Esamai Fabian, Ernerudh Jan, Janols Helena, Welin Susanne, Ekerfelt Christina, Mining Simeon, Forsberg Pia
Department of Child Health and Pediatrics, Faculty of Health Sciences, Moi University, Eldoret, Kenya.
J Trop Pediatr. 2003 Aug;49(4):216-23. doi: 10.1093/tropej/49.4.216.
This was a prospective study conducted at the Moi Teaching and Referral Hospital, Eldoret, Kenya. Twenty-three children admitted to the hospital with cerebral (CM) and 10 children with non-cerebral malaria (NCM) were studied. The aim of the study was to establish and compare levels of tumour necrosis factor (TNF-alpha) and transforming growth factor (TGF-beta1) in these children. Serum and cerebrospinal fluid (CSF) cytokine levels were assayed using ELISA kits. In serum, TGF-beta1 and TNF-alpha decreased over 5 days after admission to the hospital in both groups of patients with CM and NCM. In the CSF of cerebral cases the levels of TNF-alpha and TGF-beta1 were low and inversely related. Children in deeper coma had lower levels in serum of TGF-beta and higher levels of TNF-alpha than those in lighter levels of coma. The serum TNF-alpha levels in CM children were the same irrespective of the duration of illness before admission, but children with NCM who had been sick for a shorter duration before admission tended to have higher serum levels of TNF-alpha and higher levels of TGF-beta than those with a longer duration of illness before admission. In conclusion, this study shows that TNF-alpha and TGF-beta1 may not be useful in predicting the outcome for CM. They may, however, be useful in detecting children at risk of developing deep coma. TNF-alpha and TGF-beta levels were inversely related both in serum and CSF.
这是一项在肯尼亚埃尔多雷特的莫伊教学与转诊医院进行的前瞻性研究。对23名因脑型疟疾（CM）入院的儿童和10名非脑型疟疾（NCM）儿童进行了研究。该研究的目的是测定并比较这些儿童体内肿瘤坏死因子（TNF-α）和转化生长因子（TGF-β1）的水平。使用酶联免疫吸附测定（ELISA）试剂盒检测血清和脑脊液（CSF）中的细胞因子水平。在血清中，CM组和NCM组患者入院后5天内，TGF-β1和TNF-α水平均下降。在脑型病例的脑脊液中，TNF-α和TGF-β1水平较低且呈负相关。深度昏迷的儿童血清中TGF-β水平低于浅昏迷儿童，而TNF-α水平则高于浅昏迷儿童。CM儿童血清TNF-α水平与入院前患病时长无关，但入院前患病时间较短的NCM儿童血清TNF-α水平和TGF-β水平往往高于入院前患病时间较长的儿童。总之，本研究表明，TNF-α和TGF-β1可能无助于预测CM的预后。然而，它们可能有助于检测有发展为深度昏迷风险的儿童。TNF-α和TGF-β水平在血清和脑脊液中均呈负相关。
