title: Cerebrospinal fluid and serum cytokine profiling to detect immune control of infectious and inflammatory neurological and psychiatric diseases.
abstract: The present study aimed at profiling inflammatory cytokines for neurological and psychiatric diseases. A total of 86 patients with meningitis, multiple sclerosis, tension-type headache, idiopathic facial nerve palsy (IFNP), affective and schizophrenic disorders were tested for both, serum and cerebrospinal fluid (CSF) using a multiplexed cytokine ELISA for IFN-γ, TNF-α, IL-1β, IL-2, IL-4, IL-5, IL-8/CXCL8, IL-10, IL12p70, IL-13 and IL-17. Cases with viral and bacterial meningitis had unequivocally higher cytokine concentrations in the CSF when compared with serum. Bacterial meningitis was unique by extremely elevated IL-17, TNF-α and IL-1β, indicating a plethora of inflammatory pathways, selectively activated in the CSF. In relapsing multiple sclerosis, IFN-γ and IL-10 were elevated in both, serum and CSF, but IL-12p70, IL-5, IL-13, and TNF-α were more prominent in serum than in CSF. Qualitatively similar biomarker patterns were detected in patients with idiopathic facial nerve palsy and tension-type cephalgia. Affective and schizophrenic disorders clearly present with an inflammatory phenotype in the CSF and also serum, the cytokines determined were in general higher in schizophrenia. Except IFN-γ, schizophrenic patients had higher IL-12p70 and a trend of higher IL-10 and IL-13 in serum suggesting a more prominent TH2-type counter regulatory immune response than in affective disorders. These differences were also mirrored in the CSF. Elevated IL-8 appears to be the most sensitive marker for inflammation in the CSF of all diseases studied, whereas TNF-α was restricted to peripheral blood. With the exception of IL-8, all but viral and bacterial meningitis, studied, displayed higher means of elevated lymphokine concentrations in the serum than in the CSF. This observation supports the concept of immunological crosstalk between periphery and intrathecal immunity in neurological and psychiatric diseases.
authors.affiliation: Clinic for Psychiatry and Psychotherapy II, Ulm University, BKH-Guenzburg, Germany.
authors.forename: Horst-Guenter
authors.initials: HG
authors.lastname: Maxeiner
authors.affiliation: Department of Neurology, RKU Ulm University, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Marion Schneider
authors.affiliation: Sektion Experimentelle Anaesthesiologie, University Hospital Ulm, Albert Einstein Allee 23, 89081 Ulm, Germany.
authors.forename: Sina-Tatjana
authors.initials: ST
authors.lastname: Kurfiss
authors.affiliation: Sektion Experimentelle Anaesthesiologie, University Hospital Ulm, Albert Einstein Allee 23, 89081 Ulm, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brettschneider
authors.affiliation: Sektion Experimentelle Anaesthesiologie, University Hospital Ulm, Albert Einstein Allee 23, 89081 Ulm, Germany.
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Tumani
authors.affiliation: Clinic for Psychiatry and Psychotherapy II, Ulm University, BKH-Guenzburg, Germany. Electronic address: karl.bechter@bkh-guenzburg.de.
authors.forename: Karl
authors.initials: K
authors.lastname: Bechter
mesh_terms: D000328:Adult; D003141:Communicable Diseases / Q000175:diagnosis / Q000276:immunology*; D016207:Cytokines / Q000097:blood* / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000276:immunology*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000276:immunology*
chemical_list: D016207:Cytokines
keywords: Affective and schizophrenic disorders; Cerebrospinal fluid; Multiplexed cytokine analysis; Neuroinflammation; Viral and bacterial meningitis