Acta Tropica 113 (2010) 263–268 Contents lists available at ScienceDirect Acta Tropica journal homepage: www.elsevier.com/locate/actatropica A preliminary study on pro- and anti-inflammatory cytokine profiles in Plasmodium vivax malaria patients from central zone of India Vidhan Jain a,1 , Puspendra P. Singh a,1 , Nipun Silawat a , Rakesh Patel a , Ajay Saxena a , Praveen K. Bharti a , Manmohan Shukla a , Sukla Biswas b , Neeru Singh a,c,∗ a National Institute of Malaria Research, FS-Jabalpur, MP, India b National Institute of Malaria Research, 22 Sham Nath Marg, Delhi 110054, India c Regional Medical Research Centre for Tribals & National Institute of Malaria Research, FS-Jabalpur, Nagpur Road, Garha, Jabalpur, MP, India article info Article history: Received 16 January 2009 Received in revised form 11 November 2009 Accepted 24 November 2009 Available online 1 December 2009 Keywords: Malaria Plasmodium vivax Cytokines ELISA abstract The aim of this preliminary study was to investigate the plasma cytokine profiles in a group of patients suffering from Plasmodium vivax malaria during the peak of its transmission season. Plasma samples of 173 P. vivax patients and 34 healthy individuals were analyzed for IFN-, TNF-, IL-10 and IP-10 levels by ELISA. Levels of both pro- and anti-inflammatory cytokines were significantly higher in P. vivax patients compared to controls. Children with P. vivax infection had significantly higher levels of IFN- than adults (P = 0.017). Asexual parasitaemia versus TNF- (r = -0.31, P = 0.01), IL-10 (r = -0.30, P = 0.015) and gametocytaemia versus IFN- (r = -0.26; P = 0.034) levels showed significant negative correlation in children compared to adults. The median concentrations of IFN- (P = 0.001), IL-10 (P = 0.032) and IP-10 (P ≤ 0.05) were higher in children reported with chills and rigors, whereas in adults only IFN- levels was higher (P < 0.0001). The median plasma concentrations of IFN-  (P = 0.02), IL-10 (P < 0.0001) and IP-10 (P = 0.068) were higher in patients with mild anaemia compared to non-anaemic patients. The results indicated that both pro- and anti-inflammatory cytokine responses are associated with clinical signs of mild anaemia and paroxysm during symptomatic P. vivax malaria in Central India. © 2009 Elsevier B.V. All rights reserved. 1. Introduction Malaria is the major cause of morbidity and mortality in many tropics and subtropics (especially of Asia and Latin Amer- ica) including India where ∼52% of the malaria infections are caused by Plasmodium vivax followed by Plasmodium falciparum (www.nvbdcp.gov.in). This study has been carried out in a cen- tral part of India, where both the species of Plasmodium, i.e., P. vivax and P. falciparum are prevalent in all age groups, espe- cially in older children (Singh et al., 2000). In this area, malaria is highly seasonal; P. vivax cases are common during dry season (February–June), whereas P. falciparum cases are available during post-monsoon periods from July to January. Though most of the P. vivax infections are uncomplicated and rarely fatal, this can lead to debilitating illness (Mendis and Carter, 1992). The problem is fur- ther compounded by the development of chloroquine resistance against P. vivax (Dua et al., 1996; Singh, 2000). Severe and com- ∗ Corresponding author at: Regional Medical Research Centre for Tribals, & OIC, National Institute of Malaria Research, FS-Jabalpur, Nagpur Road, Garha, Jabalpur 482003, MP, India. Tel.: +91 7612371279; fax: +91 7612672900. E-mail address: neeru.singh@gmail.com (N. Singh). 1 These authors contributed equally in this study. plicated forms of P. vivax malaria causing cerebral malaria, renal failure, severe anaemia, jaundice and even death in some patients are reported from Western India (Kochar et al., 2005, 2007). Like P. falciparum, P. vivax also induces specific immune responses in host; as a result cytokines are released causing activation of macrophages, T-lymphocytes, natural killer cells, neu- trophils to combat the infection. Cytokine profile (TH1/TH2) unveils the immune response in the disease. In Plasmodial infections, the balance between pro- and anti-inflammatory cytokines determines the level of anaemia, parasite load, degree of pyrexia, clinical sever- ity and outcome of infection (Brown et al., 1991; Newton and Krishna, 1998; Jason et al., 2001; Dodoo et al., 2002). Although role of TNF-, IFN-, IL-10 and IL-4 has been investi- gated in P. falciparum infection and related pathogenesis of malaria information regarding P. vivax malaria and cytokines are relatively rare (Yeom et al., 2003; Seoh et al., 2003; Karunaweera et al., 1992a,b). Almost no information is available from central part of India, where P. vivax malaria is highly prevalent and seasonal (Singh et al., 2000, 2006). Thus exploring P. vivax cytokine profile would be useful as it reveals the immune response mechanism of the host against the parasite. The aim of this preliminary study was to test the hypothesis that cytokines may play an important role in immunopathogenesis of P. vivax associated clinico-pathological features such as anaemia 0001-706X/$ – see front matter © 2009 Elsevier B.V. All rights reserved. doi:10.1016/j.actatropica.2009.11.009