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Background   Plasmodium falciparum  and  Plasmodium vivax  infections compromise dendritic cell (DC) function and expand regulatory T (Treg) cells in both clinical disease (malaria) and experimental human sub-microscopic infection. Conversely, in asymptomatic microscopy-positive (patent)  P. falciparum  or  P. vivax  infection in endemic areas, blood DC increase or retain HLA-DR expression and Treg cells exhibit reduced activation, suggesting that DC and Treg cells contribute to the control of patent asymptomatic infection. The effect of sub-microscopic (sub-patent) asymptomatic  Plasmodium  infection on DC and Treg cells in malaria-endemic area residents remains unclear.    Methods  In a cross-sectional household survey conducted in Papua, Indonesia, 162 asymptomatic adults were prospectively evaluated for DC and Treg cells using field-based flow cytometry. Of these, 161 individuals (99 %) were assessed retrospectively by polymerase chain reaction (PCR), 19 of whom had sub-microscopic infection with  P. falciparum  and 15 with sub-microscopic  P. vivax  infection. Flow cytometric data were re-analysed after re-grouping asymptomatic individuals according to PCR results into negative controls, sub-microscopic and microscopic parasitaemia to examine DC and Treg cell phenotype in sub-microscopic infection.    Results  Asymptomatic adults with sub-microscopic  P. falciparum  or  P. vivax  infection had DC HLA-DR expression and Treg cell activation comparable to PCR-negative controls. Sub-microscopic  P. falciparum  infection was associated with lower peripheral CD4 +  T cells and lymphocytes, however sub-microscopic  Plasmodium  infection had no apparent effect on DC sub-set number or Treg cell frequency.    Conclusions  In contrast to the impairment of DC maturation/function and the activation of Treg cells seen with sub-microscopic parasitaemia in primary experimental human  Plasmodium  infection, no phenotypic evidence of dysregulation of DC and Treg cells was observed in asymptomatic sub-microscopic  Plasmodium  infection in Indonesian adults. This is consistent with DC and Treg cells retaining their functional capacity in sub-microscopic asymptomatic infection with  P. falciparum  or  P. vivax  in malaria-endemic areas.    Electronic supplementary material  The online version of this article (doi:10.1186/s12936-016-1382-7) contains supplementary material, which is available to authorized users.

malaria journal

Characterization of blood dendritic and regulatory T cells in asymptomatic adults with sub-microscopic Plasmodium falciparum or Plasmodium vivax infection