Elevated cerebrospinal fluid tumour necrosis factor is associated with acute and long-term neurocognitive impairment in cerebral malaria

E. Shabani, B. J. Ouma, R. Idro, P. Bangirana, R. O. Opoka, G. S. Park, A. L. Conroy, Chandy John

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Systemic tumour necrosis factor-α (TNF-α) may contribute to the pathogenesis of cerebral malaria (CM) by promoting endothelial activation and parasite sequestration. However, less is known about the role of central nervous system (CNS) TNF-α in CM. We assessed plasma (n=249) and cerebrospinal fluid (CSF) (n=167) TNF-α levels in Ugandan children with CM, plasma TNF-α in Ugandan community control children (n=198) and CSF TNF-α in North American control children who had recovered from leukaemia (n=13). Plasma and CSF TNF-α were measured by magnetic bead assay. We compared plasma and CSF TNF-α levels in children with CM to mortality, acute and chronic neurologic deficits and long-term neurocognitive impairment. Plasma and CSF TNF-α levels were higher in CM than control children (P<.0001 for both). CSF TNF-α levels were higher in children who had neurologic deficits at discharge or 6-month follow-up (P≤.05 for both). Elevated CSF but not plasma TNF-α was associated with longer coma duration (Spearman's rho.18, P=.02) and deficits in overall cognition in children 5 years and older (β coefficient −.74, 95% CI −1.35 to −0.13, P=.02). The study findings suggest that CNS TNF-α may be involved in the development of acute and chronic neurologic and cognitive sequelae in children with CM.

Original languageEnglish (US)
Article numbere12438
JournalParasite Immunology
Volume39
Issue number7
DOIs
StatePublished - Jul 1 2017

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Cerebral Malaria
Cerebrospinal Fluid
Tumor Necrosis Factor-alpha
Neurologic Manifestations
Central Nervous System
Coma
Cognition
Nervous System
Leukemia
Parasites

Keywords

  • neurocognitive impairment
  • paediatric cerebral malaria
  • tumour necrosis factor-alpha

ASJC Scopus subject areas

  • Parasitology
  • Immunology

Cite this

Elevated cerebrospinal fluid tumour necrosis factor is associated with acute and long-term neurocognitive impairment in cerebral malaria. / Shabani, E.; Ouma, B. J.; Idro, R.; Bangirana, P.; Opoka, R. O.; Park, G. S.; Conroy, A. L.; John, Chandy.

In: Parasite Immunology, Vol. 39, No. 7, e12438, 01.07.2017.

Research output: Contribution to journalArticle

Shabani, E. ; Ouma, B. J. ; Idro, R. ; Bangirana, P. ; Opoka, R. O. ; Park, G. S. ; Conroy, A. L. ; John, Chandy. / Elevated cerebrospinal fluid tumour necrosis factor is associated with acute and long-term neurocognitive impairment in cerebral malaria. In: Parasite Immunology. 2017 ; Vol. 39, No. 7.
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