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Perfil de anticorpos ANTI-Plasmodium falciparum E citocinas pró-inflamatórias em indivíduos com suspeita clínica de Malária
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A malária é uma doença endémica em 109 países localizados ao longo dos trópicos. Na Europa, a malária foi erradicada exceto no Azerbaijão, Geórgia, Quirguistão, Tadjiquistão e Turquia. Estima-se que 25-30 milhões de pessoas viajem anualmente da Europa para áreas com transmissão de malária. Em Portugal a malária permaneceu endémica até cerca de 1950 e nas últimas décadas, o aumento do volume de viagens internacionais, nomeadamente para destinos tropicais, endémicos para esta doença, acarretaram também o aumento dos casos no nosso país. A sua transmissão é feita por algumas espécies de mosquitos Anopheles. A malaria severa por Plasmodium falciparum, incluindo malária cerebral (MC), anemia por malária severa (AMS) e malária placentária (MP), continua a ser uma importante causa de morbilidade e mortalidade.
O objetivo geral deste estudo prende-se na análise do perfil de anticorpos anti-Plasmodium falciparum e citocinas pró-inflamatórias em indvíduos com suspeita clínica de malária, que estiveram em diferentes regiões endémicas do continente africano, entre as quais Angola, Moçambique, Guiné, São Tomé e Príncipe, Gabão e Congo. Sabe-se que em regiões endémicas a imunidade natural adquirida contra P. falciparum é mediada por anticorpos do tipo IgG. Através de ensaios imunoenzimáticos (ELISA) distinguiu-se a população com e sem reatividade serológica a anticorpos anti-P.falciparum, frente a um grupo controlo (soros de pacientes saudáveis de Portugal, que nunca estiveram em zonas endémicas para malária). Através do método ELISA procedeu-se à determinação dos níveis de anticorpos totais anti-Plasmodium falciparum IgG, IgM, IgG1, IgG3 e IgG4 e á concentração sérica das citocinas pró-inflamatórias C5a do sistema complemento, proteína C reativa (CRP) e IFN-γ.
Das cento e trinta e duas amostras estudadas, sessenta e cinco foram classificadas como positivas para Plasmodium spp. As principais manifestações clínicas foram de febre, cefaleia e mialgias. Apenas quarenta amostras foram classificadas como serologicamente reativas para P. falciparum. Neste grupo de doentes observou-se um aumento dos mediadores inflamatórios doseados, nomeadamente IgGs totais, IgG1, IgG3, e IgM anti-P. falciparum,C5a, CRP e IFN-γ.
Pretendeu-se com este estudo contribuir para uma melhor compreensão dos mecanismos fisiopatológicos da malária importada.
Malaria is an endemic disease in 109 countries located in the tropics. In Europe, malaria has been eradicated except in Azerbaijan, Georgia, Kyrgyzstan, Tajikistan and Turkey. It is estimated that 25-30 million people travel annually from Europe to areas of malaria transmission. In Portugal malaria remained endemic until about 1950 and in recent decades, the increasing volume of international travel, particularly to tropical destinations, endemic for this disease, also led to the increase in cases. Its transmission is caused by some species of Anopheles mosquitoes. Severe Plasmodium falciparum malaria, including cerebral malaria, severe malarial anemia and placental malaria remain an important cause of morbidity and mortality. The aim of this study is to analyse the profile of anti-Plasmodium falciparum antibodies and proinflammatory cytokines in individuals with clinical suspicion of malaria who were in different endemic regions of Africa, including Angola, Mozambique, Guinea, Sao Tome and Principe, Gabon and Congo. It is known that in endemic regions natural acquired immunity against P. falciparum malaria is mediated by antibodies of the IgG type. Through enzyme immunoassays (ELISA) the population with and without serological reactivity to anti-P.falciparum antibodies was distinguished, compared to a control group (sera from healthy patients from Portugal, who had never been in endemic areas for malaria). The ELISA method was used to determine the levels of total antibody anti-Plasmodium falciparum IgG, IgM, IgG1, IgG3 and IgG4 and the serum concentration of pro-inflammatory cytokines C5a of the complement system, C-reactive protein (CRP) and IFN-γ. Out of one hundred thirty-two samples studied, sixty-five were classified as positive for Plasmodium spp. The main clinical manifestations were fever, headache and myalgia. Only forty samples were classified as positive for P. falciparum. In this group of patients there was an increase in the assayed inflammatory mediators, including total IgG, IgG1, IgG3, and IgM anti -P. falciparum, C5a, CRP and IFN-γ. The intention of this study was to contribute to a better understanding of the pathophysiological mechanisms of imported malaria.
Malaria is an endemic disease in 109 countries located in the tropics. In Europe, malaria has been eradicated except in Azerbaijan, Georgia, Kyrgyzstan, Tajikistan and Turkey. It is estimated that 25-30 million people travel annually from Europe to areas of malaria transmission. In Portugal malaria remained endemic until about 1950 and in recent decades, the increasing volume of international travel, particularly to tropical destinations, endemic for this disease, also led to the increase in cases. Its transmission is caused by some species of Anopheles mosquitoes. Severe Plasmodium falciparum malaria, including cerebral malaria, severe malarial anemia and placental malaria remain an important cause of morbidity and mortality. The aim of this study is to analyse the profile of anti-Plasmodium falciparum antibodies and proinflammatory cytokines in individuals with clinical suspicion of malaria who were in different endemic regions of Africa, including Angola, Mozambique, Guinea, Sao Tome and Principe, Gabon and Congo. It is known that in endemic regions natural acquired immunity against P. falciparum malaria is mediated by antibodies of the IgG type. Through enzyme immunoassays (ELISA) the population with and without serological reactivity to anti-P.falciparum antibodies was distinguished, compared to a control group (sera from healthy patients from Portugal, who had never been in endemic areas for malaria). The ELISA method was used to determine the levels of total antibody anti-Plasmodium falciparum IgG, IgM, IgG1, IgG3 and IgG4 and the serum concentration of pro-inflammatory cytokines C5a of the complement system, C-reactive protein (CRP) and IFN-γ. Out of one hundred thirty-two samples studied, sixty-five were classified as positive for Plasmodium spp. The main clinical manifestations were fever, headache and myalgia. Only forty samples were classified as positive for P. falciparum. In this group of patients there was an increase in the assayed inflammatory mediators, including total IgG, IgG1, IgG3, and IgM anti -P. falciparum, C5a, CRP and IFN-γ. The intention of this study was to contribute to a better understanding of the pathophysiological mechanisms of imported malaria.
Descrição
Palavras-chave
Parasitologia médica Malária Plasmodium falciparum Diagnóstico
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical