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Parasite-encoded cytokine macrophage migration inhibitory factor (MIF)
Protozoan parasites contribute to significant morbidity and mortality worldwide. Multiple protozoan parasites produce homologs of the proinflamamtory cytokine macrophage migration inhibitory factor (MIF) that play a role in their pathogenesis, invasion and immune evasion.

Entamoeba histolytica MIF: Higher Entamoeba histolytica MIF (EhMIF) levels was associated with increased gut inflammation in persons with amebiasis. EhMIF stimulated intestinal epithelial cells to cause chemokine release, immune cell infiltration and inflammation of the colon, termed amebic colitis. EhMIF also promotes matrix metalloproteinases (MMPs) production, which are necessary for parasite invasion. In addition, EhMIF enhances TNF-alpha and IL-6 production from macrophages. Both cytokines cause collateral tissue injury in amebic colitis and liver abscess. Infected children develop antibodies against EhMIF which protects them from future infection.

Plasmodium and Leishmania MIF: Plasmodium falciparum MIF (PfMIF) was associated with increased inflammatory cytokine levels in patients with malaria. Serum PfMIF levels were higher in patients with complicated malaria compared to those with uncomplicated malaria. Both Plasmodium and Leishmania encoded MIF, through their proinflammatory properties, prevented the development of immunological memory by triggering the development of short-lived effector cells instead of memory cells. The lack of memory cells allows the parasite to reinfect their host.

Toxoplasma MIF: The inflammation induced by Toxoplasma MIF is thought to facilitate T. gondii invasion and dissemination.

Trichomonas MIF: Infected persons develop antibodies against Trichomonas MIF.Trichomonas MIF driven inflammation and cell proliferation, was linked to the promotion and progression of prostate cancer.