@article{103557,
  keywords = {Plasmodium falciparum, Coinfection, helminth, Immunomodulation},
  author = {Cuamba I and Santano R and Grau-Pujol B and Vidal M and Aguilar R and Cossa A and Jairoce C and Mejia R and Nhabomba A and Muñoz J and Moncunill G and Dobaño C},
  title = {Helminth coinfections mitigate clinical, parasitological, and immune outcomes in Mozambican children with malaria.},
  abstract = {<p><strong>BACKGROUND: </strong></p>

<p>Clearance of Plasmodium falciparum infection requires a T1 immune response with production of pro-inflammatory cytokines, IgG1, and IgG3 responses. In contrast, infections with helminths are dominated by T2/T immune responses characterized by production of anti-inflammatory cytokines, IgE, and IgG4, which could potentially interfere with malaria outcomes and immune responses.</p>

<p><strong>METHODS: </strong></p>

<p>We recruited 441 malaria-symptomatic children aged 2-10&nbsp;years attending two hospitals in the Manhiça District (Mozambique) and assessed infection by rapid antigen diagnostic test, microscopy, and/or quantitative PCR. Using Luminex, we measured concentrations of 30 cytokines and IgA, IgM, IgE, IgG, and IgG1-4 levels against 12 P. falciparum antigens and total IgE.</p>

<p><strong>RESULTS: </strong></p>

<p>Among 74 children diagnosed with malaria, 22% (16) were coinfected with STH, and 78% (58) had only P. falciparum. Soil-transmitted helminths (STH) coinfection associated with lower P. falciparum density (P = 0.005) and fever (P = 0.047). Coinfected children also had lower concentrations of plasma pro-inflammatory (IL-8, TNF, IFNα, IP-10, MCP1, MIG, MIP1β, and GM-CSF) and anti-inflammatory cytokines (IL-5, IL-10) (P &lt; 0.05). Furthermore, antibody responses to a set of P. falciparum antigens, including SSP2 (IgG1, IgG4, IgG), PTRAMP (IgG3), MSP3 (IgG), RH5 (IgG1), and α-gal (IgG1), as well as total IgE, were elevated in STH coinfected children (P &lt; 0.05).</p>

<p><strong>CONCLUSIONS: </strong></p>

<p>STH infections were associated with decreased P. falciparum parasitemia, downregulation of inflammatory cytokines, and enhanced antibody responses, potentially resulting in milder malaria episodes, suggesting enhanced protective immunity.</p>
},
  year = {2026},
  journal = {BMC medicine},
  volume = {24},
  pages = {1 - 17},
  month = {03/2026},
  issn = {1741-7015},
  url = {https://pmc.ncbi.nlm.nih.gov/articles/PMC13037013/pdf/12916_2026_Article_4827.pdf},
  doi = {10.1186/s12916-026-04827-7},
  language = {ENG},
}