Department of Medical Microbiology and Immunology "Prof. Dr. Elissay Yanev", Faculty of Pharmacy, Medical University - Plovdiv, Bulgaria; Laboratory of Microbiology, University Hospital St. George, Plovdiv, Bulgaria; Research Institute at Medical University - Plovdiv, Bulgaria.
Department of Infectious Diseases and Parasitology, Faculty of Medicine, Medical University - Plovdiv, Bulgaria.
Cytokine. 2023 Oct;170:156315. doi: 10.1016/j.cyto.2023.156315. Epub 2023 Aug 5.
Bacterial meningitis is a life-threatening disease with high mortality and common long-term sequelae. The inflammatory response in the subarachnoid space, modulated by different cytokines, plays a major role in the pathogenesis of acute central nervous system infections. We aimed to examine correlations of interleukin (IL)-6, IL-8, IL-10, IL-12(p40), and tumor necrosis factor (TNF)-α levels with disease severity, complications, and outcome in patients with acute bacterial meningitis.
The study involved 30 patients with bacterial meningitis/meningoencephalitis admitted to the University Hospital St. George, Plovdiv over a period of 4 years. Patients were selected based on clinical presentation and laboratory abnormalities, consistent with a neuroinfection. Enzyme-linked immunosorbent assay was used to measure the studied cytokines in both cerebrospinal fluid (CSF) and serum in parallel. For microbiological diagnosis multiplex, polymerase chain reaction, and CSF culture were used.
In patients with acute bacterial meningitis CSF levels of IL-6, IL-8, IL-10, and TNF-α are significantly increased than in serum. CSF TNF-α, CSF IL-8, and CSF IL-10 had a moderate negative correlation to CSF glucose. It was found that serum IL-8 is significantly elevated in patients who experienced neurological complications, have severe clinical course, and in deceased patients. CSF IL-10 is increased only in patients with severe acute bacterial meningitis.
Among patients with acute bacterial meningitis serum IL-8 could delineate these with increased risk of neurological complications, severe clinical course, and fatal outcome. Serum IL-8 and CSF IL-10 could be used as indicators of disease severity.
细菌性脑膜炎是一种危及生命的疾病，死亡率高，常见长期后遗症。蛛网膜下腔的炎症反应由不同的细胞因子调节，在急性中枢神经系统感染的发病机制中起主要作用。我们旨在研究白细胞介素（IL）-6、IL-8、IL-10、IL-12(p40)和肿瘤坏死因子（TNF）-α水平与急性细菌性脑膜炎患者的疾病严重程度、并发症和预后的相关性。
本研究涉及 4 年内入住普罗夫迪夫圣乔治大学医院的 30 例细菌性脑膜炎/脑膜脑炎患者。根据临床表现和实验室异常，选择符合神经感染的患者。酶联免疫吸附试验平行检测脑脊液（CSF）和血清中研究细胞因子的水平。为了进行微生物诊断，采用多重聚合酶链反应和 CSF 培养。
急性细菌性脑膜炎患者的 CSF 中 IL-6、IL-8、IL-10 和 TNF-α水平明显高于血清。CSF TNF-α、CSF IL-8 和 CSF IL-10 与 CSF 葡萄糖呈中度负相关。发现血清 IL-8 在发生神经并发症、临床过程严重和死亡患者中显著升高。仅在严重急性细菌性脑膜炎患者中 CSF IL-10 增加。
在急性细菌性脑膜炎患者中，血清 IL-8 可以区分具有增加神经并发症、严重临床过程和致命结局风险的患者。血清 IL-8 和 CSF IL-10 可作为疾病严重程度的指标。
