title: High extracellular concentration of excitatory amino acids glutamate and aspartate in human brain abscess.
abstract: Brain abscesses often cause symptoms of brain dysfunction, including seizures, suggesting interference with normal neurotransmission. We determined the concentration of extracellular neuroactive amino acids in brain abscesses from 16 human patients. Glutamate was present at 3.6 mmol/L (median value, range 0.5-10.8), aspartate at 1.0 mmol/L (range 0.09-6.8). For comparison, in cerebroventricular fluid glutamate was ∼0.6 μmol/L, and aspartate was not different from zero. The total concentration of amino acids was higher in eight patients with seizures: 66 mmol/L (median value, range 19-109) vs. 21 mmol/L (range 4-52) in eight patients without seizures (p=0.026). The concentration of aspartate and essential amino acids tryptophan, phenylalanine, tyrosine, leucine, and isoleucine was higher in pus from patients with seizures (p⩽0.040), whereas that of glutamate was not (p=0.095). The median concentration of the non-proteinogenic, inhibitory amino acid taurine was similar in the two groups, 0.7-0.8 mmol/L (range 0.1-6.1). GABA could not be detected in pus. The patient groups did not differ with respect to abscess volume, the cerebral lobe affected, age, or time from symptom onset to surgery. Seven patients with extracerebral, intracranial abscesses had significantly lower pus concentration of glutamate (352 μmol/L, range 83-1368) and aspartate (71 μmol/L, range 22-330) than intracerebral abscesses (p<0.001). We conclude that excitatory amino acids glutamate and aspartate may reach very high concentrations in brain abscesses, probably contributing to symptoms through activation of glutamate receptors in the surrounding brain tissue.
authors.affiliation: Department of Neurosurgery, Oslo University Hospital, 0027 Oslo, Norway. Electronic address: daniel.dahlberg@ous-hf.no.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dahlberg
authors.affiliation: Department of Neurosurgery, Oslo University Hospital, 0027 Oslo, Norway. Electronic address: jugiva@ous-hf.no.
authors.forename: Jugoslav
authors.initials: J
authors.lastname: Ivanovic
authors.affiliation: Department of Neurology, Oslo University Hospital, 0027 Oslo, Norway; Norwegian Defence Research Establishment, 2027 Kjeller, Norway. Electronic address: bjornar.hassel@ffi.no.
authors.forename: Bjørnar
authors.initials: B
authors.lastname: Hassel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001224:Aspartic Acid / Q000378:metabolism*; D001922:Brain Abscess / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005110:Extracellular Space / Q000378:metabolism*; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000378:metabolism*; D055815:Young Adult
chemical_list: D001224:Aspartic Acid; D018698:Glutamic Acid
keywords: Amino acids; Brain abscess; Empyema; Protein hydrolysis; Proteolysis; Seizure