The causative pathogen determines the inflammatory profile in cerebrospinal fluid and outcome in patients with bacterial meningitis

Grandgirard, Denis; Gäumann, Rahel; Coulibaly, Boubacar; Dangy, Jean-Pierre; Sie, Ali; Junghanss, Thomas; Schudel, Hans; Pluschke, Gerd; Leib, Stephen L. (2013). The causative pathogen determines the inflammatory profile in cerebrospinal fluid and outcome in patients with bacterial meningitis. Mediators of inflammation, 2013, p. 312476. Hindawi Publishing Corp. 10.1155/2013/312476

Preview

Text __ifik.unibe.ch_Daten_Forschung_Gruppe Leib_NEUROINFECTION LAB_Forschungsevaluation_The causative pathogen determines the inflammatory profile in cerebrospinal fluid and outcome in patients with bacterial meningitis..pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview

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.

Interest & Impact

Downloads

256 since deposited on 26 May 2014
14 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item