Inflammatory response in bacterial meningitis: Cytokine levels in the cerebrospinal fluid

Abstract

Inflammatory response plays an important role in the pathogenesis of cerebral injury in bacterial meningitis. In this study, we evaluated the cytokine levels of interleukin 1-beta (IL1β), tumour necrosis factor alpha (TNFα) and interleukin 6 (IL6) in the cerebrospinal fluid (CSF), and determined their correlation with acute clinical complications and with changes in CSF biochemistry. Interleukin 6, TNFα and IL1β were present in 9/9, 3/9 and 4/9 patients, respectively. The CSFs with detectable TNFα or IL1β had higher levels of IL6 (p < 0.02), protein (NS) and lower glucose levels (p < 0.02), compared with those in which TNFα and IL1β were absent. Tumour necrosis factor alpha and IL1β levels also correlated with the presence of prolonged fever, fits, spasticity and death (logTNFα: r = 0.70, p < 0.05; logIL1β: r = 0.62, p = 0.08). The cytokine levels reflect the degree of inflammatory response and are positively correlated with the severity of acute clinical complications. Modulation of this inflammatory response in bacterial meningitis may improve its morbidity and mortality.