TUMOR-NECROSIS-FACTOR-ALPHA INTERFERON-GAMMA AND MACROPHAGE STIMULATING FACTOR IN RELATION TO THE SEVERITY OF PLASMODIUM-FALCIPARUM MALARIAIN THE BRAZILIAN AMAZON

We compared the tumor necrosis factor (TNF-alpha), interferon gamma (I FN-gamma) and granulocyte macrophage colony stimulating factor (SM-CSF ) serum levels in 87 patients with malaria from the Brazilian Amazon, They included asymptomatic infected individuals and symptomatic patien ts with mild disease or severe malaria with or without cerebral involv ement, As controls we examined individuals living in endemic areas wit hout past history of malaria, The TNF-alpha serum levels were increase d in patients with malaria and progressively decreased in those with s evere disease 7 days after specific treatment, We found correlation be tween parasitaemia, TNF-alpha levels and severity of the disease, The correlation between high TNF-alpha levels and severe malaria was indep endent of cerebral involvement. The increase in both IFN-gamma and GM- CSF levels among malarious patients was not related to the degree of s everity or mortality. IFN-gamma concentration, however, was associated with high parasitaemia at admission.