title: A proteomic approach for the diagnosis of bacterial meningitis.
abstract: BACKGROUND
  The discrimination of bacterial meningitis (BM) versus viral meningitis (VM) shapes up as a problem, when laboratory data are not equivocal, in particular, when Gram stain is negative.
  
  
  RESULTS
  With the aim to determine reliable marker for bacterial or viral meningitis, we subjected cerebrospinal fluid (CSF) to a quantitative proteomic screening. By using a recently established 2D-DIGE protocol which was adapted to the individual CSF flow, we compared a small set of patients with proven BM and VM. Thereby, we identified six potential biomarkers out of which Prostaglandin-H2 D-isomerase was already described in BM, showing proof of concept. In the subsequent validation phase on a more comprehensive collective of 80 patients, we could validate that in BM high levels of glial fibrillary acidic protein (GFAP) and low levels of soluble amyloid precursor protein alpha/beta (sAPPalpha/beta) are present as possible binding partner of Fibulin-1.
  
  
  CONCLUSIONS
  We conclude that our CSF flow-adapted 2D-DIGE protocol is valid especially in comparing samples with high differences in total protein and suppose that GFAP and sAPPalpha/beta have a high potential as additional diagnostic markers for differentiation of BM from VM. In the clinical setting, this might lead to an improved early diagnosis and to an individual therapy.
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Jesse
authors.forename: Petra
authors.initials: P
authors.lastname: Steinacker
authors.forename: Stefan
authors.initials: S
authors.lastname: Lehnert
authors.forename: Martin
authors.initials: M
authors.lastname: Sdzuj
authors.forename: Lukas
authors.initials: L
authors.lastname: Cepek
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Tumani
authors.forename: Olaf
authors.initials: O
authors.lastname: Jahn
authors.forename: Holger
authors.initials: H
authors.lastname: Schmidt
authors.forename: Markus
authors.initials: M
authors.lastname: Otto
mesh_terms: D016564:Amyloid beta-Protein Precursor / Q000032:analysis; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002135:Calcium-Binding Proteins / Q000032:analysis; D002555:Cerebrospinal Fluid / Q000737:chemistry; D003937:Diagnosis, Differential; D015180:Electrophoresis, Gel, Two-Dimensional; D005904:Glial Fibrillary Acidic Protein / Q000032:analysis; D006801:Humans; D016920:Meningitis, Bacterial / Q000175:diagnosis*; D008587:Meningitis, Viral / Q000175:diagnosis; D011506:Proteins / Q000032:analysis; D040901:Proteomics / Q000379:methods*
chemical_list: D016564:Amyloid beta-Protein Precursor; D015415:Biomarkers; D002135:Calcium-Binding Proteins; D005904:Glial Fibrillary Acidic Protein; D011506:Proteins; C060820:fibulin
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