CYTOKINE LEVELS DURING MILD AND CEREBRAL FALCIPARUM-MALARIA IN CHILDREN LIVING IN A MESOENDEMIC AREA

Cell-mediated immunity and cytokines are probably involved in the path ogenesis of malaria. To investigate the role and the activity of diffe rent immune cells, we measured levels of tumour necrosis factor-(TNF-a lpha), gamma interferon (IFN-gamma) and several interleukins (IL-2, IL -4, IL-6 and IL-10) in children with mild (MM) and cerebral (CM) Plasm odium falciparum malaria and compared them with those of healthy child ren from Guadalupe - Lobata District, St. Tome Island, where malaria i s mesoendemic. Both groups of patients had significantly higher levels of IL-6, IL-10 and TNF-alpha than controls. For IL-1, IL-4 and IFN-ga mma we found no difference between the groups. However, 24 h after adm ission the levels of IL-10 and IL-6 were significantly higher in CM th an in MM patients, although 7 days after treatment they returned to no rmal levels, similar to those found in control children. Therefore, TN F-alpha IL-6 and IL-10 increase during Plasmodium falciparum attacks i n all children, not only in those with cerebral malaria. This finding suggests the activation of the monocyte/macrophage system during the e arly stage of clinical malaria.