title: Expression of neurotrophic factors in cerebrospinal fluid and plasma of children with viral and bacterial meningoencephalitis.
abstract: OBJECTIVE
  To evaluate the expression of neurotrophic factors (nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF)) and their association with the clinical-radiological characteristics and outcome of children with viral and bacterial meningoencephalitis (ME).
  
  
  METHODS
  Prospective observational clinical study performed on 13 children with ME and 12 controls with non-inflammatory obstructive hydrocephalus. Neurotrophic factor levels in the cerebro-spinal fluid (CSF) and plasma were measured using an immunoenzymatic assay.
  
  
  RESULTS
  High levels of NGF and BDNF were demonstrated in all patients, while GDNF levels did not undergo significant variations. NGF expression in the CSF was higher in viral ME than in bacterial ME and was correlated with CSF cellularity (particularly mononuclear cells). BDNF expression in the CSF was higher in bacterial ME than in viral ME and was correlated with CSF cellularity and blood platelet count. No relationships were noted between CSF protein or serum C-reactive protein levels and the expression of neurotrophic factors. Regarding clinical and radiological features, elevated NGF/BDNF levels in the CSF correlated with higher incidence of seizures and prolonged comatose state and with specific radiological lesions. No correlation was found between NGF/BDNF levels and final outcome.
  
  
  CONCLUSIONS
  The variations in neurotrophic factor levels may reflect an endogenous attempt at neuroprotection against biochemical and molecular changes during both viral and bacterial ME. The expression of these factors is likely to play a neuro-immunomodulatory or neurosurvival role in ME infections.
authors.affiliation: Paediatric Intensive Care Unit, Catholic University Medical School, Rome, Italy. achiaretti@yahoo.it
authors.forename: A
authors.initials: A
authors.lastname: Chiaretti
authors.forename: A
authors.initials: A
authors.lastname: Antonelli
authors.forename: M
authors.initials: M
authors.lastname: Piastra
authors.forename: O
authors.initials: O
authors.lastname: Genovese
authors.forename: G
authors.initials: G
authors.lastname: Polidori
authors.forename: L
authors.initials: L
authors.lastname: Aloe
mesh_terms: D016022:Case-Control Studies; D020806:Central Nervous System Bacterial Infections / Q000000981:diagnostic imaging / Q000378:metabolism*; D020805:Central Nervous System Viral Diseases / Q000000981:diagnostic imaging / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D007223:Infant; D008297:Male; D008590:Meningoencephalitis / Q000378:metabolism* / Q000382:microbiology / Q000821:virology; D009414:Nerve Growth Factors / Q000097:blood* / Q000134:cerebrospinal fluid*; D011446:Prospective Studies; D011859:Radiography
chemical_list: D009414:Nerve Growth Factors