title: Correlation between proinflammatory cytokines and antiinflammatory mediators and the severity of disease in meningococcal infections.
abstract: Pro- and antiinflammatory cytokines and mediators were measured in 39 patients with acute life-threatening meningococcal infections classified into 3 groups: A, meningitis without shock (n = 20); B, meningitis with shock (n = 9); and C, shock without meningitis (n = 10). The plasma concentrations of proinflammatory endotoxin, tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, and IL-8 and antiinflammatory cytokines and mediators IL-1 receptor antagonist, IL-10, and soluble TNF receptors p55 and p75 were strongly associated with this classification; the highest concentrations were in group C. IL-4 was not measurable. IL-1 beta was increased only in rapidly fatal cases. In addition, cerebrospinal fluid (CSF) was analyzed in 21 patients for TNF-alpha and its soluble receptors. In CSF, these compounds were mainly increased in group A, reflecting an intrathecal compartmentalized cytokine production. It is concluded that both pro- and antiinflammatory mediators are simultaneously increased and are strongly associated with a classification based on simple clinical parameters.
authors.affiliation: Department of Internal Medicine, University Hospital Nijmegen, Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: van Deuren
authors.forename: J
authors.initials: J
authors.lastname: van der Ven-Jongekrijg
authors.forename: A K
authors.initials: AK
authors.lastname: Bartelink
authors.forename: R
authors.initials: R
authors.lastname: van Dalen
authors.forename: R W
authors.initials: RW
authors.lastname: Sauerwein
authors.forename: J W
authors.initials: JW
authors.lastname: van der Meer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D004731:Endotoxins / Q000097:blood / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007378:Interleukins / Q000097:blood / Q000134:cerebrospinal fluid; D008297:Male; D016920:Meningitis, Bacterial / Q000276:immunology / Q000401:mortality; D008589:Meningococcal Infections / Q000276:immunology* / Q000401:mortality; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000032:analysis; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000276:immunology / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D016207:Cytokines; D004731:Endotoxins; D007378:Interleukins; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha