title: The diagnostic value of cytokine and nitric oxide concentrations in cerebrospinal fluid for the differential diagnosis of meningitis.
abstract: OBJECTIVE
  In several cases of meningitis routinely used diagnostic procedures are unable to identify the cause of this disease. The objective of the present study was to determine whether proinflammatory cytokine (tumour necrosis factor (TNF-α), interleukin-1β (IL-1β), interleukin-8 (IL-8)) and nitric oxide (NO) concentrations in the CSF are useful markers for the differential diagnosis of meningitis.
  
  
  METHODS
  Sixty-seven patients (42 patients with bacterial meningitis and 25 patients with viral meningitis) were included in the present study. In the investigated group, the TNF-α, IL-1β and IL-8 concentrations in the CSF samples collected on the day of admission were assessed. Furthermore, the NO concentrations were assessed in 23 patients.
  
  
  RESULTS
  The results revealed that the measurement of proinflammatory cytokines in CSF can aid in a differential diagnosis. In particular, a high concentration of TNF-α may be a sensitive and specific marker of a bacterial aetiology of the neuroinfection. In the present study, TNF-α concentrations greater than 75.8 pg/ml differentiated between bacterial and viral meningitis with 100% sensitivity and specificity. The NO concentration in the CSF was also significantly greater in patients with bacterial meningitis than in those with viral meningitis.
  
  
  CONCLUSIONS
  The assessment of TNF-α, IL-1β and IL-8 concentrations in the CSF is useful in the differential diagnosis of neuroinfection. Because many factors may influence NO production in the central nervous system (CNS), it is not clear whether NO values can be used for the differential diagnosis of meningitis, and further studies are required.
authors.affiliation: Department of Infectious Diseases, Jagiellonian University, Collegium Medicum, Krakow, Poland. monika.bociagajasik@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Bociąga-Jasik
authors.forename: A
authors.initials: A
authors.lastname: Garlicki
authors.forename: A
authors.initials: A
authors.lastname: Cieśla
authors.forename: A
authors.initials: A
authors.lastname: Kalinowska-Nowak
authors.forename: I
authors.initials: I
authors.lastname: Sobczyk-Krupiarz
authors.forename: T
authors.initials: T
authors.lastname: Mach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002555:Cerebrospinal Fluid / Q000378:metabolism*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000378:metabolism; D008587:Meningitis, Viral / Q000175:diagnosis* / Q000378:metabolism; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism*; D055815:Young Adult
chemical_list: D016207:Cytokines; D053583:Interleukin-1beta; D016209:Interleukin-8; D009569:Nitric Oxide