The causative pathogen determines the inflammatory profile in cerebrospinal fluid and outcome in patients with bacterial meningitis.
- Grandgirard D Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbuehlstraße 51, 3010 Bern, Switzerland.
- Gäumann R
- Coulibaly B
- Dangy JP
- Sie A
- Junghanss T
- Schudel H
- Pluschke G
- Leib SL
- 2013-07-19
Published in:
- Mediators of inflammation. - 2013
Adolescent
Adult
Cerebrospinal Fluid
Chemokines
Child
Child, Preschool
Cytokines
Female
Humans
Infant
Inflammation
Leukocytes
Male
Meningitis, Bacterial
Meningitis, Haemophilus
Meningitis, Meningococcal
Meningitis, Pneumococcal
Middle Aged
Treatment Outcome
Young Adult
English
BACKGROUND
The brain's inflammatory response to the infecting pathogen determines the outcome of bacterial meningitis (BM), for example, the associated mortality and the extent of brain injury. The inflammatory cascade is initiated by the presence of bacteria in the cerebrospinal fluid (CSF) activating resident immune cells and leading to the influx of blood derived leukocytes. To elucidate the pathomechanisms behind the observed difference in outcome between different pathogens, we compared the inflammatory profile in the CSF of patients with BM caused by Streptococcus pneumonia (n = 14), Neisseria meningitidis (n = 22), and Haemophilus influenza (n = 9).
METHODS
CSF inflammatory parameters, including cytokines and chemokines, MMP-9, and nitric oxide synthase activity, were assessed in a cohort of patients with BM from Burkina Faso.
RESULTS
Pneumococcal meningitis was associated with significantly higher CSF concentrations of IFN-γ , MCP-1, and the matrix-metalloproteinase (MMP-) 9. In patients with a fatal outcome, levels of TNF-α, IL-1 β, IL-1RA, IL-6, and TGF-α were significantly higher.
CONCLUSION
The signature of pro- and anti-inflammatory mediators and the intensity of inflammatory processes in CSF are determined by the bacterial pathogen causing bacterial meningitis with pneumococcal meningitis being associated with a higher case fatality rate than meningitis caused by N. meningitidis or H. influenzae.
The brain's inflammatory response to the infecting pathogen determines the outcome of bacterial meningitis (BM), for example, the associated mortality and the extent of brain injury. The inflammatory cascade is initiated by the presence of bacteria in the cerebrospinal fluid (CSF) activating resident immune cells and leading to the influx of blood derived leukocytes. To elucidate the pathomechanisms behind the observed difference in outcome between different pathogens, we compared the inflammatory profile in the CSF of patients with BM caused by Streptococcus pneumonia (n = 14), Neisseria meningitidis (n = 22), and Haemophilus influenza (n = 9).
METHODS
CSF inflammatory parameters, including cytokines and chemokines, MMP-9, and nitric oxide synthase activity, were assessed in a cohort of patients with BM from Burkina Faso.
RESULTS
Pneumococcal meningitis was associated with significantly higher CSF concentrations of IFN-γ , MCP-1, and the matrix-metalloproteinase (MMP-) 9. In patients with a fatal outcome, levels of TNF-α, IL-1 β, IL-1RA, IL-6, and TGF-α were significantly higher.
CONCLUSION
The signature of pro- and anti-inflammatory mediators and the intensity of inflammatory processes in CSF are determined by the bacterial pathogen causing bacterial meningitis with pneumococcal meningitis being associated with a higher case fatality rate than meningitis caused by N. meningitidis or H. influenzae.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1155/2013/312476
- PMID 23864766
- Persistent URL
- https://sonar.ch/global/documents/354
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