Figure 2.

Immune modulation during asymptomatic vs. symptomatic malaria infections. The outcome of a malaria infection is influenced by the balance between anti-inflammatory and pro-inflammatory cytokines. Clinical malaria is the result of elevated (+) production of pro-inflammatory cytokines (e.g., IFN-γ, TNF-α) and increased levels of immune cells (e.g., Vδ2⁺ γδ, NK cells, and T regs) and the downregulation (–) of anti-inflammatory cytokines (e.g., IL-10). However, with repeated malaria exposure, the immune balance shifts toward an increased production of anti-inflammatory cytokines, leading to asymptomatic infection. The cytokines are encoded by immune genes, thus differential expression of these genes depicts that there is a balance between anti-inflammatory and pro-inflammatory cytokines.