title: Blood-brain barrier damage in patients with bacterial meningitis: association with tumor necrosis factor-alpha but not interleukin-1 beta.
abstract: Brain damage after meningeal infection could result from impairment of cerebral endothelial cell functions and disruption of blood-brain barriers. Tumor necrosis factor-alpha (TNF alpha) and interleukin-1 beta (IL-1 beta) produce many of their effects by acting on endothelial cells. This study correlates levels of TNF alpha and IL-1 beta in paired cerebrospinal fluid (CSF) and serum samples with the degree of blood-brain barrier damage, as manifested by CSF to serum albumin quotient, in 48 patients with bacterial meningitis and 66 controls. CSF levels of TNF alpha and IL-1 beta in bacterial meningitis were significantly higher than in controls. Intrathecal levels of TNF alpha, but not IL-1 beta, correlated with albumin quotient (P less than .001), with degree of blood-brain barrier disruption (P less than .001), and with disease severity and indices of meningeal inflammation. Sequential CSF samples demonstrated that IL-1 beta and TNF alpha disappear from the CSF within 24 h of antibiotic treatment. Data presented here suggest that TNF alpha is related to blood-brain barrier damage in bacterial meningitis and that its effect could be dissociated from that of IL-1 beta.
authors.affiliation: Department of Clinical Neurochemistry, Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
authors.forename: M K
authors.initials: MK
authors.lastname: Sharief
authors.forename: M
authors.initials: M
authors.lastname: Ciardi
authors.forename: E J
authors.initials: EJ
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000418:Albumins / Q000134:cerebrospinal fluid; D001812:Blood-Brain Barrier; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007375:Interleukin-1 / Q000134:cerebrospinal fluid / Q000502:physiology*; D008297:Male; D016920:Meningitis, Bacterial / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014409:Tumor Necrosis Factor-alpha / Q000134:cerebrospinal fluid / Q000502:physiology*
chemical_list: D000418:Albumins; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha