Prognostic Value of Cytokines and Their Soluble Receptors and HLA-DR Alleles in African Patients with Severe Malaria.

41 african patients suffering from clinically defined severe malaria were studied in Dakar, Senegal which is an area of low and seasonal Plasmodium faciparum transmission. Cytokine levels of TNF-a, TNF-a sRI, TNF-a sRII, IL-2 sR, IL-6, IL-6 sR, and IL-10 were evaluated in order to determine their prognostic value in the course of disease. Also, the influence of the HLA-DR alleles in the susceptibility to severe malaria was explored.At the day of admission (day 0) and 3 days later,blood samples were collected to test cytokines by ELISA and to type the HLA-DR by PCR-SSP.The concentrations of all the cytokines and/or their receptors were significantly increased at day 0 in the patients who died and decreased rapidly in the patients who recovered from the disease.Significant differences were observed (p < 0.001) between patients with severe malaria and a control group for the following HLA-DR alleles : DR3, DR10 and DR13.