Rugemalira Emilie, Roine Irmeli, Kuligowski Julia, Sánchez-Illana Ángel, Piñeiro-Ramos José David, Andersson Sture, Cruzeiro Manuel Leite, Vento Máximo, Pelkonen Tuula
Children's Hospital, Pediatric Research Center, Helsinki University Hospital, Stenbäckinkatu 9, 00029 Helsinki, Finland.
Faculty of Medicine, University of Helsinki, Yliopistonkatu 4, 00014 Helsinki, Finland.
Antioxidants (Basel). 2023 Mar 2;12(3):621. doi: 10.3390/antiox12030621.
Neuronal damage in bacterial meningitis (BM) partly stems from the host´s inflammatory response and induced oxidative stress (OS). We studied the association of cerebrospinal fluid (CSF) biomarkers indicating oxidative damage to proteins with course of illness and outcome in childhood BM in Angola. Ortho-tyrosine/phenylalanine (o-Tyr/Phe), 3-chlorotyrosine/para-tyrosine (3Cl-Tyr/p-Tyr), and 3-nitrotyrosine/para-tyrosine (3NO-Tyr/p-Tyr) concentration ratios were measured in 79 BM admission CSF samples, employing liquid chromatography coupled to tandem mass spectrometry. Besides death, disease outcomes were registered on Day 7 of treatment and one month after discharge (control visit). The outcome was graded according to the modified Glasgow Outcome Scale (GOS), which considers neurological and audiological sequelae. Children with a o-Tyr/Phe ratio below the median were more likely to present focal convulsions and secondary fever during recovery and suboptimal outcome (GOS < 5) on Day 7 and at control visit (odds ratio (OR) 2.85; 95% CI 1.14-7.14 and OR 5.23; 95% CI 1.66-16.52, respectively). Their most common sequela was ataxia on Day 7 and at control visit (OR 8.55; 95% CI 2.27-32.22 and OR 5.83; 95% CI 1.12-30.4, respectively). The association of a higher admission CSF o-Tyr/Phe ratio with a better course and outcome for pediatric BM points to a beneficial effect of OS.
细菌性脑膜炎（BM）中的神经元损伤部分源于宿主的炎症反应和诱导的氧化应激（OS）。我们研究了安哥拉儿童BM中指示蛋白质氧化损伤的脑脊液（CSF）生物标志物与病程及预后的关系。采用液相色谱-串联质谱法测量了79份BM入院时CSF样本中的邻酪氨酸/苯丙氨酸（o-Tyr/Phe）、3-氯酪氨酸/对酪氨酸（3Cl-Tyr/p-Tyr）和3-硝基酪氨酸/对酪氨酸（3NO-Tyr/p-Tyr）浓度比。除死亡外，在治疗第7天和出院后1个月（对照访视）记录疾病转归。根据改良格拉斯哥预后量表（GOS）对转归进行分级，该量表考虑了神经和听力后遗症。o-Tyr/Phe比值低于中位数的儿童在恢复期间更易出现局灶性惊厥和继发发热，且在第7天和对照访视时转归不佳（GOS<5）（优势比（OR）分别为2.85；95%CI 1.14-7.14和OR 5.23；95%CI 1.66-16.52）。他们最常见的后遗症在第7天和对照访视时为共济失调（OR分别为8.55；95%CI 2.27-32.22和OR 5.83；95%CI 1.12-30.4）。儿童BM入院时CSF中较高的o-Tyr/Phe比值与较好的病程和转归相关，这表明氧化应激具有有益作用。
