Supportive Pentoxifylline in Falciparum Malaria: No Effect on Tumor Necrosis Factor Alpha Levels or Clinical Outcome: A Prospective, Randomized, Placebo-Controlled Study
| Autor: | Rudolf Egbring, Marcus Hassemer, Peter Kern, Wilhelm Gaus, Peter P. Nawroth, Christoph Josef Hemmer, Gabi Hort, Rainer Seitz, Manfred Dietrich, Josef Högel, Collins Batsirai Chiwakata |
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| Rok vydání: | 1997 |
| Předmět: |
Male
endocrine system diseases Phosphodiesterase Inhibitors medicine.medical_treatment Placebo-controlled study Parasitemia Severity of Illness Index Gastroenterology Pentoxifylline Single-Blind Method Malaria Falciparum biology Analgesics Non-Narcotic Middle Aged female genital diseases and pregnancy complications Mefloquine Treatment Outcome Infectious Diseases Drug Therapy Combination Female medicine.symptom medicine.drug Adult medicine.medical_specialty Nausea Placebo Neopterin Antimalarials Virology Internal medicine parasitic diseases medicine Humans Acetaminophen Aged Chemotherapy L-Lactate Dehydrogenase Tumor Necrosis Factor-alpha business.industry Plasmodium falciparum Phenanthrenes medicine.disease biology.organism_classification Biopterin Immunology Parasitology business Malaria |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene. 56:397-403 |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.1997.56.397 |
| Popis: | Pentoxifylline (POF) may suppress overproduction of tumor necrosis factor alpha (TNF alpha), which is thought to contribute to complications of human falciparum malaria. However, POF is believed to improve impaired capillary blood flow, which can be impaired in falciparum malaria. To test whether POF affects TNF alpha serum levels or other variables in this disease, we administered POF (20 mg/kg/day intravenously in 150 ml of saline for five days) randomized versus placebo (150 ml of saline without POF) in addition to standard antimalarial therapy. After recruitment of 51 patients with Plasmodium falciparum malaria, those receiving POF had more nausea and abdominal discomfort than the placebo group, as expected. Eleven of 27 patients receiving POF and three of 24 patients receiving placebo requested termination of the study medication (P < 0.05). Pentoxifylline did not change the decrease of TNF alpha levels or affect the clinical course in a significant way. Since POF failed to improve the clinical situation or to impact numerous laboratory parameters (including TNF alpha, thrombin-antithrombin III, thrombomodulin, and human neutrophil elastase), the study was terminated earlier than planned. While this study does not specifically address cerebral complications of malaria, the results suggest that POF is not useful as a routine adjunct to the standard therapy of falciparum malaria. |
| Databáze: | OpenAIRE |
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