MODULATORY POTENTIAL OF IRON CHELATION-THERAPY ON NITRIC-OXIDE FORMATION IN CEREBRAL MALARIA

To determine whether iron chelation modulates nitric oxide (NO) format ion and sell-mediated immune effector function in children with cerebr al malaria, serum concentrations Here measured of the stable end produ cts of NO, nitrite and nitrate (NO2-/NO3-). interleukin (IL)-4, -6, an d -10, and neopterin in 39 Zambian children enrolled in a placebo-cont rolled trial of desferrioxamine B and quinine therapy. Mean concentrat ions of NO2-/NO3- increased significantly over 3 days in children rece iving desferrioxamine plus quinine but not in those given placebo and quinine, Necopterin levels declined significantly with placebo but not with desferrioxamine. IL-4 levels increased progressively in the plac ebo group and ultimately decreased in the desferrioxamine group, but t he trends were not statistically significant, IL-6 and IL-10 levels we re elevated initially and decreased significantly in both groups over 3 days. These data are consistent with the hypothesis that iron chelat ion therapy in children with cerebral malaria strengthens Th1-mediated immune effector function involving increased production of NO.