Alterations in cytokines and haematological parameters during the acute and convalescent phases of Plasmodium falciparum and Plasmodium vivax infections

Haematological and cytokine alterations in malaria are a broad and controversial subject in the literature. However, few studies have simultaneously evaluated various cytokines in a single patient group during the acute and convalescent phases of infection. The aim of this study was to sequentially characterise alterations in haematological patters and circulating plasma cytokine and chemokine levels in patients infected with Plasmodium vivax or Plasmodium falciparum from a Brazilian endemic area during the acute and convalescent phases of infection. During the acute phase, thrombocytopaenia, eosinopaenia, lymphopaenia and an increased number of band cells were observed in the majority of the patients. During the convalescent phase, the haematologic parameters returned to normal. During the acute phase, P. vivax and P. falciparum patients had significantly higher interleukin (IL)-6, IL-8, IL-17, interferon-γ, tumour necrosis factor (TNF)-α, macrophage inflammatory protein-1β and granulocyte-colony stimulating factor levels than controls and maintained high levels during the convalescent phase. IL-10 was detected at high concentrations during the acute phase, but returned to normal levels during the convalescent phase. Plasma IL-10 concentration was positively correlated with parasitaemia in P. vivax and P. falciparum-infected patients. The same was true for the TNF-α concentration in P. falciparum-infected patients. Finally, the haematological and cytokine profiles were similar between uncomplicated P. falciparum and P. vivax infections.

Alterations in cytokines and haematological parameters during the acute and convalescent phases of Plasmodium falciparum and Plasmodium vivax infections.

Haematological and cytokine alterations in malaria are a broad and controversial subject in the literature. However, few studies have simultaneously evaluated various cytokines in a single patient group during the acute and convalescent phases of infection. The aim of this study was to sequentially characterise alterations in haematological patters and circulating plasma cytokine and chemokine levels in patients infected with Plasmodium vivax or Plasmodium falciparum from a Brazilian endemic area during the acute and convalescent phases of infection. During the acute phase, thrombocytopaenia, eosinopaenia, lymphopaenia and an increased number of band cells were observed in the majority of the patients. During the convalescent phase, the haematologic parameters returned to normal. During the acute phase, P. vivax and P. falciparum patients had significantly higher interleukin (IL)-6, IL-8, IL-17, interferon-γ, tumour necrosis factor (TNF)-α, macrophage inflammatory protein-1ß and granulocyte-colony stimulating factor levels than controls and maintained high levels during the convalescent phase. IL-10 was detected at high concentrations during the acute phase, but returned to normal levels during the convalescent phase. Plasma IL-10 concentration was positively correlated with parasitaemia in P. vivax and P. falciparum-infected patients. The same was true for the TNF-α concentration in P. falciparum-infected patients. Finally, the haematological and cytokine profiles were similar between uncomplicated P. falciparum and P. vivax infections.

Cells and mediators of inflammation (C-reactive protein, nitric oxide, platelets and neutrophils) in the acute and convalescent phases of uncomplicated Plasmodium vivax and Plasmodium falciparum infection

The haematological changes and release of soluble mediators, particularly C-reactive protein (CRP) and nitric oxide (NO), during uncomplicated malaria have not been well studied, especially in Brazilian areas in which the disease is endemic. Therefore, the present study examined these factors in acute (day 0) and convalescent phase (day 15) patients infected with Plasmodium falciparum and Plasmodium vivax malaria in the Brazilian Amazon. Haematologic parameters were measured using automated cell counting, CRP levels were measured with ELISA and NO plasma levels were measured by the Griess reaction. Our data indicate that individuals with uncomplicated P. vivax and P. falciparum infection presented similar inflammatory profiles with respect to white blood cells, with high band cell production and a considerable degree of thrombocytopaenia during the acute phase of infection. Higher CRP levels were detected in acute P. vivax infection than in acute P. falciparum infection, while higher NO was detected in patients with acute and convalescent P. falciparum infections. Although changes in these mediators cannot predict malaria infection, the haematological aspects associated with malaria infection, especially the roles of platelets and band cells, need to be investigated further.

