Oxidative stress and S-100B protein in children with bacterial meningitis.
BACKGROUND
Bacterial meningitis is often associated with cerebral compromise which may be responsible for neurological sequelae in nearly half of the survivors. Little is known about the mechanisms of CNS involvement in bacterial meningitis. Several studies have provided substantial evidence for the key role of nitric oxide (NO) and reactive oxygen species in the complex pathophysiology of bacterial meningitis.


METHODS
In the present study, serum and CSF levels of NO, lipid peroxide (LPO) (mediators for oxidative stress and lipid peroxidation); total thiol, superoxide dismutase (SOD) (antioxidant mediators) and S-100B protein (mediator of astrocytes activation and injury), were investigated in children with bacterial meningitis (n = 40). Albumin ratio (CSF/serum) is a marker of blood-CSF barriers integrity, while mediator index (mediator ratio/albumin ratio) is indicative of intrathecal synthesis.


RESULTS
Compared to normal children (n = 20), patients had lower serum albumin but higher NO, LPO, total thiol, SOD and S-100B. The ratios and indices of NO and LPO indicate blood-CSF barriers dysfunction, while the ratio of S-100B indicates intrathecal synthesis. Changes were marked among patients with positive culture and those with neurological complications. Positive correlation was found between NO index with CSF WBCs (r = 0.319, p < 0.05); CSF-LPO with CSF-protein (r = 0.423, p < 0.01); total thiol with LPO indices (r = 0.725, p < 0.0001); S-100B and Pediatric Glasow Coma Scores (0.608, p < 0.0001); CSF-LPO with CSF-S-100B (r = 0.482, p < 0.002); serum-total thiol with serum S-100B (r = 0.423, p < 0.01).


CONCLUSIONS
This study suggests that loss of integrity of brain-CSF barriers, oxidative stress and S-100B may contribute to the severity and neurological complications of bacterial meningitis.
Hamed
Sherifa A
SA
Department of Neurology, Faculty of Medicine, Assiut University, Assiut, Egypt. hamed_sherifa@yahoo.com
Hamed
Enas A
EA
Zakary
Madeha M
MM
D000293:Adolescent; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood* / Q000134:cerebrospinal fluid*; D009414:Nerve Growth Factors / Q000097:blood* / Q000134:cerebrospinal fluid; D009460:Neurologic Examination; D009569:Nitric Oxide / Q000097:blood / Q000134:cerebrospinal fluid; D018384:Oxidative Stress; D018579:Patient Selection; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood* / Q000134:cerebrospinal fluid; D012709:Serum Albumin / Q000378:metabolism; D013129:Spinal Puncture; D018709:Statistics, Nonparametric; D013482:Superoxide Dismutase / Q000097:blood / Q000134:cerebrospinal fluid
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D012709:Serum Albumin; D009569:Nitric Oxide; D013482:Superoxide Dismutase