Publication: Effect of pentoxifylline on cytokine patterns in the therapy of complicated Plasmodium falciparum malaria
Issued Date
1998-01-01
Resource Type
ISSN
00029637
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2-s2.0-0031923048
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.58, No.3 (1998), 343-347
Suggested Citation
Christoph Wenisch, Sornchai Looareesuwan, Polrat Wilairatana, Bernhard Parschalk, Suparp Vannapann, Vara Wanaratana, Walther Wernsdorfer, Wolfgang Graninger Effect of pentoxifylline on cytokine patterns in the therapy of complicated Plasmodium falciparum malaria. American Journal of Tropical Medicine and Hygiene. Vol.58, No.3 (1998), 343-347. doi:10.4269/ajtmh.1998.58.343 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/18414
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Title
Effect of pentoxifylline on cytokine patterns in the therapy of complicated Plasmodium falciparum malaria
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Abstract
The effect of pentoxifylline (PTX) was tested for its capacity to modulate cytokine responses during therapy of severe Plasmodium falciparum malaria in a placebo-controlled, randomized study in 45 adult patients in Bangkok, Thailand. The patients received standard antimalarial treatment with artesunate (120 mg intravenously given immediately, then 60 mg every 12 hr for a total dose of 600 mg). The patients received either low-dose PTX (20 mg/kg/day, n = 15), high-dose PTX (40 mg/kg/day, n = 15), or placebo (n = 15) as continuous infusion for the first three days of antimalarial treatment. Tumor necrosis factor (TNF) and interleukin-6 (IL-6) plasma levels were markedly elevated in all patients prior to treatment. After 6 hr of high- dose PTX treatment, TNF and IL-6 levels significantly decreased while an increase in TNF and IL-6 levels was seen after 6 hr of low-dose PTX or placebo treatment (P < 0.01). After 12 and 24 hr of high-dose PTX infusion, TNF-receptor plasma concentrations were lower than in low-dose PTX- or placebo-treated patients (P < 0.01), whereas no differences between the groups with regard to IL6 receptor levels were observed. We conclude that 40 mg/kg/day of PTX reduces plasma levels of TNF IL-6, and TNF-receptor in patients with severe malaria. Whether this reduction improves clinical outcome remains to be determined.