title: Cerebrospinal fluid TNF-α, IL-6, and IL-8 in children with bacterial meningitis.
abstract: OBJECTIVE
  We evaluated the levels of cerebrospinal fluid concentrations of tumor necrosis factor-α, interleukin-6, and interleukin-8 in bacterial meningitis in children.
  
  
  METHODS
  The study included children up to 14 years of age admitted to a pediatric ward with fever, headache, vomiting, and seizures. The diagnosis of bacterial meningitis was based on clinical features: physical examination, blood and cerebrospinal fluid cytochemical findings, Gram stain, and bacterial culture. The cerebrospinal fluid levels of tumor necrosis factor-α, interleukin-6, and interleukin-8 were measured in 57 children with bacterial meningitis, 15 with viral meningitis, and 15 controls by enzyme-linked immunosorbent assay methods.
  
  
  RESULTS
  The mean concentrations of cerebrospinal fluid, tumor necrosis factor-α, interleukin-6, and interleukin-8 were 1108 ± 183, 652 ± 287, and 442 ± 120 pg/mL, respectively, in children with bacterial meningitis and were significantly increased in those in the viral meningitis group (tumor necrosis factor-α : 711 ± 105, IL-6 : 272 ± 161, IL-8 : 175 ± 62 pg/mL; P < 0.001) or control (390 ± 37, 59 ± 17, 19 ± 13 pg/mL, respectively, P < 0.001). At optimum cutoff level based on the receiver operating characteristic curve, cerebrospinal fluid cytokines (tumor necrosis factor-α, interleukin-6, and interleukin-8) showed sensitivity and specificity of 100% for the diagnosis of bacterial meningitis. For differentiation of bacterial from viral meningitis, cerebrospinal fluid level of tumor necrosis factor-α, IL-6, and IL-8 showed sensitivity and specificity of 94.7% and 86.7%, 80.7% and 53.3%, and 89.5% and 86.7%, respectively.
  
  
  CONCLUSIONS
  The increased concentration of cerebrospinal fluid tumor necrosis factor-α, interleukin-6, and interleukin-8 in children with meningitis suggests a role in the pathogenesis of bacterial meningitis and these levels might prove to be useful in children whose diagnosis is in question.
authors.affiliation: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Electronic address: rajnitip@gmail.com.
authors.forename: Rajniti
authors.initials: R
authors.lastname: Prasad
authors.affiliation: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Rishi
authors.initials: R
authors.lastname: Kapoor
authors.affiliation: Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Ragini
authors.initials: R
authors.lastname: Srivastava
authors.affiliation: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Om Prakash
authors.initials: OP
authors.lastname: Mishra
authors.affiliation: Department of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
authors.forename: Tej Bali
authors.initials: TB
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000097:blood / Q000134:cerebrospinal fluid*; D016209:Interleukin-8 / Q000097:blood / Q000134:cerebrospinal fluid*; D008297:Male; D016920:Meningitis, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000134:cerebrospinal fluid*
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha
keywords: cerebrospinal fluid; interleukin-6 (IL-6); interleukin-8 (IL-8); meningitis; tumor necrosis factor-alpha (TNF-α)