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Background <p>Clearance of <i>Plasmodium falciparum</i> infection requires a T<sub>H</sub>1 immune response with production of pro-inflammatory cytokines, IgG1, and IgG3 responses. In contrast, infections with helminths are dominated by T<sub>H</sub>2/T<sub>reg</sub> immune responses characterized by production of anti-inflammatory cytokines, IgE, and IgG4, which could potentially interfere with malaria outcomes and immune responses.</p> Methods <p>We recruited 441 malaria-symptomatic children aged 2–10&#xa0;years attending two hospitals in the Manhiça District (Mozambique) and assessed infection by rapid antigen diagnostic test, microscopy, and/or quantitative PCR. Using Luminex, we measured concentrations of 30 cytokines and IgA, IgM, IgE, IgG, and IgG1–4 levels against 12 <i>P. falciparum</i> antigens and total IgE.</p> Results <p>Among 74 children diagnosed with malaria, 22% (16) were coinfected with STH, and 78% (58) had only <i>P. falciparum</i>. Soil-transmitted helminths (STH) coinfection associated with lower <i>P. falciparum</i> density (<i>P</i> = 0.005) and fever (<i>P</i> = 0.047). Coinfected children also had lower concentrations of plasma pro-inflammatory (IL-8, TNF, IFNα, IP-10, MCP1, MIG, MIP1β, and GM-CSF) and anti-inflammatory cytokines (IL-5, IL-10) (<i>P</i> &lt; 0.05). Furthermore, antibody responses to a set of <i>P. falciparum</i> antigens, including SSP2 (IgG1, IgG4, IgG), PTRAMP (IgG3), MSP3 (IgG), RH5 (IgG1), and α-gal (IgG1), as well as total IgE, were elevated in STH coinfected children (<i>P</i> &lt; 0.05).</p> Conclusions <p>STH infections were associated with decreased <i>P. falciparum</i> parasitemia, downregulation of inflammatory cytokines, and enhanced antibody responses, potentially resulting in milder malaria episodes, suggesting enhanced protective immunity.</p>

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Helminth coinfections mitigate clinical, parasitological, and immune outcomes in Mozambican children with malaria

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月31日

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  • Inocência Cuamba,
  • Rebeca Santano,
  • Berta Grau-Pujol,
  • Marta Vidal,
  • Ruth Aguilar,
  • Anélsio Cossa,
  • Chenjerai Jairoce,
  • Rojelio Mejia,
  • Augusto Nhabomba,
  • Jose Muñoz,
  • Gemma Moncunill,
  • Carlota Dobaño

摘要

Background

Clearance of Plasmodium falciparum infection requires a TH1 immune response with production of pro-inflammatory cytokines, IgG1, and IgG3 responses. In contrast, infections with helminths are dominated by TH2/Treg immune responses characterized by production of anti-inflammatory cytokines, IgE, and IgG4, which could potentially interfere with malaria outcomes and immune responses.

Methods

We recruited 441 malaria-symptomatic children aged 2–10 years attending two hospitals in the Manhiça District (Mozambique) and assessed infection by rapid antigen diagnostic test, microscopy, and/or quantitative PCR. Using Luminex, we measured concentrations of 30 cytokines and IgA, IgM, IgE, IgG, and IgG1–4 levels against 12 P. falciparum antigens and total IgE.

Results

Among 74 children diagnosed with malaria, 22% (16) were coinfected with STH, and 78% (58) had only P. falciparum. Soil-transmitted helminths (STH) coinfection associated with lower P. falciparum density (P = 0.005) and fever (P = 0.047). Coinfected children also had lower concentrations of plasma pro-inflammatory (IL-8, TNF, IFNα, IP-10, MCP1, MIG, MIP1β, and GM-CSF) and anti-inflammatory cytokines (IL-5, IL-10) (P < 0.05). Furthermore, antibody responses to a set of P. falciparum antigens, including SSP2 (IgG1, IgG4, IgG), PTRAMP (IgG3), MSP3 (IgG), RH5 (IgG1), and α-gal (IgG1), as well as total IgE, were elevated in STH coinfected children (P < 0.05).

Conclusions

STH infections were associated with decreased P. falciparum parasitemia, downregulation of inflammatory cytokines, and enhanced antibody responses, potentially resulting in milder malaria episodes, suggesting enhanced protective immunity.