Tumor Necrosis Factor Alpha and Clinical Severity in Non-Immune Plasmodium Vivax

Abstract

SUMMARY Objective: Evaluate the relationship between the TNF-a, the severity of clinical presentation, the thrombocytopenia, the frequency of TNF2 and its influence over cytokine levels. Material e Methods: We evaluated patients with first episode of vivax malaria, ³ 15 years, with disease duration £ 21 days, coming from the city of Belém, Pará, attended at the Instituto Evandro Chagas (IEC) or hospitalized. The parasitemia was quantified every day till the negativation. The adopted treatment was cloroquine and primaquine PO, during seven days. Blood samples were collected at D0 and D7 to realize quantification of hematological and biochemical parameters, TNF-a titles and TNF2 frequency. The programs Biostat 2.0 and Excel for Windows were applied to analyze the differences and correlations between the parameters. Results: Eighty three patients were attended and accompanied clinically at D0, D1, D2, D3 and D7, from february/2002 till march/2003. The TNF-a level correlated positively and significantly with parasitemia (rs = 0.33, p < 0.01) and clinical scores (rs = 0.48, p = 0.0001), but negatively with the platelets (rs = -0.48, p < 0.0001) at D0. Consequently, high titles of TNF-a levels were beneficial to the majority of the cases; the thrombocytopenia is a signal of severity, and others genetic factors were responsible for the high levels of this cytokine and phenotypic manifestations on this sample. DESCRIPTORS Vivax Malaria. Clinical Manifestation. Thrombocytopenia. TNF-a, TNF2.