title: Ibuprofen does not affect levels of tumor necrosis factor alpha and soluble tumor necrosis factor receptor types I and II in Gabonese children with uncomplicated Plasmodium falciparum malaria.
abstract: We assessed the ability of ibuprofen to modulate tumor necrosis factor alpha (TNF-alpha), soluble tumor necrosis factor receptor type I (sTNFR-I), and soluble tumor necrosis factor receptor type II (sTNFR-II) responses during the treatment of fever in uncomplicated Plasmodium falciparum malaria, in a placebo-controlled, randomized, double-blind study of 50 pediatric patients in Lambaréné, Gabon. Treatment of the malaria involved the patients receiving intravenous quinine (12 mg/kg of quinine dihydrochloride every 12 h for 72 h) followed by a single dose of oral sulfadoxine/pyrimethamine (25 mg and 1.25 mg/kg). Fever was treated by mechanical treatment plus either ibuprofen (7 mg/kg every 8 h) or placebo during the hospitalization period. We determined serum concentrations of TNF-alpha, sTNFR-I, and sTNFR-II in peripheral blood throughout the treatment period in the two groups: ibuprofen and placebo groups. TNF-alpha levels were found to be positively correlated with body temperature. In contrast, TNF receptors levels did not differ between the two groups and the antipyretic effect of ibuprofen was not correlated with specific changes in sTNFR-I and sTNFR-II production. Our data suggest that TNF-alpha is involved in malarial fever, but soluble TNF receptors play no major role in fever modulation.
authors.affiliation: Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon.
authors.forename: Pierre-Blaise
authors.initials: PB
authors.lastname: Matsiegui
authors.forename: Michel A
authors.initials: MA
authors.lastname: Missinou
authors.forename: Saadou
authors.initials: S
authors.lastname: Issifou
authors.forename: Magdalena
authors.initials: M
authors.lastname: Necek
authors.forename: Elie
authors.initials: E
authors.lastname: Mavoungou
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage*; D002648:Child; D004311:Double-Blind Method; D000068800:Etanercept; D005681:Gabon; D006801:Humans; D007052:Ibuprofen / Q000494:pharmacology*; D007074:Immunoglobulin G / Q000096:biosynthesis*; D016778:Malaria, Falciparum / Q000097:blood* / Q000469:parasitology; D010919:Placebos; D010963:Plasmodium falciparum / Q000378:metabolism*; D011739:Pyrimethamine / Q000008:administration & dosage*; D011803:Quinine / Q000008:administration & dosage*; D018124:Receptors, Tumor Necrosis Factor / Q000096:biosynthesis*; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000096:biosynthesis*; D013413:Sulfadoxine / Q000008:administration & dosage*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis* / Q000378:metabolism
chemical_list: D000962:Antimalarials; D007074:Immunoglobulin G; D010919:Placebos; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha; D013413:Sulfadoxine; D011803:Quinine; D000068800:Etanercept; D007052:Ibuprofen; D011739:Pyrimethamine