Cargando…
A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity
BACKGROUND: Interleukin (IL)-4 had been linked to malaria severity, but the findings are controversial, and the evidence is inconsistent and imprecise. In the current investigation, data on IL-4 levels in patients with severe and uncomplicated malaria were compiled. METHODS: The systematic review wa...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277793/ https://www.ncbi.nlm.nih.gov/pubmed/35820892 http://dx.doi.org/10.1186/s12936-022-04237-z |
_version_ | 1784746056761737216 |
---|---|
author | Kotepui, Kwuntida Uthaisar Thirarattanasunthon, Phiman Rattaprasert, Pongruj Kotepui, Manas |
author_facet | Kotepui, Kwuntida Uthaisar Thirarattanasunthon, Phiman Rattaprasert, Pongruj Kotepui, Manas |
author_sort | Kotepui, Kwuntida Uthaisar |
collection | PubMed |
description | BACKGROUND: Interleukin (IL)-4 had been linked to malaria severity, but the findings are controversial, and the evidence is inconsistent and imprecise. In the current investigation, data on IL-4 levels in patients with severe and uncomplicated malaria were compiled. METHODS: The systematic review was registered at PROSPERO (CRD42022323387). Searches for relevant articles on IL-4 levels in patients with severe malaria and studies that examined IL-4 levels in both uncomplicated malaria and healthy controls were performed in PubMed, Embase, and Scopus using the search strategy without limitation to publication years or language. The quality of all included studies was evaluated using The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: standards for reporting observational studies. Qualitative and quantitative data syntheses were performed. The random-effects model, which weights each study according to its between- and within-study variance, was used to pool the mean difference (MD) of individual studies. The degree of heterogeneity was determined using Cochran's Q and I(2) statistics. Additionally, meta-regression and subgroup analyses were perfomed to investigate possible sources of heterogeneity. The outliers were identified using the leave-one-out method and assessed publication bias using funnel plots, Egger’s test, and a contour-enhanced funnel plot. RESULTS: A total of 2300 studies were identified through database searches, and 36 were included for analyses. The meta-analysis results showed lower mean IL-4 levels in severe malaria (434 cases) than in uncomplicated malaria (611 cases) (P = 0.01, pooled MD: −3.36 pg/mL, 95% confidence intervals CI −5.55 to −1.16 pg/mL, I(2): 98.15%, 11 studies). The meta-analysis results showed no difference in mean IL-4 levels between cerebral malaria (96 cases) and noncerebral severe malaria (108 cases) (P = 0.71, pooled MD: 0.86 pg/mL, 95% CI −3.60 to 5.32 pg/mL, I(2) 92.13%, four studies). Finally, no difference was found in mean IL-4 levels between uncomplicated malaria (635 cases) and healthy controls (674 cases) (P = 0.57, pooled MD: 0.79 pg/mL, 95% CI −1.92 to 3.50 pg/mL, I(2): 99.89%, 11 studies). CONCLUSION: The meta-analysis revealed lower IL-4 levels in patients with severe malaria than in those with uncomplicated malaria, though a trend toward comparable IL-4 levels between both groups was more likely because several sources of heterogeneities were observed. Based on the limited number of studies included in the meta-analysis, until additional investigations have been conducted, IL-4 consideration as an alternative prognostic factor for malaria severity is not warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-022-04237-z. |
format | Online Article Text |
