Tumor Necrosis Factor in Falciparum Malaria

Abstract

To investigate the relationship of TNFα levels to Plasmodium falciparum (PF) infection, plasma TNFα concentrations were measured in Pakistani adults and children with mild, severe, cerebral and chronic falciparum malaria and healthy (control) subjects. The initial geometric mean plasma concentrations of TNFα in adult patients with severe malaria (187.6 pg/mL) were significantly higher than mild malaria patients (87.1 pg/mL, P < 0.001). TNFα levels were not correlated to parasite density, cerebral malaria, young age, hypoglycemia or fatal outcome; however, they were associated with severe anemia, and hepatic and kidney dysfunction. TNFα levels were not significantly increased in 16 patients with hyperparasitemia and were significantly elevated (P < 0.02) in chronic malaria patients as compared to control subjects. TNFα levels were elevated independently in patients with anemia, hypoglycemia (P < 0.001, P < 0.05), and hepatic and kidney (P < 0.001 each) dysfunction. In this study, high TNFα levels were associated with several manifestations of severe malaria and were not specific to cerebral malaria and hyperparasitemia.

Malaria: Hematological Aspects

“…3,16 Other studies have also discussed the role of TNF-α in falciparum malaria. 18 In a recent report, the investigators' observations indicated that hemolysis is the prime cause of the anemia seen in acute falciparum malaria, but destruction of parasitized erythrocytes is not the only cause of the hemolytic process, and bone marrow suppression appears to have an insignificant role. 19 It should be borne in mind also that red cell morphology in malaria patients may be influenced by their nutritional status i.e., patients could be iron deficient, folic acid or vitamin B 12 deficient or they may have a concurrent thalassemia, which aggravates the severity of the anemia, as was the case in some of the patients in this study.…”

Association between inflammatory cytokine levels and anemia during Plasmodium falciparum and Plasmodium vivax infections in Mangaluru: A Southwestern Coastal Region of India

“…[36] Research studies also suggest that increased IL-6 levels have a strong association with increase in transferrin receptor density, and decreased transferrin synthesis which play a significant role in anemic severity. [3536] Our observation of a negative correlation between decreased Hb levels and increased IL-6 suggests that higher IL-6 production which may contribute to the pathogenesis of SMA. [25]…”

“…IL-6 also could play a role in inflammatory response and pathophysiology of SMA. [35] It is well known that IL-6 production is upregulated by TNF-α and acts together with other inflammatory mediators to reduce the parasitic burden. In this study, in comparison to HC, we observed increased IL-6 levels among infected patients and a reciprocal relationship was also observed between increasing parasitemia and IL-6 levels.…”