Department of Infectious Diseases, Jagiellonian University, Collegium Medicum, Krakow, Poland.
Adv Med Sci. 2012 Jun 1;57(1):142-7. doi: 10.2478/v10039-012-0013-y.
In several cases of meningitis routinely used diagnostic procedures are unable to identify the cause of this disease. The objective of the present study was to determine whether proinflammatory cytokine (tumour necrosis factor (TNF-α), interleukin-1β (IL-1β), interleukin-8 (IL-8)) and nitric oxide (NO) concentrations in the CSF are useful markers for the differential diagnosis of meningitis.
Sixty-seven patients (42 patients with bacterial meningitis and 25 patients with viral meningitis) were included in the present study. In the investigated group, the TNF-α, IL-1β and IL-8 concentrations in the CSF samples collected on the day of admission were assessed. Furthermore, the NO concentrations were assessed in 23 patients.
The results revealed that the measurement of proinflammatory cytokines in CSF can aid in a differential diagnosis. In particular, a high concentration of TNF-α may be a sensitive and specific marker of a bacterial aetiology of the neuroinfection. In the present study, TNF-α concentrations greater than 75.8 pg/ml differentiated between bacterial and viral meningitis with 100% sensitivity and specificity. The NO concentration in the CSF was also significantly greater in patients with bacterial meningitis than in those with viral meningitis.
The assessment of TNF-α, IL-1β and IL-8 concentrations in the CSF is useful in the differential diagnosis of neuroinfection. Because many factors may influence NO production in the central nervous system (CNS), it is not clear whether NO values can be used for the differential diagnosis of meningitis, and further studies are required.
在一些脑膜炎病例中，常规使用的诊断程序无法确定该病的病因。本研究的目的是确定脑脊液中促炎细胞因子（肿瘤坏死因子 (TNF-α)、白细胞介素-1β (IL-1β)、白细胞介素-8 (IL-8)) 和一氧化氮 (NO) 的浓度是否可作为鉴别脑膜炎的有用标志物。
本研究纳入了 67 名患者（42 名细菌性脑膜炎患者和 25 名病毒性脑膜炎患者）。在研究组中，评估了入院当天采集的 CSF 样本中 TNF-α、IL-1β 和 IL-8 的浓度。此外，还评估了 23 名患者的 NO 浓度。
结果表明，CSF 中促炎细胞因子的测量有助于鉴别诊断。特别是，TNF-α 浓度升高可能是神经感染细菌病因的敏感和特异性标志物。在本研究中，TNF-α 浓度大于 75.8 pg/ml 可 100%敏感和特异地鉴别细菌性和病毒性脑膜炎。细菌性脑膜炎患者的 CSF 中 NO 浓度也明显高于病毒性脑膜炎患者。
评估 CSF 中 TNF-α、IL-1β 和 IL-8 的浓度有助于神经感染的鉴别诊断。由于许多因素可能影响中枢神经系统 (CNS) 中的 NO 产生，因此尚不清楚 NO 值是否可用于鉴别诊断脑膜炎，还需要进一步研究。
