Serum neopterin, interleukin-4, and interleukin-6 concentrations in cerebral malaria patients and the effect of iron chelation therapy

Am J Trop Med Hyg. 1996 Feb;54(2):164-8. doi: 10.4269/ajtmh.1996.54.164.

Abstract

To determine if iron chelation therapy alters immune responses in children with cerebral malaria, we retrospectively measured mean serum levels of neopterin, interleukin-4 (IL-4), and IL-6 in children who received desferrioxamine B or placebo for three days in addition to quinine-based therapy. Mean levels of neopterin, IL-4, and IL-6 were elevated above the expected normal range on admission. Neopterin correlated significantly with the degree of anemia, IL-4 with the duration of fever prior to admission, and IL-6 with parasite density. Serial measurements of cytokines and neopterin were performed over four days in 39 children, 21 randomized to receive desferrioxamine B and 18 to receive placebo. Mean concentrations of neopterin did not change significantly in either group while levels of IL-4 increased significantly in the placebo group (P = 0.04) but remained unchanged in the desferrioxamine B group. Interleukin-6 concentrations decreased markedly in both groups (P < 0.025). Stable IL-4 levels in children given desferrioxamine B may represent an inhibition of the T helper lymphocyte-2 (TH-2) response resulting from a strengthened TH-1 response associated with iron chelation therapy. Any effect of iron chelation on immunity in the setting of severe malaria will have to be confirmed in future prospective investigations.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Biopterins / analogs & derivatives*
  • Biopterins / blood
  • Child, Preschool
  • Deferoxamine / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Infant
  • Interleukin-4 / blood*
  • Interleukin-6 / blood*
  • Malaria, Cerebral / drug therapy
  • Malaria, Cerebral / immunology*
  • Male
  • Neopterin
  • Prospective Studies
  • Siderophores / therapeutic use*

Substances

  • Interleukin-6
  • Siderophores
  • Interleukin-4
  • Biopterins
  • Neopterin
  • Deferoxamine