CSF interleukin-1 beta, tumor necrosis factor-alpha and free radicals production in relation to clinical outcome in acute bacterial meningitis.
OBJECTIVE
To study the relationship of CSF IL-1 beta and TNF-alpha with free radicals in acute bacterial meningitis (ABM) and to evaluate the clinical outcome in relation to the levels of these cytokines and free radicals in CSF.


METHODS
Prospective with controls.


METHODS
Referral unit of a teaching hospital.


METHODS
32 children between 3m-12 yrs of age with proven acute bacterial meningitis comprised the study group. In the control group, 20 children with febrile seizures were included. CSF cytokines- Interleukin Ib and tumour necrosis factor a,free radicals O(2)-, H(2)O(2) and enzymes SOD and CPK were measured in all the children.


RESULTS
CSF IL-Ib and TNF-a concentration were markedly elevated in children with ABM (441.5 +/- 216.1 pg/ml, and 1009 +/- 529.1 pg/ml, respectively) as compared to controls (52.67 +/- 6.92 pg/ml, and 86.42 +/- 16.24 pg/ml) (p <0.0001). Free radicals viz., superoxide anion, hydrogen peroxide production and enzymes creatinine phosphokinase and superoxide dismutase were also significantly elevated in ABM as compared to controls. There was direct correlation of CSF cytokines with CSF cytology, protein and free radicals production in ABM. Patients who expired or had neurological sequelae had markedly elevated concentrations of cytokines and free radicals.


CONCLUSIONS
IL-I beta, TNF-alpha and free radicals are significantly elevated in CSF of patients with ABM. The concentration of these cytokines correlated well with free radical production, and with routinely measured CSF parameters and had a direct bearing on outcome of ABM
Jain
M
M
Departments of Pediatrics, Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi 110 001, India.
Aneja
S
S
Mehta
G
G
Ray
G N
GN
Batra
S
S
Randhava
V S
VS
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005609:Free Radicals / Q000134:cerebrospinal fluid*; D006801:Humans; D007223:Infant; D007375:Interleukin-1 / Q000134:cerebrospinal fluid*; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid*; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000134:cerebrospinal fluid*
D005609:Free Radicals; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha