title: The role of nitric oxide in bacterial meningitis in children.
abstract: To investigate the role of nitric oxide (NO) in bacterial meningitis, concentrations in serum, cerebrospinal fluid (CSF), or both of the precursor (L-arginine) and degradation products of NO (nitrate, nitrite) and tumor necrosis factor (TNF)-alpha were measured in 35 patients and 30 controls. CSF nitrate levels were significantly elevated, mainly due to increased blood-brain barrier permeability, and are therefore not a good parameter for gauging endogenous NO production in the CSF compartment. CSF NO/nitrite levels were significantly elevated in patients. NO/nitrite levels decreased over time (26%/6 h; P < .001). CSF levels of NO/nitrite correlated with those of TNF-alpha (r = .55; P = .001) and glucose (r = -.43; P = .02). CSF levels of L-arginine were lower in patients than in controls (P < .001). Dexamethasone did not exert a significant effect on NO metabolism. In conclusion, enhanced NO production may contribute to anaerobic glycolysis and neurologic damage in bacterial meningitis.
authors.affiliation: Department of Pediatrics, Sophia Children's Hospital/University Hospital, Rotterdam, Netherlands.
authors.forename: R F
authors.initials: RF
authors.lastname: Kornelisse
authors.forename: K
authors.initials: K
authors.lastname: Hoekman
authors.forename: J J
authors.initials: JJ
authors.lastname: Visser
authors.forename: W C
authors.initials: WC
authors.lastname: Hop
authors.forename: J G
authors.initials: JG
authors.lastname: Huijmans
authors.forename: P J
authors.initials: PJ
authors.lastname: van der Straaten
authors.forename: A J
authors.initials: AJ
authors.lastname: van der Heijden
authors.forename: R N
authors.initials: RN
authors.lastname: Sukhai
authors.forename: H J
authors.initials: HJ
authors.lastname: Neijens
authors.forename: R
authors.initials: R
authors.lastname: de Groot
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D001120:Arginine / Q000097:blood / Q000134:cerebrospinal fluid; D001812:Blood-Brain Barrier; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000494:pharmacology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D009566:Nitrates / Q000097:blood / Q000134:cerebrospinal fluid; D009569:Nitric Oxide / Q000096:biosynthesis / Q000097:blood* / Q000134:cerebrospinal fluid*; D009573:Nitrites / Q000097:blood / Q000134:cerebrospinal fluid; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D000893:Anti-Inflammatory Agents; D009566:Nitrates; D009573:Nitrites; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D003907:Dexamethasone; D001120:Arginine