Cells and mediators of inflammation (C-reactive protein, nitric oxide, platelets and neutrophils) in the acute and convalescent phases of uncomplicated Plasmodium vivax and Plasmodium falciparum infection.

The haematological changes and release of soluble mediators, particularly C-reactive protein (CRP) and nitric oxide (NO), during uncomplicated malaria have not been well studied, especially in Brazilian areas in which the disease is endemic. Therefore, the present study examined these factors in acute (day 0) and convalescent phase (day 15) patients infected with Plasmodium falciparum and Plasmodium vivax malaria in the Brazilian Amazon. Haematologic parameters were measured using automated cell counting, CRP levels were measured with ELISA and NO plasma levels were measured by the Griess reaction. Our data indicate that individuals with uncomplicated P. vivax and P. falciparum infection presented similar inflammatory profiles with respect to white blood cells, with high band cell production and a considerable degree of thrombocytopaenia during the acute phase of infection. Higher CRP levels were detected in acute P. vivax infection than in acute P. falciparum infection, while higher NO was detected in patients with acute and convalescent P. falciparum infections. Although changes in these mediators cannot predict malaria infection, the haematological aspects associated with malaria infection, especially the roles of platelets and band cells, need to be investigated further.

Vacinação contra hepatite B pode não induzir imunidade: estudo transversal com cirurgiões-dentistas de Porto Velho-RO / Vaccination against hepatitis B cannot induce immunity: study transverse with surgeons dentists

O presente estudo transversal avaliou a condição vacinal e perfil sorológico de cirurgiões- dentistas para a hepatite viral do tipo B no município de Porto Velho - RO. Foram analisadas pela técnica ELlSA uma amostra de sangue (soro) por participante visando a detecção dos marcadores sorológicos do Vírus da Hepatite B: HBsAg, anti HBc total, anti-HBc IgM e anti-HBs. As amostras anti-HBc total positivas foram testadas para o marcador anti HBc IgM. Achados laboratoriais, informações de formação profissional, uso de equipamento de proteção individual (EPI) e índice vacinal também foram avaliados. Os dados foram comparados utilizando-se o teste Kruskal-Wallis (p-. 0,05). Dos oitenta cirurgiões-dentistas avaliados, 45% faziam clínica geral e 38% relataram atualizar-se profissionalmente uma vez ao ano. A maioria dos participantes (59%; p< 0,05) recebeu as três doses da vacina contra hepatite B e 11% apenas duas doses. Dentre os que receberam três doses a maior porcentagem (47%; p< 0,05) apresentou soroconversão decorrente da vacinação embora, preocupantemente, 13,75% não tenha soroconvertido. Conclui-se que o perfil sorológico nem sempre foi compatível com a cobertura vacina! Os achados sugerem a necessidade de execução de provas laboratoriais tanto para confirmação como para monitoramento da imunização decorrente do esquema de vacinação de três doses contra a hepatite B.

This cross-sectional study evaluated the vaccination's status and serological profile of a sample of dentists for viral hepatitis B in Porto Velho, RO. One blood (serum) sample for each participant had been analyzed by ELlSA detects the following Hepatitis B virus markers: H BsAg, anti-total HBc, anti-HBc IgM and anti-HBs. The positive samples for the anti-total HBc marker had been tested for the anti-HBc IgM marker. Also, laboratorial findings were analyzed con- sidering professional carrier aspects, self protection equipment, and vaccination rate among participants. Data had been statistically compared using the Kruskal-Wallis test (p-. 0.05). Out of 80 analyzed dentists, 45% practice as general dentist while 38% of the study population reported a professional updating once a year. Most of the dentists (59%; p < 0.05) received the indicated three dosages of the vaccine against Hepatitis B and 11% only two dosages quantities. Among people that received three dosages the majority percentage (47%; P < 0.05) developed immunization while 13.75% did not. The serological profile of immunization was not always compatible with the vaccination status. Our findings suggest that laboratorial tests are reques- ted to confirm and/or to monitor the immunization profile derived from Hepatitis B 3 dosages of vaccination scheme.