Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In vitro and in vivo, tryptophan degradation was found to be associated with T cell functional loss and tolerance induction. In systemic lupus erythematosus (SLE) besides the Th2-type cytokine interleukin-10, Th1-type cytokines including interferon-gamma (IFN-gamma) are expressed especially during exacerbation of the disease. IFN-gamma stimulates the enzyme indoleamine (2,3)-dioxygenase (IDO) converting tryptophan to the metabolite kynurenine which in macrophages is subsequently degraded to other, partly neurotoxic compounds like quinolinic acid, and finally to nicrotinamides. We measured kynurenine and tryptophan concentrations in the sera of 55 SLE patients. In these patients, the concentrations of tryptophan (median, interquartile range: 53.9, 45.7-64.1 microM) were lower (p < 0.0001), and the kynurenine concentrations (2.45, 1.75-3.40 microM) were increased (p < 0.0005) compared to healthy blood donors (70.0, 63.8-80.6; 1.80, 1.45-2.27 microM, respectively). Also the kynurenine per tryptophan quotients (K/T), which allow to estimate IDO activity, were significantly higher in patients than in normals (0.043, 0.033-0.062 vs. 0.027, 0.021-0.030; p < 0.0001), indicating enhanced IDO-induced tryptophan degradation in SLE. There was no significant relationship between tryptophan, kynurenine and the SLEDAI, and also the correlation of K/T with SLEDAI was rather weak (rs = 0.243, p < 0.05). Higher K/T was found in patients presenting with serositis (p = 0.01), decrease of complement (c3, c4; p < 0.01) and blood count change (anemia, leucopenia, lymphopenia; p = 0.032) than in patients without such disease manifestations. The significant correlation found between K/T and neopterin (rs = 0.808, p < 0.001), a marker of immune activation, points to a role of immune activation to be responsible for tryptophan degradation in SLE patients.
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PMID:Enhanced tryptophan degradation in systemic lupus erythematosus. 1083 18

We have examined IgG and complement factor C3d deposition on erythrocytes by means of the direct Coombs' test (DAT) and looked for an association with the anaemia seen in falciparum malaria in children living in an area of hyperendemic malaria transmission (in Ghana). In one study (in 1997), 53 out of 199 patients had a positive DAT. Of these, 45 samples reacted with anti-C3d antibodies, 2 with anti-IgG and 6 with both reagents. There were significantly lower haemoglobin (Hb)-levels and higher prevalence of spleen enlargement in DAT-positive than in DAT-negative patients. Hb-levels were independently associated with DAT and age. This initial study was designed to investigate the role of intravascular haemolysis (IVH), but we found no association between IVH and either DAT result or anaemia. Because of the risk of selection bias we repeated the study using consecutive enrollment of malaria patients and were able to confirm the results in a total of 49 DAT-positive and 183 DAT-negative patients. This second study (in 1998) was designed to look at the importance of erythrophagocytosis through measurement of plasma neopterin levels and total nitrite and nitrate as markers of NO-release. Both parameters were significantly higher in DAT-positive than in DAT-negative patients (P < 0.001), indicating that complement binding to erythrocytes was associated with macrophage activation. Plasma levels of haptoglobin, interleukin-10 and tumour necrosis factor-alpha did not vary between the groups. The studies support the role of complement activation and erythrophagocytosis in the pathogenesis of anaemia in falciparum malaria in African children.
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PMID:Complement binding to erythrocytes is associated with macrophage activation and reduced haemoglobin in Plasmodium falciparum malaria. 1170 71

