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      Haplotype of non-synonymous mutations within IL-23R is associated with susceptibility to severe malaria anemia in a P. falciparum holoendemic transmission area of Kenya

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          Abstract

          Background

          Improved understanding of the molecular mechanisms involved in pediatric severe malarial anemia (SMA) pathogenesis is a crucial step in the design of novel therapeutics. Identification of host genetic susceptibility factors in immune regulatory genes offers an important tool for deciphering malaria pathogenesis. The IL-23/IL-17 immune pathway is important for both immunity and erythropoiesis via its effects through IL-23 receptors (IL-23R). However, the impact of IL-23R variants on SMA has not been fully elucidated.

          Methods

          Since variation within the coding region of IL-23R may influence the pathogenesis of SMA, the association between IL-23R rs1884444 (G/T), rs7530511 (C/T), and SMA (Hb < 6.0 g/dL) was examined in children ( n = 369, aged 6–36 months) with P. falciparum malaria in a holoendemic P. falciparum transmission area.

          Results

          Logistic regression analysis, controlling for confounding factor of anemia, revealed that individual genotypes of IL-23R rs1884444 (G/T) [GT; OR = 1.34, 95% CI = 0.78–2.31, P = 0.304 and TT; OR = 2.02, 95% CI = 0.53–7.74, P = 0.286] and IL-23R rs7530511 (C/T) [CT; OR = 2.6, 95% CI = 0.59–11.86, P = 0.202 and TT; OR = 1.66, 95% CI = 0.84–3.27, P = 0.142] were not associated with susceptibility to SMA. However, carriage of IL-23R rs1884444T/rs7530511T (TT) haplotype, consisting of both mutant alleles, was associated with increased susceptibility to SMA (OR = 1.12, 95% CI = 1.07–4.19, P = 0.030).

          Conclusion

          Results presented here demonstrate that a haplotype of non-synonymous IL-23R variants increase susceptibility to SMA in children of a holoendemic P. falciparum transmission area.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12879-017-2404-y) contains supplementary material, which is available to authorized users.

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          Most cited references56

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          Severe falciparum malaria. World Health Organization, Communicable Diseases Cluster.

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            Novel p19 Protein Engages IL-12p40 to Form a Cytokine, IL-23, with Biological Activities Similar as Well as Distinct from IL-12

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              A critical function for transforming growth factor-beta, interleukin 23 and proinflammatory cytokines in driving and modulating human T(H)-17 responses.

              Interleukin 17 (IL-17)-producing T helper 17 cells (T(H)-17 cells) have been described as a T helper cell subset distinct from T helper type 1 (T(H)1) and T(H)2 cells, with specific functions in antimicrobial defense and autoimmunity. The factors driving human T(H)-17 differentiation remain controversial. Using a systematic approach combining experimental and computational methods, we show here that transforming growth factor-beta, interleukin 23 (IL-23) and proinflammatory cytokines (IL-1beta and IL-6) were all essential for human T(H)-17 differentiation. However, individual T(H)-17 cell-derived cytokines, such as IL-17, IL-21, IL-22 and IL-6, as well as the global T(H)-17 cytokine profile, were differentially modulated by T(H)-17-promoting cytokines. Transforming growth factor-beta was critical, and its absence induced a shift from a T(H)-17 profile to a T(H)1-like profile. Our results shed new light on the regulation of human T(H)-17 differentiation and provide a framework for the global analysis of T helper responses.
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                Author and article information

                Contributors
                ellymunde@gmail.com
                eraballah@hotmail.com
                okeyo.winnie@gmail.com
                michaelongecha@yahoo.com
                dperkins@salud.unm.edu
                collinouma@yahoo.com
                Journal
                BMC Infect Dis
                BMC Infect. Dis
                BMC Infectious Diseases
                BioMed Central (London )
                1471-2334
                20 April 2017
                20 April 2017
                2017
                : 17
                : 291
                Affiliations
                [1 ]GRID grid.442486.8, Department of Biomedical Sciences and Technology, School of Public Health and Community Development, , Maseno University, ; Maseno, Kenya
                [2 ]ISNI 0000 0001 0155 5938, GRID grid.33058.3d, University of New Mexico/KEMRI Laboratories of Parasitic and Viral Diseases, Centre for Global Health Research, , Kenya Medical Research Institute, ; Kisumu, Kenya
                [3 ]ISNI 0000 0000 9025 6237, GRID grid.442475.4, Department of Medical Laboratory Science, School of Public Health, Biomedical Sciences and Technology, , Masinde Muliro University of Science and Technology, ; Kakamega, Kenya
                [4 ]ISNI 0000 0001 2188 8502, GRID grid.266832.b, Department of Internal Medicine, Centre for Global Health, Health Sciences Centre, , University of New Mexico, ; Albuquerque, NM USA
                [5 ]ISNI 0000 0001 0155 5938, GRID grid.33058.3d, Centre for Global Health Research, , Kenya Medical Research Institute, ; Kisumu, Kenya
                [6 ]Ideal Research Centre, Kisumu, Kenya
                Article
                2404
                10.1186/s12879-017-2404-y
                5397818
                28427357
                bf672b8e-e1c3-4459-97d6-2f23f6216494
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 December 2016
                : 13 April 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: 7R01-TW008306-05
                Award ID: TW05884-04
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Infectious disease & Microbiology
                il-23r,exon,genotypes,haplotypes
                Infectious disease & Microbiology
                il-23r, exon, genotypes, haplotypes

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