TY - JOUR
T1 - Relationship between antipyretic effects and cytokine levels in uncomplicated falciparum malaria during different treatment regimes
AU - Hugosson, Elisabeth
AU - Montgomery, Scott M.
AU - Premji, Zul
AU - Troye-Blomberg, Marita
AU - Björkman, Anders
N1 - Funding Information:
We would like to thank the children, their families and the staff at Kibaha Hospital for their participation in this study. We thank Donath Tarimo, Fredrick Kalokola, late Jeremiah Masunga and Anette Sundstedt for clinical and laboratory assistance in the hospital. The work was supported by Swedish International Development Co-operation Agency (SAREC), The Swedish Medical Research Council and Bergvall's Foundation.
PY - 2006/8
Y1 - 2006/8
N2 - We have previously shown that both chloroquine and paracetamol (acetaminophen) have antipyretic activity during treatment of acute uncomplicated Plasmodium falciparum malaria in children 1-4 years old. Here, we studied if this effect was accompanied by changes in plasma cytokine levels. The 104 children were treated with either chloroquine or sulfadoxine/pyrimethamine (SP) alone, SP + chloroquine or SP + paracetamol for 4 days. Cytokine levels were determined days 0, 2 and 3, body temperature every sixth hour until 72 h and parasitemia once daily for 4 days. At admission, body temperature correlated with levels of IL-10, IFN-γ and IL-6, and parasitemia correlated with IL-10 and IL-6. Except for TNF-α and IL-1β, where no significant effect was found, all cytokine levels (IL-10, IFN-γ, IL-6, IL-12, IL-13, IL-18 and IL-4) decreased up to day 2 (p < 0.05). IL-6 levels continued to fall from days 2 to 3 (p < 0.05), whereas increased levels were found for several cytokines (IL-12, IL-13, IL-18 and IL-1β) (p < 0.05). The antipyretic effects of chloroquine and paracetamol could not be related to any specific changes in the evaluated cytokine production or in Th1/Th2 or inflammatory/anti-inflammatory cytokine ratios. Alternative mechanisms for antipyretic effects and associations between fever and cytokine levels during uncomplicated P. falciparum malaria are therefore discussed.
AB - We have previously shown that both chloroquine and paracetamol (acetaminophen) have antipyretic activity during treatment of acute uncomplicated Plasmodium falciparum malaria in children 1-4 years old. Here, we studied if this effect was accompanied by changes in plasma cytokine levels. The 104 children were treated with either chloroquine or sulfadoxine/pyrimethamine (SP) alone, SP + chloroquine or SP + paracetamol for 4 days. Cytokine levels were determined days 0, 2 and 3, body temperature every sixth hour until 72 h and parasitemia once daily for 4 days. At admission, body temperature correlated with levels of IL-10, IFN-γ and IL-6, and parasitemia correlated with IL-10 and IL-6. Except for TNF-α and IL-1β, where no significant effect was found, all cytokine levels (IL-10, IFN-γ, IL-6, IL-12, IL-13, IL-18 and IL-4) decreased up to day 2 (p < 0.05). IL-6 levels continued to fall from days 2 to 3 (p < 0.05), whereas increased levels were found for several cytokines (IL-12, IL-13, IL-18 and IL-1β) (p < 0.05). The antipyretic effects of chloroquine and paracetamol could not be related to any specific changes in the evaluated cytokine production or in Th1/Th2 or inflammatory/anti-inflammatory cytokine ratios. Alternative mechanisms for antipyretic effects and associations between fever and cytokine levels during uncomplicated P. falciparum malaria are therefore discussed.
KW - Antipyretics
KW - Chloroquine
KW - Cytokines
KW - Paracetamol
KW - Plasmodium falciparum malaria
KW - Sulfadoxine-pyrimethamine
UR - http://www.scopus.com/inward/record.url?scp=33748903630&partnerID=8YFLogxK
U2 - 10.1016/j.actatropica.2006.07.005
DO - 10.1016/j.actatropica.2006.07.005
M3 - Article
C2 - 16962547
AN - SCOPUS:33748903630
SN - 0001-706X
VL - 99
SP - 75
EP - 82
JO - Acta Tropica
JF - Acta Tropica
IS - 1
ER -
