Changes in cerebrospinal fluid cytokine expression in tuberculous meningitis patients with treatment.
BACKGROUND
The prevalence of tuberculous meningitis (TBM) is very high in developing areas of the world. Inflammation and cytokine patterns produced by T lymphocytes play an important role in susceptibility to infections. The inflammatory response and production of cytokines in the cerebrospinal fluid (CSF) of patients with TBM are well documented. Conversely, little is known about the role of pro- and anti-inflammatory cytokines in the CSF of TBM patients. The goal of the present study was to estimate the level of proinflammatory cytokine and anti-inflammatory cytokine levels in CSF samples from TBM patients.


METHODS
To study this, in vivo levels of IL-2 and IFN-gamma (proinflammatory cytokines), and IL-10 (anti-inflammatory cytokine) in the CSF of 60 adult TBM patients and 50 age- and sex-matched non-TBM controls were measured. These cytokines were estimated in the CSF of TBM patients before and after starting treatment.


RESULTS
High levels of proinflammatory cytokines as compared to anti-inflammatory cytokines were found in TBM patients before treatment. However, CSF samples from TBM patients after treatment showed elevated levels of anti-inflammatory and low levels of proinflammatory cytokines.


CONCLUSIONS
We hypothesize that an increase in anti-inflammatory cytokines during treatment may indicate a favorable response.
Kashyap
Rajpal S
RS
Biochemistry Research Laboratory, Central India Institute of Medical Sciences, Nagpur, India.
Deshpande
Poonam S
PS
Ramteke
Sonali R
SR
Panchbhai
Milind S
MS
Purohit
Hemant J
HJ
Taori
Girdhar M
GM
Daginawala
Hatim F
HF
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016207:Cytokines / Q000096:biosynthesis* / Q000134:cerebrospinal fluid* / Q000235:genetics; D005260:Female; D006801:Humans; D007249:Inflammation / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000276:immunology*; D015854:Up-Regulation / Q000187:drug effects / Q000276:immunology; D055815:Young Adult
D000995:Antitubercular Agents; D016207:Cytokines