title: Cerebrospinal fluid cytokine levels and cognitive impairment in cerebral malaria.
abstract: Cerebrospinal fluid (CSF) and serum levels of 12 cytokines or chemokines important in central nervous system (CNS) infections were measured in 76 Ugandan children with cerebral malaria (CM) and 8 control children. As compared with control children, children with cerebral malaria had higher cerebrospinal fluid levels of interleukin (IL)-6, CXCL-8/IL-8, granulocyte-colony stimulating factor (G-CSF), tumor necrosis factor-alpha (TNF-alpha), and IL-1 receptor antagonist. There was no correlation between cerebrospinal and serum cytokine levels for any cytokine except G-CSF. Elevated cerebrospinal fluid but not serum TNF-alpha levels on admission were associated with an increased risk of neurologic deficits 3 months later (odds ratio 1.55, 95% CI: 1.10, 2.18, P = 0.01) and correlated negatively with age-adjusted scores for attention (Spearman rho, -0.34, P = 0.04) and working memory (Spearman rho, -0.32, P = 0.06) 6 months later. In children with cerebral malaria, central nervous system TNF-alpha production is associated with subsequent neurologic and cognitive morbidity.
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA. ccj@umn.edu
authors.forename: Chandy C
authors.initials: CC
authors.lastname: John
authors.forename: Angela
authors.initials: A
authors.lastname: Panoskaltsis-Mortari
authors.forename: Robert O
authors.initials: RO
authors.lastname: Opoka
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Park
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Orchard
authors.forename: Anne M
authors.initials: AM
authors.lastname: Jurek
authors.forename: Richard
authors.initials: R
authors.lastname: Idro
authors.forename: Justus
authors.initials: J
authors.lastname: Byarugaba
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Boivin
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D016207:Cytokines / Q000097:blood / Q000134:cerebrospinal fluid*; D006801:Humans; D016779:Malaria, Cerebral / Q000134:cerebrospinal fluid / Q000150:complications* / Q000276:immunology*; D009422:Nervous System Diseases / Q000209:etiology*; D011379:Prognosis; D013997:Time Factors; D014454:Uganda / Q000453:epidemiology
chemical_list: D016207:Cytokines