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Michaël Boele van Hensbroek, Ayo Palmer, Emeka Onyiorah, Gisela Schneider, Shabbar Jaffar, Grainne Dolan, Hannah Memming, Joost Frenkel, Godwin Enwere, Steve Bennett, Dominic Kwiatkowski, Brian Greenwood, The Effect of a Monoclonal Antibody to Tumor Necrosis Factor on Survival from Childhood Cerebral Malaria, The Journal of Infectious Diseases, Volume 174, Issue 5, November 1996, Pages 1091–1097, https://doi.org/10.1093/infdis/174.5.1091
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Abstract
Tumor necrosis factor (TNF) is thought to playa key role in the pathogenesis of cerebral malaria. A double-blind, placebo-controlled trial of an anti- TNF monoclonal antibody (B-C7) comprised 610 Gambian children with cerebral malaria, with mortality and residual neurologic sequelae as primary study end points. Sixty (19.9%) of 302 children who received B-C7 died compared with 64 (20.8%) of 308 children who received placebo (adjusted odds ratio [OR], 0.90; 95% confidence interval [CI], 0.57–1.42). Residual neurologic sequelae were detected in 15 (6.8%) of 221 survivors from the B-C7 group and in 5 (2.2%) of 225 survivors of the placebo group (adjusted OR, 3.35; 95% CI, 1.08–10.4). The monoclonal antibody used in this study did not improve survival in cerebral malaria and was associated with a significant increase in neurologic sequelae. A possible explanation of the latter observation is that the antibody acts to retain TNF within the circulation and thereby prolongs its effects on vascular endothelium.