The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial Meningitis
Background. The brain’s inflammatory response to the infecting pathogen determines the outcome of bacterial meningitis (BM), for example, the associated mortality and the extent of brain injury. The inflammatory cascade is initiated by the presence of bacteria in the cerebrospinal fluid (CSF) activa...
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Wiley
2013-01-01
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Series: | Mediators of Inflammation |
Online Access: | http://dx.doi.org/10.1155/2013/312476 |
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author | Denis Grandgirard Rahel Gäumann Boubacar Coulibaly Jean-Pierre Dangy Ali Sie Thomas Junghanss Hans Schudel Gerd Pluschke Stephen L. Leib |
author_facet | Denis Grandgirard Rahel Gäumann Boubacar Coulibaly Jean-Pierre Dangy Ali Sie Thomas Junghanss Hans Schudel Gerd Pluschke Stephen L. Leib |
author_sort | Denis Grandgirard |
collection | DOAJ |
description | Background. The brain’s inflammatory response to the infecting pathogen determines the outcome of bacterial meningitis (BM), for example, the associated mortality and the extent of brain injury. The inflammatory cascade is initiated by the presence of bacteria in the cerebrospinal fluid (CSF) activating resident immune cells and leading to the influx of blood derived leukocytes. To elucidate the pathomechanisms behind the observed difference in outcome between different pathogens, we compared the inflammatory profile in the CSF of patients with BM caused by Streptococcus pneumonia (n=14), Neisseria meningitidis (n=22), and Haemophilus influenza (n=9). Methods. CSF inflammatory parameters, including cytokines and chemokines, MMP-9, and nitric oxide synthase activity, were assessed in a cohort of patients with BM from Burkina Faso. Results. Pneumococcal meningitis was associated with significantly higher CSF concentrations of IFN-γ, MCP-1, and the matrix-metalloproteinase (MMP-) 9. In patients with a fatal outcome, levels of TNF-α, IL-1β, IL-1RA, IL-6, and TGF-α were significantly higher. Conclusion. The signature of pro- and anti-inflammatory mediators and the intensity of inflammatory processes in CSF are determined by the bacterial pathogen causing bacterial meningitis with pneumococcal meningitis being associated with a higher case fatality rate than meningitis caused by N. meningitidis or H. influenzae. |
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institution | Kabale University |
issn | 0962-9351 1466-1861 |
language | English |
publishDate | 2013-01-01 |
publisher | Wiley |
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series | Mediators of Inflammation |
spelling | doaj-art-f0a119b3fd9d44caa73fdf8c9615314c2025-02-03T06:12:37ZengWileyMediators of Inflammation0962-93511466-18612013-01-01201310.1155/2013/312476312476The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial MeningitisDenis Grandgirard0Rahel Gäumann1Boubacar Coulibaly2Jean-Pierre Dangy3Ali Sie4Thomas Junghanss5Hans Schudel6Gerd Pluschke7Stephen L. Leib8Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbuehlstraße 51, 3010 Bern, SwitzerlandNeuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbuehlstraße 51, 3010 Bern, SwitzerlandCentre de Recherche en Sante de Nouna, Nouna, Burkina FasoSwiss Tropical and Public Health Institute and University of Basel, 4051 Basel, SwitzerlandCentre de Recherche en Sante de Nouna, Nouna, Burkina FasoSection of Clinical Tropical Medicine, Heidelberg University Hospital, 69120 Heidelberg, GermanyNeuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbuehlstraße 51, 3010 Bern, SwitzerlandSwiss Tropical and Public Health Institute and University of Basel, 4051 Basel, SwitzerlandNeuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbuehlstraße 51, 3010 Bern, SwitzerlandBackground. The brain’s inflammatory response to the infecting pathogen determines the outcome of bacterial meningitis (BM), for example, the associated mortality and the extent of brain injury. The inflammatory cascade is initiated by the presence of bacteria in the cerebrospinal fluid (CSF) activating resident immune cells and leading to the influx of blood derived leukocytes. To elucidate the pathomechanisms behind the observed difference in outcome between different pathogens, we compared the inflammatory profile in the CSF of patients with BM caused by Streptococcus pneumonia (n=14), Neisseria meningitidis (n=22), and Haemophilus influenza (n=9). Methods. CSF inflammatory parameters, including cytokines and chemokines, MMP-9, and nitric oxide synthase activity, were assessed in a cohort of patients with BM from Burkina Faso. Results. Pneumococcal meningitis was associated with significantly higher CSF concentrations of IFN-γ, MCP-1, and the matrix-metalloproteinase (MMP-) 9. In patients with a fatal outcome, levels of TNF-α, IL-1β, IL-1RA, IL-6, and TGF-α were significantly higher. Conclusion. The signature of pro- and anti-inflammatory mediators and the intensity of inflammatory processes in CSF are determined by the bacterial pathogen causing bacterial meningitis with pneumococcal meningitis being associated with a higher case fatality rate than meningitis caused by N. meningitidis or H. influenzae.http://dx.doi.org/10.1155/2013/312476 |
spellingShingle | Denis Grandgirard Rahel Gäumann Boubacar Coulibaly Jean-Pierre Dangy Ali Sie Thomas Junghanss Hans Schudel Gerd Pluschke Stephen L. Leib The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial Meningitis Mediators of Inflammation |
title | The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial Meningitis |
title_full | The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial Meningitis |
title_fullStr | The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial Meningitis |
title_full_unstemmed | The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial Meningitis |
title_short | The Causative Pathogen Determines the Inflammatory Profile in Cerebrospinal Fluid and Outcome in Patients with Bacterial Meningitis |
title_sort | causative pathogen determines the inflammatory profile in cerebrospinal fluid and outcome in patients with bacterial meningitis |
url | http://dx.doi.org/10.1155/2013/312476 |
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