Experimental infection of non-human primates with simian malaria parasites offers a controlled system to study malarial immunity. Plasmodium cynomolgi (P. vivax-like) and P. knowlesi (P. falciparum-like) infections in the rhesus monkey were used as a model to test the hypothesis that initial acute infection stimulates type 1/pro-inflammatory cytokine expression followed by a gradual type 2/anti-inflammatory response upon re-infection. This study analyzed cytokine gene expression (interleukin-12, interferon-gamma, tumor necrosis factor-alpha = type 1; interleukin-4, interleukin-10 = type 2) using a semi-quantitative reverse transcriptase-polymerase chain reaction in monkeys infected with each of the parasites (three per group). Clinicoparasitologic and serologic parameters were also monitored. Monkeys were re-infected to assess whether enhanced immunity could increase parasite clearance. The immune response to P. cynomolgi infection in rhesus monkeys seemed to be mediated by anti-parasite, pro-inflammatory responses during primary infection with a transition to protective type 2 responses after repeat infection. The immune responses to P. knowlesi infection were more varied. Anti-inflammatory responses were more prevalent during primary infection. Repeat infection stimulated a wide variety of responses; most included expression of tumor necrosis factor-alpha, a cytokine that has been associated with inflammatory and host-destructive effects (weight loss, fever, anemia). These observations further confirmed that the simian malaria/rhesus monkey model is well suited for studies on the regulation of immunity to acute Plasmodium infection.
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PMID:Cytokine responses during acute simian Plasmodium cynomolgi and Plasmodium knowlesi infections. 1251 48

To investigate if severe malarial anemia is associated with specific cytokine overproduction, we evaluated serum levels of soluble Fas ligand (sFasL), tumor necrosis factor (TNF-alpha) and interleukin-10 (IL-10) from three groups of young children with Plasmodium falciparum infection (asymptomatic cases, uncomplicated malaria cases and severe malarial anemia cases), in a hyperendemic area of Gabon. In uncomplicated cases, only TNF levels were significantly (p < 0.001) increased in comparison to asymptomatic cases with P. falciparum infection. High levels of sFasL, TNF-alpha and IL-10 were associated with low hemoglobin concentrations, sFasL levels were significantly higher in children with severe malarial anemia (p < 0.001) as compared to both other groups. The parasite density was positively correlated with IL-10, TNF-alpha and sFasL levels. TNF-alpha and sFasL, but not IL-10 or parasitemia, were independent predictors of hemoglobin concentrations. These results suggest that, in malaria, a specific dysregulation of the cytokine balance may lead to complications such as severe anemia.
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PMID:Severe malarial anemia associated with increased soluble Fas ligand (sFasL) concentrations in Gabonese children. 1471 16

In experimental murine trypanosomiasis, resistance is often scored as the capacity to control peak parasitemia levels, which results in prolonged survival. Infection-induced pathology has not systematically been used as a resistance criterion. Because this parameter could be the most relevant for comparative analysis of natural and experimental infections, as well as for understanding of pathology-associated immune alterations, we analyzed Trypanosoma brucei infections in 4 different established conventional mouse models, as well as in tumor necrosis factor (TNF)-deficient and TNF-receptor-deficient mice. Results indicate the following: (1) there is no correlation between peak parasitemia control or survival and the induction of infection-associated anemia, loss of body weight, liver pathology, reduced locomotor activity, and general morbidity; (2) serum levels of TNF, interferon- gamma, and interleukin-10, which are known to affect survival, do not correlate with induction of pathology; and (3) infection-induced occurrence of lipopolysaccharide hypersensitivity does not correlate with survival. However, one parameter that was found to correlate with the inhibition of trypanosomiasis-associated pathology in all models was the shedding of soluble p75 TNF-receptor during peak parasitemia stages. These results are important for future cytokine and trypanosomiasis pathology studies, because the interplay between TNF and the soluble receptors it sheds has not been considered in either human clinical sleeping sickness studies or in veterinary trypanosomiasis research.
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PMID:P75 tumor necrosis factor-receptor shedding occurs as a protective host response during African trypanosomiasis. 1474 12

