Nguyen Sylvie, Godon Jeanne, de Barros Jean-Paul Pais, Masson David, Piroth Lionel, Blot Mathieu
Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France.
Department of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, France.
PLoS One. 2025 May 21;20(5):e0324153. doi: 10.1371/journal.pone.0324153. eCollection 2025.
Lipopolysaccharide (LPS) is a major virulence factor during both meningococcal and Haemophilus influenzae meningitis. Pneumococcus does not produce LPS but could be responsible for bacterial digestive translocation as a consequence of sepsis. We addressed this question in the context of pneumococcal meningitis.
A cross-sectional study on 24 patients with pneumococcal meningitis (20 (83%) admitted in intensive care unit, 4 (17%) with septic shock) and 34 prospectively-enrolled healthy volunteers. Interleukin 6 and C-reactive proteins plasma concentrations were measured as markers of systemic inflammation. Endotoxemia was measured using mass spectrometry (LC-MS/MS) for detection of molecules bound to the lipid A, namely 3-OH fatty acids.
Meningitis patients had significantly higher levels of plasma C-reactive protein (237 (74-373) vs. 2 (2-2) mg/l, p < 0.001 and interleukin 6 (43 (13-128) vs. 4.6 (4.6-16.6) pg/ml; p < 0.001) than healthy volunteers. However, we observed no significant difference in plasma lipopolysaccharide concentrations between patients and healthy volunteers (674 (554-896) vs. 668 (623-777) pmol/ml; p = 0.546).
Our results suggest that LPS is not a key determinant of the excessive inflammation associated with severe forms of pneumococcal meningitis.
脂多糖（LPS）是脑膜炎奈瑟菌和流感嗜血杆菌性脑膜炎的主要毒力因子。肺炎球菌不产生LPS，但败血症可能导致细菌消化性易位。我们在肺炎球菌性脑膜炎的背景下探讨了这个问题。
对24例肺炎球菌性脑膜炎患者（20例（83%）入住重症监护病房，4例（17%）患有感染性休克）和34名前瞻性招募的健康志愿者进行横断面研究。测量白细胞介素6和C反应蛋白的血浆浓度作为全身炎症的标志物。使用质谱法（LC-MS/MS）检测与脂多糖A结合的分子（即3-羟基脂肪酸）来测定内毒素血症。
脑膜炎患者的血浆C反应蛋白水平（237（74-373）对2（2-2）mg/l，p<0.001）和白细胞介素6水平（43（13-128）对4.6（4.6-16.6）pg/ml；p<0.001）显著高于健康志愿者。然而，我们观察到患者和健康志愿者之间的血浆脂多糖浓度没有显著差异（674（554-896）对668（623-777）pmol/ml；p=0.546）。
我们的结果表明，LPS不是与严重形式的肺炎球菌性脑膜炎相关的过度炎症的关键决定因素。
