Expression of tolerance via a self-protective feedback control of serum level of TNF-α, IFN-γ, IL-12, IL-4, CRP, and NO in Nigerian children with severe complicated falciparum malaria


  • Caroline A Okoli
  • A Igunnu
  • S O Malomo
  • J Adebayo
  • S Oguche


Tolerance, immunity, cytokines, self-protective, nitric-oxide, children


Tolerance is a host’s defensive strategy. Host expression of tolerance as a means of preventing symptomatic or severe malaria has been elucidated. However, host expression of tolerance in severe complicated malaria has not been investigated. Serum levels of tumour necrosis factor-α (TNF-α), interferon-γ, interleukin (IL) (IL-12),IL-10, IL-4, C-reactive protein (CRP), nitric oxide (NO), leucocytes indices, total protein (TP), albumin, aminotransferases, alkaline phosphatase, total bilirubin, conjugated bilirubin (CB), creatinine and urea were determined using standard  methods in 100 children (1-10years) with severe malaria; before treatment, 48hours of treatment and 48hours after treatment with WHO recommended dosage of artesunate/artemether-lumefantrine combination therapy. Our results show that the serum levels of IL-12, IL-4 TNF-α, interferon-γ, CRP, NO, creatinine, albumin, TP and CB showed a unique trend of response with parasite density. Before treatment; there was a significant difference (p<0.05) in the levels of these parameters with significant rise (p<0.05) in parasite density mainly from 201 to 500x103parasites (mild to moderate severe malaria), followed by a maximum or minimum level of the respective parameter, and then  non-significant difference (p>0.05) in the subsequent levels of the respective parameters with further continuous significant rise (p<0.05) in parasite density mainly from 501 to 800x103parasites/µl (marked severe malaria) suggesting a self-protective feed-back control; this pattern of regulation and the parameters’ significant correlation (p<0.05) with parasitaemia and disease severity depict host expression of tolerance for the pathogen.

 In conclusion, serum IL-12, IL-4, TNF-α, interferon-γ, CRP and NO are immune-protective markers for tolerance in children with severe complicated malaria


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How to Cite

Okoli, C. A., Igunnu, A., Malomo, S. O., Adebayo, J., & Oguche, S. (2019). Expression of tolerance via a self-protective feedback control of serum level of TNF-α, IFN-γ, IL-12, IL-4, CRP, and NO in Nigerian children with severe complicated falciparum malaria. African Journal of Biomedical Research, 22(2), 165 - 177. Retrieved from



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