Granert C, Raud J, Waage A, Lindquist L
Department of Infectious Diseases, Huddinge Hospital, S-141 86 Huddinge, Sweden.
Infect Immun. 1999 May;67(5):2071-4. doi: 10.1128/IAI.67.5.2071-2074.1999.
The inflammatory response in bacterial meningitis is mediated by cytokines, such as tumor necrosis factor alpha (TNF-alpha) and interleukin-1 (IL-1), which are produced in the subarachnoid space by different cells, e.g., leukocytes, astrocytes, and microglia. The recruitment of leukocytes into the cerebrospinal fluid (CSF) has been shown to contribute to the neurological damage in this disease, a process which could be enhanced by treatment with antibiotics. In this study, we have used a rabbit meningitis model for two sets of experiments with intracisternal (i.c.) injections of Streptococcus pneumoniae. First, pneumococcal cell wall (PCW) components were injected i.c., inducing an inflammatory response with pleocytosis and increased levels of CSF TNF-alpha) and IL-1 at 6 and 12 h after PCW injection. Treatment with fucoidin, known to inhibit leukocyte rolling, abolished pleocytosis and inhibited the release of TNF-alpha and IL-1. In the second experiment, live pneumococcal bacteria were injected i.c. and treatment with one dose of ampicillin (40 mg/kg of body weight intravenously) was given 16 h after induction of meningitis, causing a sevenfold increase in CSF leukocytes over a 4-h period. CSF IL-1 levels at 16 h were high but did not increase further at 20 h. Also, CSF TNF-alpha levels were high at 16 h and tended to increase at 20 h. Fucoidin treatment prevented the antibiotic-induced increase of CSF leukocytes but had no effect on the TNF-alpha and IL-1 levels. Taken together, fucoidin reduced CSF TNF-alpha and IL-1 levels in acute bacterial meningitis induced by PCW fragments but had no effect later in the course of the disease, when live bacteria were used and an inflammatory increase was caused by a dose of antibiotics.
细菌性脑膜炎中的炎症反应由细胞因子介导,如肿瘤坏死因子α(TNF-α)和白细胞介素-1(IL-1),这些细胞因子由蛛网膜下腔中的不同细胞产生,例如白细胞、星形胶质细胞和小胶质细胞。已表明白细胞募集到脑脊液(CSF)中会导致该疾病的神经损伤,抗生素治疗可能会加剧这一过程。在本研究中,我们使用兔脑膜炎模型进行了两组实验,通过脑池内(i.c.)注射肺炎链球菌。首先,脑池内注射肺炎球菌细胞壁(PCW)成分,在注射PCW后6小时和12小时诱导炎症反应,伴有细胞增多以及CSF中TNF-α和IL-1水平升高。用已知可抑制白细胞滚动的岩藻依聚糖进行治疗,可消除细胞增多现象,并抑制TNF-α和IL-1的释放。在第二个实验中,脑池内注射活的肺炎球菌,在诱导脑膜炎16小时后给予一剂氨苄西林(40mg/kg体重静脉注射)治疗,导致CSF白细胞在4小时内增加了7倍。16小时时CSF中IL-1水平较高,但在20小时时未进一步升高。此外,16小时时CSF中TNF-α水平较高,20小时时趋于升高。岩藻依聚糖治疗可防止抗生素诱导的CSF白细胞增加,但对TNF-α和IL-1水平无影响。综上所述,岩藻依聚糖可降低由PCW片段诱导的急性细菌性脑膜炎中CSF的TNF-α和IL-1水平,但在疾病后期使用活细菌且一剂抗生素引起炎症增加时,岩藻依聚糖无作用。