Christoph WenischSornchai LooareesuwanPolrat WilairatanaBernhard ParschalkSuparp VannapannVara WanaratanaWalther WernsdorferWolfgang GraningerAllgemeines KrankenHaus WienMahidol UniversityUniversitat Wien2018-07-042018-07-041998-01-01American Journal of Tropical Medicine and Hygiene. Vol.58, No.3 (1998), 343-347000296372-s2.0-0031923048https://repository.li.mahidol.ac.th/handle/20.500.14594/18414The 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.Mahidol UniversityImmunology and MicrobiologyMedicineArticleSCOPUS10.4269/ajtmh.1998.58.343