title: Cytokine and adhesion molecule expression evolves between the neutrophilic and lymphocytic phases of viral meningitis.
abstract: Viral meningitis is characterized by cerebrospinal fluid (CSF) lymphocyte pleocytosis, although neutrophils may predominate in the early phase. The T helper 1 (Th1)/Th2 cytokine balance and expression of adhesion molecules seem to be involved in the CSF chemotaxis. We aimed to determine expression of cytokines and adhesion molecules in enteroviral meningitis. We investigated the serum and CSF levels of adhesion molecules (E-selectin, L-selectin, vascular cell adhesion molecule-1 [VCAM-1], and intracellular adhesion molecule-1 [ICAM-1]) and cytokines (interleukin-12 [IL-12] and IL-4) in 105 children during an outbreak of enteroviral meningitis. Diagnosis was confirmed with positive polymerase chain reaction (PCR) and/or serology for echovirus or Coxsackie virus, and matched with control subjects for clinical features but with negative PCR and/or serology. Apart from VCAM-1, the CSF levels of all investigated inflammatory molecules were significantly increased. In serum, sL-selectin and ICAM-1 levels were significantly higher than control subjects. Serum and CSF L-selectin, serum VCAM-1, and CSF IL-12 were all observed to be expressed in significantly higher levels in the neutrophil-dominant subgroup (72% had duration of symptoms <24 h) than in the lymphocyte-dominant group (87.5% had duration of symptoms >24 h). Serum and CSF ICAM-1 was found at significantly higher levels in the latter group. Evolving expression of adhesion molecules and cytokines indicates a shift from Th1 to Th2 immune responses as infection progresses.
authors.affiliation: Child Health Department, University of Ioannina Medical School, Ioannina, Greece. amakis@cc.uoi.gr
authors.forename: Alexandros
authors.initials: A
authors.lastname: Makis
authors.forename: David
authors.initials: D
authors.lastname: Shipway
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Hatzimichael
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Galanakis
authors.forename: Dmitry
authors.initials: D
authors.lastname: Pshezhetskiy
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Chaliasos
authors.forename: Justin
authors.initials: J
authors.lastname: Stebbing
authors.forename: Antigone
authors.initials: A
authors.lastname: Siamopoulou
mesh_terms: D000293:Adolescent; D015815:Cell Adhesion Molecules / Q000096:biosynthesis / Q000097:blood / Q000134:cerebrospinal fluid / Q000235:genetics; D002555:Cerebrospinal Fluid / Q000166:cytology / Q000276:immunology / Q000378:metabolism* / Q000821:virology; D002648:Child; D002675:Child, Preschool; D004770:Enterovirus / Q000276:immunology* / Q000472:pathogenicity; D005260:Female; D005786:Gene Expression Regulation / Q000276:immunology; D006801:Humans; D007223:Infant; D018664:Interleukin-12 / Q000096:biosynthesis / Q000097:blood / Q000134:cerebrospinal fluid / Q000235:genetics; D015847:Interleukin-4 / Q000096:biosynthesis / Q000097:blood / Q000134:cerebrospinal fluid / Q000235:genetics; D007964:Leukocytosis; D008214:Lymphocytes / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D008297:Male; D008587:Meningitis, Viral / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology* / Q000503:physiopathology; D009504:Neutrophils / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D058408:Th1-Th2 Balance
chemical_list: D015815:Cell Adhesion Molecules; D018664:Interleukin-12; D015847:Interleukin-4