Vogetseder Alexander, Ospelt Caroline, Reindl Markus, Schober Maria, Schmutzhard Erich
University Hospital Innsbruck, Department of Neurology and Central Laboratories, Innsbruck, Austria.
Trop Med Int Health. 2004 Jul;9(7):767-73. doi: 10.1111/j.1365-3156.2004.01265.x.
We studied 38 patients with malaria tropica over a period of 5 days during antiparasitic therapy. Serum or plasma levels of interleukin (IL) 1beta, IL-6, IL-10, tumour necrosis factor-alpha (TNF-alpha), the soluble vascular adhesion molecule (sVCAM) and the soluble intracellular adhesion molecule (sICAM) were determined by enzyme-linked immunosorbent assay. Protein C and antithrombin III activity were analysed by chromogenic tests and protein S activity by a clotting test. Antithrombin III, protein C and protein S activity was significantly lower in patients with severe malaria and displayed a highly significant increase in activity over the time of evaluation. Levels of sVCAM and sICAM were increased for the whole study period, but no significant differences were found between severe and mild malaria cases. Serum IL-1beta, IL-6 and IL-10 levels were significantly higher in patients with severe malaria, whereas no significant differences were found for TNF-alpha. IL-6 and IL-10 decreased significantly over 5 days during schizontocidal therapy. Our data show an impairment of the coagulation system which correlates with pro-inflammatory cytokines and therefore with the severity of the disease.
我们在抗寄生虫治疗的5天期间对38例热带疟疾患者进行了研究。通过酶联免疫吸附测定法测定白细胞介素（IL）-1β、IL-6、IL-10、肿瘤坏死因子-α（TNF-α）、可溶性血管黏附分子（sVCAM）和可溶性细胞间黏附分子（sICAM）的血清或血浆水平。通过发色试验分析蛋白C和抗凝血酶III活性，通过凝血试验分析蛋白S活性。严重疟疾患者的抗凝血酶III、蛋白C和蛋白S活性显著降低，且在评估期间活性呈现高度显著增加。在整个研究期间，sVCAM和sICAM水平升高，但严重和轻度疟疾病例之间未发现显著差异。严重疟疾患者的血清IL-1β、IL-6和IL-10水平显著更高，而TNF-α未发现显著差异。在裂殖体杀灭疗法的5天期间，IL-6和IL-10显著下降。我们的数据显示凝血系统受损，这与促炎细胞因子相关，因此与疾病的严重程度相关。