Prostaglandins (PGs) are important mediators of macrophage activity, vascular permeability, fever, erythropoiesis, and proinflammatory responses to infection. Our recent studies have shown that plasma levels of bicyclo-PGE2 (a stable end product of PGE2 metabolism) and leukocyte cyclooxygenase (COX)-2 gene expression are suppressed in children with malarial anemia. Since the role of PGs as immunomodulators of human cerebral malaria (CM) has not been examined, we investigated urinary levels of bicyclo-PGE2/creatinine in children with varying clinical outcomes of CM. Among parasitemic children, those with asymptomatic parasitemia had the highest levels of bicyclo-PGE2/creatinine, whereas those with CM had significantly lower levels of bicyclo-PGE2. Systemic levels of bicyclo-PGE2/creatinine were not significantly associated with parasitemia, hemoglobin levels, or levels of the PG-regulatory cytokine tumor necrosis factor- alpha but were positively correlated with levels of interleukin-10. The results presented here show that impaired systemic production of PGE2 is associated with adverse outcomes of CM, whereas elevated levels of PGE2 in asymptomatic parasitemia suggest a potential role for PGs in protective immunity.
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PMID:Impaired systemic production of prostaglandin E2 in children with cerebral malaria. 1580 15

In this review I attempt to advance hypotheses that might help contribute toward understanding the molecular pathogenesis of cerebral malaria (CM) and other complications based on a now widely accepted argument that the illness and pathology occasioned by Plasmodiumfalciparum infection might not necessarily be due to the direct effects of the parasite's 'toxins' and/or exoantigens or even its sequestration and consequent attendant effects in vital organs but rather to the parasite's mediated production of microbicidal molecules by the host. Tumor necrosis factor (TNF)-alpha is implicated in the pathogenesis of complicated malaria. There is a positive correlation between high levels of TNF-alpha and severity of malaria. The role of nitric oxide in the pathophysiology of complicated malaria is not clearly understood. Mononuclear phagocytes by virtue of their capacity to secrete toxic intermediates like reactive oxygen intermediates can inhibit the growth of both murine and human plasmodia. The role of interleukin-10 (IL-10) in malaria is also not well characterized to date. IL-10 is a powerful immunosuppressor factor. It acts as a natural dampener of immunoproliferative and inflammatory responses. Although transforming growth factor-beta has a crucial role in inflammation and repair, its role in complicated malaria is not too clearly understood. Furthermore, the anatomical source of these microbicidal molecules is not precisely known. The role of immune complexes (IC) in the pathophysiology of complicated malaria has hitherto not been tested. I argue here that IC play a critical role in influencing the outcome of malarial disease; IC-mediated stimulation of leukocytes to produce high levels of both TNF-alpha and NO and the fact that leukocytes are probably the principal anatomical source of these microbicidal and other pro-inflammatory mediators in complicated malaria provide a much more plausible explanation for the pathogenesis of CM and other complications. I also review the arguments that help contribute to rationalize hypoglycemia and hyperlactatemia in malarial disease and to some extent severe anemia. I am therefore tempted to conclude that CM and other complications are probably immune-mediated diseases or, at least, they present an inflammatory pathogenesis.
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PMID:Cell-mediated effector molecules and complicated malaria. 1597 Jun 42

The aim of the study was to confirm whether plasma levels of interleukin-10 (IL-10) correlate with the prognosis in diffuse, large B-cell lymphoma (DLBCL) patients. Plasma IL-10 levels were determined at the time of diagnosis in a group of 157 consecutively treated, DLBCL patients. Of those, 122 patients (78%) had IL-10 plasma levels below the detection limit (< 5 pg/mL) and 35 (22%) above this value. The median value for patients with detectable IL-10 levels was 35 pg/mL (range, 5 to 2480 pg/mL). Detectable plasma IL-10 levels were significantly associated with age > 60 years, ECOG performance status > or = 2, Ann Arbor advanced disease stage, bulky tumor mass, elevated serum levels of LDH and beta2-microglobulin, presence of anemia and low serum albumin levels as well as the presence of B symptoms. The patients with detectable IL-10 levels had lower probability of CR achievement (OR = 0.23, 95% CI 0.1-0.5, p = 0.0003). In addition, detectable IL-10 levels were significantly associated with shorter PFS (OR = 2.5, 95% CI 1.5-4.4, p = 0.001) and OS (OR = 3.0, 95% CI 1.7-5.2, p = 0.0001). In conclusion, we confirmed in this large group of DLBCL patients that elevated plasma IL-10 levels correlated with adverse disease features and poor prognosis. The plasma concentration of IL-10 may be a useful marker for evaluation of disease activity.
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PMID:Elevated IL-10 plasma levels correlate with poor prognosis in diffuse large B-cell lymphoma. 1661 64

