The role of nitric oxide in bacterial meningitis in children.
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.
Kornelisse
R F
RF
Department of Pediatrics, Sophia Children's Hospital/University Hospital, Rotterdam, Netherlands.
Hoekman
K
K
Visser
J J
JJ
Hop
W C
WC
Huijmans
J G
JG
van der Straaten
P J
PJ
van der Heijden
A J
AJ
Sukhai
R N
RN
Neijens
H J
HJ
de Groot
R
R
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
D000893:Anti-Inflammatory Agents; D009566:Nitrates; D009573:Nitrites; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D003907:Dexamethasone; D001120:Arginine