The association between blood-cerebrospinal fluid barrier dysfunction and the therapeutic effect in tuberculous meningitis patients.
OBJECTIVE
To explore the correlation of blood-cerebrospinal fluid (CSF) barrier (BCB) dysfunction with the therapeutic effect of antitubercular agents and their resistance, hoping to provide theoretical evidence for improvement of the therapeutic effect.


METHODS
Albumin in CSF and serum was assayed by IMMAGE. The CSF/serum albumin ratio (QALB) was used to evaluate the permeability of the BCB. Real-time fluorescence quantitative PCR was used to detect the amount of Mycobacterium tuberculosis DNA, and an MTBDRplus reagent kit was used to determine the type of drug resistance of the M. tuberculosis.


RESULTS
The correlation analysis showed that significant correlation existed between the grade of severity of tuberculous meningitis and the QALB, and the grade of severity and the total leukocyte count in the CSF, for which the correlation coefficients were 0.366 (p < 0.05) and 0.365 (p < 0.05), respectively. The QALB in the group of patients who recovered was significantly higher than that in those patients who experienced disease progression (p = 0.019).


CONCLUSIONS
Our study showed that the permeability of the BCB correlated with the cure rate in tuberculous meningitis. Specifically, in the treatment of tuberculous meningitis, it is of key importance to utilize the benefit of the permeability of the BCB to achieve a better outcome.
Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, PR China.
Jiangtao
J
Tang
Yunfei
Y
An
Yun
Y
Liao
Yi
Y
Li
Lixin
L
Li
Lanlan
L
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000418:Albumins / Q000378:metabolism; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001812:Blood-Brain Barrier / Q000503:physiopathology*; D002199:Capillary Permeability / Q000502:physiology; D002648:Child; D018450:Disease Progression; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000188:drug therapy* / Q000503:physiopathology*; D055815:Young Adult
D000418:Albumins; D000995:Antitubercular Agents