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

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Research

UniBE Contributor:

Grandgirard, Denis; Gäumann, Rahel and Leib, Stephen

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0962-9351

Publisher:

Hindawi Publishing Corp.

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Stephen Leib

Date Deposited:

26 May 2014 09:17

Last Modified:

28 Nov 2020 02:24

Publisher DOI:

10.1155/2013/312476

PubMed ID:

23864766

BORIS DOI:

10.7892/boris.52658

URI:

https://boris.unibe.ch/id/eprint/52658

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