In this review the old concept of severe malaria as a toxic disease is
re-examined in the light of recent discoveries in the field of cytoki
nes. Animal studies suggest that the induction of TNF by parasite-deri
ved molecules may be partly responsible for cerebral malaria and anaem
ia, while hypoglycaemia may be due to direct effects of similar molecu
les on glucose metabolism. These molecules appear to be phospholipids
and we suggest that when fully characterized they might form the basis
of antitoxic therapy for malaria.