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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060 EISSN: 1678-8060
Vol. 110, No. 8, 2015, pp. 945-955
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Bioline Code: oc15129
Full paper language: English
Document type: Review Article
Document available free of charge
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Memórias do Instituto Oswaldo Cruz, Vol. 110, No. 8, 2015, pp. 945-955
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Immunoregulation in human malaria: the challenge of understanding asymptomatic infection
Mendonça, Vitor R. de & Barral-Netto, Manoel
Abstract
Asymptomatic Plasmodium infection carriers represent a major threat to malaria control worldwide as they are
silent natural reservoirs and do not seek medical care. There are no standard criteria for asymptomatic Plasmodium
infection; therefore, its diagnosis relies on the presence of the parasite during a specific period of symptomless
infection. The antiparasitic immune response can result in reduced Plasmodium sp. load with control of disease
manifestations, which leads to asymptomatic infection. Both the innate and adaptive immune responses seem to play
major roles in asymptomatic Plasmodium infection; T regulatory cell activity (through the production of interleukin-
10 and transforming growth factor-β) and B-cells (with a broad antibody response) both play prominent roles.
Furthermore, molecules involved in the haem detoxification pathway (such as haptoglobin and haeme oxygenase-1)
and iron metabolism (ferritin and activated c-Jun N-terminal kinase) have emerged in recent years as potential biomarkers
and thus are helping to unravel the immune response underlying asymptomatic Plasmodium infection. The
acquisition of large data sets and the use of robust statistical tools, including network analysis, associated with welldesigned
malaria studies will likely help elucidate the immune mechanisms responsible for asymptomatic infection.
Keywords
asymptomatic infection; immune response; biomarkers; networks
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