Soluble receptors for tumor necrosis factor as markers of disease activity in visceral leishmaniasis.

Serum concentrations of soluble receptors for tumor necrosis factor (sTNFRs) were measured before and after antimony therapy in 25 Sudanese patients with active visceral leishmaniasis (VL). Both sTNFR types I and II were significantly elevated in patients with VL compared with healthy controls from the same region and from the Netherlands (P < .01). In all 23 patients who initially responded to therapy, both sTNFR types decreased sharply, reaching and remaining at levels similar to those found in normal controls; 2 relapsed after an initial response to therapy, and their sTNFR concentrations had increased at the time of relapse. The 2 patients who did not respond to therapy had persistently elevated sTNFR levels. Tumor necrosis factor was detectable in only 16% of patients with VL. Hence, the serum concentrations of sTNFRs may be useful for monitoring therapeutic efficacy in patients with VL.