title: Gelatinase B [matrix metalloproteinase (MMP)-9] and collagenases (MMP-8/-13) are upregulated in cerebrospinal fluid during aseptic and bacterial meningitis in children.
abstract: We investigated the protein expression of gelatinases [matrix metalloproteinase (MMP)-2 and -9] and collagenases (MMP-8 and -13) in cerebrospinal fluid (CSF) from patients with bacterial (BM, n = 17) and aseptic (AM, n = 14) meningitis. In both, MMP-8 and -9 were increased in 100% of patients, whereas MMP-13 was detectable in 53% and 82% respectively. Three patients with clinical signs of meningitis, without CSF pleocytosis, scored positive for all three MMPs. MMP-8 appeared in two isoforms, granulocyte-type [polymorphonuclear cell (PMN)] and fibroblast/macrophage (F/M) MMP-8. Analysis of kinetic changes from serial lumbar punctures showed that these MMPs are independently regulated, and correlate only partly with CSF cytosis or levels of the endogenous inhibitor, tissue inhibitor of matrix metalloproteinase-1. In vitro, T cells, peripheral blood mononuclear cells (PBMCs) and granulocytes (PMN) release MMP-8 and -9, whereas MMP-13 could be found only in the former two cell types. Using models of exogenous (n-formyl-Met-Leu-Phe, T cell receptor cross-linking) and host-derived stimuli (interleukin-2), the kinetics and the release of the MMP-8, -9 and -13 showed strong variation between these immune cells and suggest release from preformed stocks. In addition, MMP-9 is also synthesized de novo in PBMCs and T cells. In conclusion, invading immune cells contribute only partially to MMPs in CSF during meningitis, and parenchymal cells are an equally relevant source. In this context, in patients with clinical signs of meningitis, but without CSF pleocytosis, MMPs seem to be a highly sensitive marker for intrathecal inflammation. The present data support the concept that broad-spectrum enzyme inhibition targeting gelatinases and collagenases is a potential strategy for adjunctive therapy in infectious meningitis.
authors.affiliation: Clinical Neuroimmunology Laboratory, Department of Research and Neurology, University Hospital of Basel, Basel, Switzerland. Raija.lindberg@unibas.ch
authors.forename: R L P
authors.initials: RL
authors.lastname: Lindberg
authors.forename: T
authors.initials: T
authors.lastname: Sorsa
authors.forename: T
authors.initials: T
authors.lastname: Tervahartiala
authors.forename: F
authors.initials: F
authors.lastname: Hoffmann
authors.forename: L
authors.initials: L
authors.lastname: Mellanen
authors.forename: L
authors.initials: L
authors.lastname: Kappos
authors.forename: U B
authors.initials: UB
authors.lastname: Schaad
authors.forename: S L
authors.initials: SL
authors.lastname: Leib
authors.forename: D
authors.initials: D
authors.lastname: Leppert
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000134:cerebrospinal fluid; D015153:Blotting, Western; D002648:Child; D002675:Child, Preschool; D017364:Collagenases / Q000134:cerebrospinal fluid* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D006098:Granulocytes / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000378:metabolism; D053509:Matrix Metalloproteinase 13; D020784:Matrix Metalloproteinase 8 / Q000134:cerebrospinal fluid* / Q000276:immunology; D020780:Matrix Metalloproteinase 9 / Q000134:cerebrospinal fluid* / Q000276:immunology; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000276:immunology; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D017364:Collagenases; C507079:MMP13 protein, human; D053509:Matrix Metalloproteinase 13; D020784:Matrix Metalloproteinase 8; D020780:Matrix Metalloproteinase 9