The typical complications of end-stage renal disease (ESRD) vary in frequency and severity. Whereas anemia of chronic kidney disease might require high doses of exogenous erythropoietin (EPO) in some individuals, others hardly ever need hormone replacement. The same observation can be made for immune defense functions in patients with ESRD. Our understanding of the functional consequences of genetic polymorphisms in a wide array of genes has recently gained momentum. In patients with ESRD, interindividual differences in anemia parameters have been linked in part to genetic polymorphisms. Indeed, although inflammation is an important predictor of the need for EPO, to date a link to cytokine gene polymorphisms has not been established. However, the need for EPO has been linked to polymorphisms in the angiotensin-converting enzyme (ACE) and vitamin D receptor genes. In contrast, in dialysis patients, interindividual variability in host immune responses, including nonspecific (bacterial) and antigen-specific (viral) immune mechanisms has been linked to variations in the interleukin-10 and myeloperoxidase genes as well as variability in human leukocyte antigens (HLAs). In conclusion, the role of genetic polymorphisms in predicting the development and severity of anemia in chronic kidney disease as well as host immune competence is in its infancy and warrants further inquiry.
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PMID:Gene polymorphism association studies in dialysis: anemia and host immunity. 1668 74

To examine the hormonal and immunological mechanisms that mediate sex differences in susceptibility to malaria infection, intact and gonadectomized (gdx) C57BL/6 mice were inoculated with Plasmodium chabaudi AS-infected erythrocytes, and the responses to infection were monitored. In addition to reduced mortality, intact females recovered from infection-induced weigh loss and anemia faster than intact males. Expression microarrays and real-time reverse transcription-PCR revealed that gonadally intact females exhibited higher expression of interleukin-10 (IL-10), IL-15Ralpha, IL-12Rbeta, Gadd45gamma, gamma interferon (IFN-gamma), CCL3, CXCL10, CCR5, and several IFN-inducible genes in white blood cells and produced more IFN-gamma than did intact males and gdx females, with these differences being most pronounced during peak parasitemia. Intact females also had higher anti-P. chabaudi immunoglobulin G (IgG) and IgG1 responses than either intact males or gdx females. To further examine the effector mechanisms mediating sex differences in response to P. chabaudi infection, responses to infection were compared among male and female wild-type (WT), T-cell-deficient (TCRbetadelta-/-), B-cell-deficient (microMT), combined T- and B-cell-deficient (RAG1), and IFN-gamma knockout (IFN-gamma-/-) mice. Males were 3.5 times more likely to die from malaria infection than females, with these differences being most pronounced among TCRbetadelta-/-, microMT, and RAG1 mice. Male mice also exhibited more severe weight loss, anemia, and hypothermia, and higher peak parasitemia than females during infection, with WT, RAG1, TCRbetadelta-/-, and microMT mice exhibiting the most pronounced sexual dimorphism. The absence of IFN-gamma reduced the sex difference in mortality and was more detrimental to females than males. These data suggest that differential transcription and translation of IFN-gamma, that is influenced by estrogens, may mediate sex differences in response to malaria.
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PMID:Involvement of gonadal steroids and gamma interferon in sex differences in response to blood-stage malaria infection. 1671 46


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