CD4+ CD25+ Foxp3+ regulatory T cells, dendritic cells, and circulating cytokines in uncomplicated malaria: do different parasite species elicit similar host responses?

Infect Immun. 2010 Nov;78(11):4763-72. doi: 10.1128/IAI.00578-10. Epub 2010 Aug 16.


Clearing blood-stage malaria parasites without inducing major host pathology requires a finely tuned balance between pro- and anti-inflammatory responses. The interplay between regulatory T (Treg) cells and dendritic cells (DCs) is one of the key determinants of this balance. Although experimental models have revealed various patterns of Treg cell expansion, DC maturation, and cytokine production according to the infecting malaria parasite species, no studies have compared all of these parameters in human infections with Plasmodium falciparum and P. vivax in the same setting of endemicity. Here we show that during uncomplicated acute malaria, both species induced a significant expansion of CD4(+) CD25(+) Foxp3(+) Treg cells expressing the key immunomodulatory molecule CTLA-4 and a significant increase in the proportion of DCs that were plasmacytoid (CD123(+)), with a decrease in the myeloid/plasmacytoid DC ratio. These changes were proportional to parasite loads but correlated neither with the intensity of clinical symptoms nor with circulating cytokine levels. One-third of P. vivax-infected patients, but no P. falciparum-infected subjects, showed impaired maturation of circulating DCs, with low surface expression of CD86. Although vivax malaria patients overall had a less inflammatory cytokine response, with a higher interleukin-10 (IL-10)/tumor necrosis factor alpha (TNF-α) ratio, this finding did not translate to milder clinical manifestations than those of falciparum malaria patients. We discuss the potential implications of these findings for species-specific pathogenesis and long-lasting protective immunity to malaria.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • CD4 Antigens / metabolism
  • Cytokines / blood*
  • Dendritic Cells / immunology*
  • Female
  • Forkhead Transcription Factors / metabolism
  • Host-Parasite Interactions / immunology*
  • Humans
  • Interleukin-2 Receptor alpha Subunit / metabolism
  • Lymphocyte Activation
  • Malaria, Falciparum / immunology
  • Malaria, Falciparum / parasitology
  • Malaria, Vivax / immunology
  • Malaria, Vivax / parasitology
  • Male
  • Middle Aged
  • Plasmodium falciparum / immunology*
  • Plasmodium falciparum / physiology
  • Plasmodium vivax / immunology*
  • Plasmodium vivax / physiology
  • Species Specificity
  • T-Lymphocytes, Regulatory / immunology*
  • Young Adult


  • CD4 Antigens
  • Cytokines
  • FOXP3 protein, human
  • Forkhead Transcription Factors
  • IL2RA protein, human
  • Interleukin-2 Receptor alpha Subunit