Association of cerebral malaria and TNF-alpha levels: a systematic review

• Autor(a) principal: Leão, Luana
• Data de Publicação: 2020
• Outros Autores: Puty, Bruna, Dolabela, Maria Fâni, Povoa, Marinete Marins, Né, Yago Gecy de Sousa, Eiró, Luciana Guimarães, Fagundes, Nathália Carolina Fernandes, Maia, Lucianne Cople, Lima, Rafael Rodrigues
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Digital do Instituto Evandro Chagas (Patuá)
• Texto Completo: https://patua.iec.gov.br/handle/iec/4121
• topic: Malária Cerebral / patologia; Plasmodium falciparum / patogenicidade; Fator de Necrose Tumoral alfa; Revisão Sistemática

Background: Cerebral malaria is the most severe form of infection with Plasmodium falciparum characterized by a highly inflammatory response. This systematic review aimed to investigate the association between TNF-α levels and cerebral malaria. Methods: This review followed the Preferred Reporting of Systematic Review and Meta-analyses (PRISMA) guidelines. The search was performed at PubMed, LILACS, Scopus, Web of Science, The Cochrane Library, OpenGrey and Google Scholar. We have included studies of P. falciparum-infected humans with or without cerebral malaria and TNF-α dosage level. All studies were evaluated using a risk of bias tool and the GRADE approach. Results: Our results have identified 2338 studies, and 8 articles were eligible according to this systematic review inclusion criteria. Among the eight articles, five have evaluated TNF- α plasma dosage, while two have evaluated at the blood and one at the brain (post-Morten). Among them, only five studies showed higher TNF-α levels in the cerebral malaria group compared to the severe malaria group. Methodological problems were identified regarding sample size, randomization and blindness, but no risk of bias was detected. Conclusion: Although the results suggested that that TNF-α level is associated with cerebral malaria, the evidence is inconsistent and imprecise. More observational studies evaluating the average TNF-alpha are needed.