id | pubmed-9277793 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-92777932022-07-14 A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity Kotepui, Kwuntida Uthaisar Thirarattanasunthon, Phiman Rattaprasert, Pongruj Kotepui, Manas Malar J Research BACKGROUND: Interleukin (IL)-4 had been linked to malaria severity, but the findings are controversial, and the evidence is inconsistent and imprecise. In the current investigation, data on IL-4 levels in patients with severe and uncomplicated malaria were compiled. METHODS: The systematic review was registered at PROSPERO (CRD42022323387). Searches for relevant articles on IL-4 levels in patients with severe malaria and studies that examined IL-4 levels in both uncomplicated malaria and healthy controls were performed in PubMed, Embase, and Scopus using the search strategy without limitation to publication years or language. The quality of all included studies was evaluated using The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: standards for reporting observational studies. Qualitative and quantitative data syntheses were performed. The random-effects model, which weights each study according to its between- and within-study variance, was used to pool the mean difference (MD) of individual studies. The degree of heterogeneity was determined using Cochran's Q and I(2) statistics. Additionally, meta-regression and subgroup analyses were perfomed to investigate possible sources of heterogeneity. The outliers were identified using the leave-one-out method and assessed publication bias using funnel plots, Egger’s test, and a contour-enhanced funnel plot. RESULTS: A total of 2300 studies were identified through database searches, and 36 were included for analyses. The meta-analysis results showed lower mean IL-4 levels in severe malaria (434 cases) than in uncomplicated malaria (611 cases) (P = 0.01, pooled MD: −3.36 pg/mL, 95% confidence intervals CI −5.55 to −1.16 pg/mL, I(2): 98.15%, 11 studies). The meta-analysis results showed no difference in mean IL-4 levels between cerebral malaria (96 cases) and noncerebral severe malaria (108 cases) (P = 0.71, pooled MD: 0.86 pg/mL, 95% CI −3.60 to 5.32 pg/mL, I(2) 92.13%, four studies). Finally, no difference was found in mean IL-4 levels between uncomplicated malaria (635 cases) and healthy controls (674 cases) (P = 0.57, pooled MD: 0.79 pg/mL, 95% CI −1.92 to 3.50 pg/mL, I(2): 99.89%, 11 studies). CONCLUSION: The meta-analysis revealed lower IL-4 levels in patients with severe malaria than in those with uncomplicated malaria, though a trend toward comparable IL-4 levels between both groups was more likely because several sources of heterogeneities were observed. Based on the limited number of studies included in the meta-analysis, until additional investigations have been conducted, IL-4 consideration as an alternative prognostic factor for malaria severity is not warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-022-04237-z. BioMed Central 2022-07-12 /pmc/articles/PMC9277793/ /pubmed/35820892 http://dx.doi.org/10.1186/s12936-022-04237-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Kotepui, Kwuntida Uthaisar Thirarattanasunthon, Phiman Rattaprasert, Pongruj Kotepui, Manas A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity |
title | A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity |
title_full | A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity |
title_fullStr | A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity |
title_full_unstemmed | A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity |
title_short | A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity |
title_sort | systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277793/ https://www.ncbi.nlm.nih.gov/pubmed/35820892 http://dx.doi.org/10.1186/s12936-022-04237-z |
work_keys_str_mv | AT kotepuikwuntidauthaisar asystematicreviewandmetaanalysisofbloodinterleukin4levelsconcerningmalariainfectionandseverity AT thirarattanasunthonphiman asystematicreviewandmetaanalysisofbloodinterleukin4levelsconcerningmalariainfectionandseverity AT rattaprasertpongruj asystematicreviewandmetaanalysisofbloodinterleukin4levelsconcerningmalariainfectionandseverity AT kotepuimanas asystematicreviewandmetaanalysisofbloodinterleukin4levelsconcerningmalariainfectionandseverity AT kotepuikwuntidauthaisar systematicreviewandmetaanalysisofbloodinterleukin4levelsconcerningmalariainfectionandseverity AT thirarattanasunthonphiman systematicreviewandmetaanalysisofbloodinterleukin4levelsconcerningmalariainfectionandseverity AT rattaprasertpongruj systematicreviewandmetaanalysisofbloodinterleukin4levelsconcerningmalariainfectionandseverity AT kotepuimanas systematicreviewandmetaanalysisofbloodinterleukin4levelsconcerningmalariainfectionandseverity |