02734nas a2200325   4500000000100000008004100001260001200042653002600054653001600080653001300096653002100109100001300130700001400143700001700157700001200174700001400186700001200200700001400212700001200226700001500238700001300253700001600266700001400282245011900296856008600415300001100501490000700512520187500519022001402394       2026                            d  c03/202610aPlasmodium falciparum10aCoinfection10ahelminth10aImmunomodulation1 aCuamba I1 aSantano R1 aGrau-Pujol B1 aVidal M1 aAguilar R1 aCossa A1 aJairoce C1 aMejia R1 aNhabomba A1 aMuñoz J1 aMoncunill G1 aDobaño C00aHelminth coinfections mitigate clinical, parasitological, and immune outcomes in Mozambican children with malaria.  uhttps://pmc.ncbi.nlm.nih.gov/articles/PMC13037013/pdf/12916_2026_Article_4827.pdf  a1 - 170 v243 a<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>
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