A pilot study to detect high mobility group box 1 and heat shock protein 72 in cerebrospinal fluid of pediatric patients with meningitis.
OBJECTIVE
To determine whether cerebrospinal fluid (CSF) levels of high mobility group box 1 (HMGB1) or heat shock protein 72 (Hsp72) are elevated in patients with meningitis.


METHODS
Prospective study of four cohorts of patients.


METHODS
Intensive care unit and infectious disease clinic of pediatrics at the Xiangya Hospital.


METHODS
A total of 104 children (13 with bacterial meningitis, 38 with aseptic meningitis, 7 with tuberculous meningitis, and 46 without meningitis).


METHODS
None.


RESULTS
At the time of admission, CSF samples were obtained from 104 patients with suspected meningitis and examined for the presence of invading pathogens, changes in CSF white blood cell counts, and protein and/or glucose concentrations. Based on CSF parameters, 13, 38, and 7 patients were diagnosed as having bacterial, aseptic, and tuberculous meningitis, respectively. All CSF samples were assayed for HMGB1 or Hsp72 using semiquantitative Western blot analysis. CSF levels of HMGB1 were elevated in patients with bacterial meningitis or aseptic meningitis but were four times higher in patients with bacterial meningitis vs. aseptic meningitis. There was a significant correlation between CSF HMGB1 levels and CSF white blood cell counts and glucose levels in patients with bacterial meningitis. Similarly, CSF levels of Hsp72 were significantly elevated in patients with bacterial meningitis or tuberculous meningitis and correlated well with CSF white blood cell counts in patients with bacterial meningitis or tuberculous meningitis.


CONCLUSIONS
CSF levels of HMGB1 and Hsp72 were significantly higher in patients with bacterial meningitis than those with aseptic meningitis and correlated well with CSF white blood cell counts in patients with bacterial (but not aseptic) meningitis.
Tang
Daolin
D
Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, PR China.
Kang
Rui
R
Cao
Lizhi
L
Zhang
Guoyuan
G
Yu
Yan
Y
Xiao
Weimin
W
Wang
Haichao
H
Xiao
Xianzhong
X
D000293:Adolescent; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D024243:HMGB1 Protein / Q000134:cerebrospinal fluid*; D050884:HSP72 Heat-Shock Proteins / Q000134:cerebrospinal fluid*; D006801:Humans; D007223:Infant; D008297:Male; D008581:Meningitis / Q000378:metabolism*; D008582:Meningitis, Aseptic / Q000378:metabolism; D016920:Meningitis, Bacterial / Q000378:metabolism; D010865:Pilot Projects; D011446:Prospective Studies; D014390:Tuberculosis, Meningeal / Q000378:metabolism
D015415:Biomarkers; D024243:HMGB1 Protein; D050884:HSP72 Heat-Shock Proteins