IL-10 plays a crucial role for the protection of experimental cerebral malaria by co-infection with non-lethal malaria parasites.

Cerebral malaria is an infrequent but serious complication of Plasmodium falciparum infection in humans. Co-infection with different Plasmodium species is common in endemic areas and the existence of benign malaria parasites, such as Plasmodium vivax, during P. falciparum infection has been considered to reduce the risk of developing pathogenesis. However, it is still unknown how disease severity is reduced in the host during co-infection. In the present study, we investigated the influence of co-infection with non-lethal malaria parasites, Plasmodium berghei (Pb) XAT strain, on the outcome of Pb ANKA strain infection which causes experimental cerebral malaria (ECM) in mice. The co-infection with non-lethal Pb XAT suppressed ECM caused by Pb ANKA infection and prolonged survival of mice. The production of TNF-alpha and IFN-gamma, which had been shown to be involved in development of ECM, was suppressed in co-infected mice early in infection. The suppression of ECM by co-infection with Pb XAT was abrogated in IL-10-deficient mice. IL-10 plays a crucial role in the suppression of ECM by co-infection with non-lethal malaria parasites, probably due to its suppressive effect on the induction of TNF-alpha and IFN-gamma. Co-infection with Pb XAT and Pb ANKA is a useful model for understanding how ECM is suppressed.