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TNF-α may mediate link between psychotic symptoms and malaria

03 Feb 2019
Only certain species of mosquitoes of the Anopheles genus – and only females of those species – can transmit malaria.

Tumour necrosis factor (TNF)-α plays a role in the pathogenesis of malaria and psychotic symptoms, independently, and may potentially mediate a link between the two, a recent study has shown.

The study included 1,158 adults (mean age 40.3±17.7 years; 50.6 percent female), in whom the mean log of the CD4-to-CD3 ratio was 0.18±0.04. This value was slightly elevated in patients infected with malaria, but were not significantly changed in those with any common mental disorders (CMD) or psychotic symptoms.

In addition, participants with malaria also showed elevated levels of interleukin (IL)-10 and reduced concentrations of TNF-α. Unadjusted bivariate analysis identified high vs low log10TNF-α as the only marker marginally correlated with the risk of malaria (odds ratio [OR], 0.3; 0.06–1.27; p=0.097).

In comparison, levels of IL-6, 8 and 10 were raised in participants with one or more psychotic symptoms, while concentrations of IL-1β were reduced, relative to individuals without. Participants with vs without CMD, on the other hand, showed higher levels of IL-8 and 10.

Fully-adjusted multivariate models showed that log10TNF-α was significantly associated with the risk of psychotic symptoms (adjusted OR, 1.3; 1.09–1.51; p=0.003), but not with that of CMD (adjusted OR, 2.9; 2.36–3.77; p=0.566).

“Our findings support the key role of TNF-α in the pathogenesis of both CMD and psychotic symptoms, and suggest that TNF-α may mediate the association between malaria and CMD. Further community studies should be longitudinal, use [polymerase chain reaction], measure anaemia and extend the range of immune markers used,” said researchers.

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The use of capsule endoscopy (CE) appears to be effective in the diagnosis of iron deficiency anaemia (IDA), yielding a 33.9-percent yield in this study, with 65.8 percent of patients undergoing further workup and 12.7 percent requiring therapeutic intervention.
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