title: Adhesion molecule levels in serum and cerebrospinal fluid in children with bacterial meningitis and sepsis.
abstract: BACKGROUND
  Adhesion molecules play a role in leukocyte recruitment during central nervous system (CNS) inflammation.
  
  
  OBJECTIVE
  This study was designed to compare serum, cerebrospinal fluid (CSF) concentrations of adhesion molecules in children with meningitis and sepsis, and to evaluate their sources.
  
  
  METHODS
  This study was carried out at Pediatric Department, King Abdulaziz University Hospital from January 2007 to June 2008.
  
  
  METHODS
  Serum and CSF samples were collected on admission from meningitis (n = 40), sepsis (n = 20) patients, and sera from controls (n = 20).
  
  
  METHODS
  Endothelial (E), leukocyte (L), platelet (P) selectins intercellular cell adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecules-1 (VCAM-1) were measured using ELISA.
  
  
  METHODS
  ANOVA and Spearman's correlations were used. Adhesion molecules with albumin concentration were estimated in CSF/serum to calculate concentration quotients.
  
  
  RESULTS
  In meningitis, serum sE-, sL-, sP-selectins sICAM-1, sVCAM-1 levels were higher than controls. Compared to sepsis, serum sE-selectin, sL-selectin, sVCAM-1, CSF-sL-selectin, CSF-sVCAM-1, VCAM-1 ratio and index were higher, while serum sP-selectin was lower than meningitis. sE-selectin ratio, CSF sICAM-1 were higher in meningitis with positive than negative culture. The sE-selectin index was higher in meningitis with neurological complication than those without it. In meningitis, correlation was found between CSF protein and CSF white blood cell counts (WBCs), CSF sICAM-1, CSF sVCAM-1 and between CSF sE-selectin and CSF sICAM-1.
  
  
  CONCLUSIONS
  This study supports the role of adhesion molecules especially sL-selectin, sVCAM-1 in meningitis and suggests further research to determine their use as biomarkers for meningitis and use of their antagonists as therapeutic for CNS inflammation. The presence of discrepancy of CSF/serum ratios for molecules of same molecular weight suggest intrathecal shedding in addition to diffusion through the blood-CSF barrier.
authors: Department of Pediatrics, Faculty of Medicine, King Abdelaziz University, Jeddah, Saudi Arabia.
authors: Soad M
authors: SM
authors: Jaber
authors: Enas A
authors: EA
authors: Hamed
authors: Sherifa A
authors: SA
authors: Hamed