title: 14-3-3β protein expression in eosinophilic meningitis caused by Angiostrongylus cantonensis infection.
abstract: BACKGROUND
  Angiostrongylus cantonensis is a parasite endemic in the Southeast Asian and Pacific regions. Humans are incidentally infected either by eating uncooked intermediate hosts or by consuming vegetables containing the living third-stage larvae. The 14-3-3β protein is a cerebrospinal fluid (CSF) marker of neuronal damage during the development of Creutzfeldt-Jakob disease. In addition, increased 14-3-3β protein is also found in CSF from patients with a variety of neurological disorders. The goal of this study is to determine the roles of serum/CSF14-3-3β protein in patients with eosinophilic meningitis.
  
  
  METHODS
  In a cohort study among nine Thai laborers with eosinophilic meningitis due to eating raw snails (Pomacea canaliculata), we examined the CSF weekly while patients were still hospitalized and followed up the serum for 6 months. The levels of 14-3-3β protein in CSF were analyzed by western blot and an in-house 14-3-3β enzyme-linked immunosorbent assay (ELISA) measurement was established and tested in an animal model of eosinophilic meningitis.
  
  
  RESULTS
  The elevated 14-3-3β level was detected in the CSF from eight out of nine (81%) patients After 2 weeks of treatment, all patients showed a declined level or cleared of 14-3-3β protein in the CSF. By developing an in-house ELISA for measurement of 14-3-3β protein, it was found that the serum 14-3-3β level was significantly increased in patients during initial visit. . This finding was consistent to the animal experiment result in which there was severe blood brain barrier damage three weeks after infection and increased 14-3-3β protein expression in the CSF and serum by western blot and in house ELISA. After treatment, the serum 14-3-3β level in meningitis patients was rapidly returned to normal threshold. There was a correlation between initial CSF 14-3-3β level with severity of headache (r = 0.692, p = 0.039), CSF pleocytosis (r = 0.807, p = 0.009) and eosinophilia (r = 0.798, p = 0.01) in the CSF of patients with eosinophilic meningitis (Spearman's correlation test).
  
  
  CONCLUSIONS
  The serum 14-3-3β concentrations may constitute a useful marker for blood brain barrier damage severity and follow up in patients with eosinophilic meningitis caused by A. cantonensis.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan. hctsai1011@yahoo.com.tw.
authors.forename: Hung-Chin
authors.initials: HC
authors.lastname: Tsai
authors.forename: Yen-Lin
authors.initials: YL
authors.lastname: Huang
authors.forename: Yao-Shen
authors.initials: YS
authors.lastname: Chen
authors.forename: Chuan-Min
authors.initials: CM
authors.lastname: Yen
authors.forename: Rachel
authors.initials: R
authors.lastname: Tsai
authors.forename: Susan Shin-Jung
authors.initials: SS
authors.lastname: Lee
authors.forename: Ming-Hong
authors.initials: MH
authors.lastname: Tai
mesh_terms: D048948:14-3-3 Proteins / Q000097:blood* / Q000134:cerebrospinal fluid; D000293:Adolescent; D017185:Angiostrongylus cantonensis / Q000254:growth & development* / Q000502:physiology; D000818:Animals; D001812:Blood-Brain Barrier / Q000378:metabolism; D015153:Blotting, Western; D015331:Cohort Studies; D004199:Disease Vectors; D004797:Enzyme-Linked Immunosorbent Assay; D004802:Eosinophilia / Q000097:blood* / Q000134:cerebrospinal fluid / Q000469:parasitology; D005070:Evans Blue / Q000378:metabolism; D006790:Host-Parasite Interactions; D006801:Humans; D008297:Male; D008581:Meningitis / Q000097:blood* / Q000134:cerebrospinal fluid / Q000469:parasitology; D008807:Mice, Inbred BALB C; D012908:Snails / Q000469:parasitology; D017206:Strongylida Infections / Q000097:blood* / Q000134:cerebrospinal fluid / Q000469:parasitology; D055815:Young Adult
chemical_list: D048948:14-3-3 Proteins; D005070:Evans Blue