Low levels of RANTES are associated with mortality in children with cerebral malaria

Chandy John, Robert Opika-Opoka, Justus Byarugaba, Richard Idro, Michael J. Boivin

Research output: Contribution to journalArticle

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Abstract

Background. In children with cerebral malaria (CM), serum chemokine levels and associated morbidity and mortality have not been characterized. Methods. Serum levels of the cytokines interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor-α and the chemokines macrophage inflammatory protein (MIP)-1α, MIP-1β, and regulated upon activation, normal T cell expressed and secreted (RANTES) were measured in Ugandan children with CM, in children with uncomplicated malaria (UM), and in healthy children from the community, as control subjects (CCs). Results. Children with CM had lower levels of RANTES and higher levels of all other cytokines and chemokines than CCs (all P <.0001), and they had lower levels of RANTES (P = .004) and higher levels of IL-10 (P = .003), IFN-γ (P = .007), and IL-1β (P = .05) than children with UM. Children with CM who died had lower levels of RANTES (P = .006) and higher of levels of IL-6 (P = .006), IL-10 (P = .01), IFN-γ (P = .03), and MIP-1β (P = .008) than children who survived. After adjustment for other cytokine and chemokine levels, only low levels of RANTES were independently associated with mortality (P = .016). Levels of RANTES correlated with platelet count but were associated with mortality independently of platelet count. Conclusions. The serum cytokine and chemokine profile of children who die of CM is similar to that of individuals who die of sepsis. Levels of RANTES are significantly lower in children with CM, and very low levels of RANTES are associated with mortality, independently of other cytokine and chemokine levels.

Original languageEnglish (US)
Pages (from-to)837-845
Number of pages9
JournalJournal of Infectious Diseases
Volume194
Issue number6
DOIs
StatePublished - Sep 15 2006
Externally publishedYes

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Cerebral Malaria
Child Mortality
T-Lymphocytes
Chemokines
Macrophage Inflammatory Proteins
Cytokines
Interleukin-10
Interferons
Mortality
Platelet Count
Interleukin-1
Malaria
Interleukin-6
Serum
Sepsis
Tumor Necrosis Factor-alpha

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

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Low levels of RANTES are associated with mortality in children with cerebral malaria. / John, Chandy; Opika-Opoka, Robert; Byarugaba, Justus; Idro, Richard; Boivin, Michael J.

In: Journal of Infectious Diseases, Vol. 194, No. 6, 15.09.2006, p. 837-845.

Research output: Contribution to journalArticle

John, Chandy ; Opika-Opoka, Robert ; Byarugaba, Justus ; Idro, Richard ; Boivin, Michael J. / Low levels of RANTES are associated with mortality in children with cerebral malaria. In: Journal of Infectious Diseases. 2006 ; Vol. 194, No. 6. pp. 837-845.
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abstract = "Background. In children with cerebral malaria (CM), serum chemokine levels and associated morbidity and mortality have not been characterized. Methods. Serum levels of the cytokines interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor-α and the chemokines macrophage inflammatory protein (MIP)-1α, MIP-1β, and regulated upon activation, normal T cell expressed and secreted (RANTES) were measured in Ugandan children with CM, in children with uncomplicated malaria (UM), and in healthy children from the community, as control subjects (CCs). Results. Children with CM had lower levels of RANTES and higher levels of all other cytokines and chemokines than CCs (all P <.0001), and they had lower levels of RANTES (P = .004) and higher levels of IL-10 (P = .003), IFN-γ (P = .007), and IL-1β (P = .05) than children with UM. Children with CM who died had lower levels of RANTES (P = .006) and higher of levels of IL-6 (P = .006), IL-10 (P = .01), IFN-γ (P = .03), and MIP-1β (P = .008) than children who survived. After adjustment for other cytokine and chemokine levels, only low levels of RANTES were independently associated with mortality (P = .016). Levels of RANTES correlated with platelet count but were associated with mortality independently of platelet count. Conclusions. The serum cytokine and chemokine profile of children who die of CM is similar to that of individuals who die of sepsis. Levels of RANTES are significantly lower in children with CM, and very low levels of RANTES are associated with mortality, independently of other cytokine and chemokine levels.",
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T1 - Low levels of RANTES are associated with mortality in children with cerebral malaria

AU - John, Chandy

AU - Opika-Opoka, Robert

AU - Byarugaba, Justus

AU - Idro, Richard

AU - Boivin, Michael J.

PY - 2006/9/15

Y1 - 2006/9/15

N2 - Background. In children with cerebral malaria (CM), serum chemokine levels and associated morbidity and mortality have not been characterized. Methods. Serum levels of the cytokines interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor-α and the chemokines macrophage inflammatory protein (MIP)-1α, MIP-1β, and regulated upon activation, normal T cell expressed and secreted (RANTES) were measured in Ugandan children with CM, in children with uncomplicated malaria (UM), and in healthy children from the community, as control subjects (CCs). Results. Children with CM had lower levels of RANTES and higher levels of all other cytokines and chemokines than CCs (all P <.0001), and they had lower levels of RANTES (P = .004) and higher levels of IL-10 (P = .003), IFN-γ (P = .007), and IL-1β (P = .05) than children with UM. Children with CM who died had lower levels of RANTES (P = .006) and higher of levels of IL-6 (P = .006), IL-10 (P = .01), IFN-γ (P = .03), and MIP-1β (P = .008) than children who survived. After adjustment for other cytokine and chemokine levels, only low levels of RANTES were independently associated with mortality (P = .016). Levels of RANTES correlated with platelet count but were associated with mortality independently of platelet count. Conclusions. The serum cytokine and chemokine profile of children who die of CM is similar to that of individuals who die of sepsis. Levels of RANTES are significantly lower in children with CM, and very low levels of RANTES are associated with mortality, independently of other cytokine and chemokine levels.

AB - Background. In children with cerebral malaria (CM), serum chemokine levels and associated morbidity and mortality have not been characterized. Methods. Serum levels of the cytokines interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor-α and the chemokines macrophage inflammatory protein (MIP)-1α, MIP-1β, and regulated upon activation, normal T cell expressed and secreted (RANTES) were measured in Ugandan children with CM, in children with uncomplicated malaria (UM), and in healthy children from the community, as control subjects (CCs). Results. Children with CM had lower levels of RANTES and higher levels of all other cytokines and chemokines than CCs (all P <.0001), and they had lower levels of RANTES (P = .004) and higher levels of IL-10 (P = .003), IFN-γ (P = .007), and IL-1β (P = .05) than children with UM. Children with CM who died had lower levels of RANTES (P = .006) and higher of levels of IL-6 (P = .006), IL-10 (P = .01), IFN-γ (P = .03), and MIP-1β (P = .008) than children who survived. After adjustment for other cytokine and chemokine levels, only low levels of RANTES were independently associated with mortality (P = .016). Levels of RANTES correlated with platelet count but were associated with mortality independently of platelet count. Conclusions. The serum cytokine and chemokine profile of children who die of CM is similar to that of individuals who die of sepsis. Levels of RANTES are significantly lower in children with CM, and very low levels of RANTES are associated with mortality, independently of other cytokine and chemokine levels.

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