Serum concentrations of granulocyte-colony stimulating factor in complicated Plasmodium falciparum malaria

Involvement of neutrophils in the control of blood parasites in malaria has been reported. Both, mononuclear phagocytes and neutrophils are known to b e stimulated by cytokines such as TNF-alpha in order to augment the defence potency against the parasites. Previously, it has been shown that serum-G- CSF concentrations are increased in patients with bacterial sepsis. In vitr o studies have shown that P. falciparum - infected erythrocytes induce the release of G-CSF by several cells such as endothelial cells and monocytes, however, nothing is known about G-CSF serum concentrations during the clini cal course of severe P. falciparum malaria. Thus, it was the aim of the pre sent study to investigate the time course for G-CSF serum concentrations in patients with complicated P. falciparum malaria, and to correlate these va lues with other mediators of inflammation and hematopoesis. Twenty-six patients suffering from complicated P. falciparum malaria were i ncluded in the study, and 20, age and sex matched, healthy volunteers were used as the negative control group. Serum samples for determination of G-CS F were taken on day 0, 7 and 14, and measured by ELISA. We found significantly increased serum concentrations of G-CSF in patients with complicated P. falciparum malaria on day 0, values decreasing to withi n the normal range by day 7. A significant correlation was found between G- CSF (d0) and procalcitonin, the parasite count, erythropoietin and macropha ge inflammatory protein, however no correlation could be shown for the neut rophil count. In conclusion, on the day of hospital admission, elevated serum concentrati ons of G-CSF were detected in patients with complicated P. falciparum malar ia, which might indicate a role of G-CSF in the acute defence mechanism aga inst the parasites.