.204-208
• Main Authors: John, Chandy C., Park, Gregory S., Sam-Agudu, Nadia, Opoka, Robert O., Boivin, Michael J.
• Format: Article
• Language: English
• ISSN: 1043-4666; 1096-0023
• DOI: 10.1016/j.cyto.2007.12.008

Animal models suggest that cytokines and chemokines play a role in cerebral malaria (CM) pathogenesis, but levels of a number of cytokines and chemokines thought to be important in the pathogenesis of other infectious diseases are not well characterized in children with CM. Serum levels of granulocyte-colony stimulating factor (G-CSF), interleukin-1 receptor antagonist (IL-1ra), interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) were measured in 77 children with CM, 70 children with uncomplicated malaria (UM) and 63 healthy community children (CC) in Uganda. Children with CM had elevated serum levels of IL-1ra and IL-8 as compared to children with UM (median levels in pg/ml, 11,891 vs. 6,510, P=0.05, and 63 vs. 41, P=0.01, respectively). Children with CM who died (n=4) had higher serum levels than survivors of IL-1ra (median levels in pg/ml, 65,757 v. 10,355, P =0.02), G-CSF (709 vs. 117, P =0.02), and MCP-1 (1,275 vs. 216, P =0.03) but not IL-8 (76 v. 62, P =NS). Elevated IL-1ra levels are associated with increased disease severity in children with malaria, and very elevated levels of IL-1ra, G-CSF and MCP-1 are seen in children who die of CM.