[Diagnostic value of tumor necrosis factor-alpha (TNF-alpha) determination in cerebrospinal fluid (CSF) in the course of neural infections].

In the central nervous system (CNS) infections a substantial role play inflammatory cytokines, especially TNF-alpha. They are implicated to initiate the local response leading to cerebral damage during meningitis. The purpose of this study was estimation of the diagnostic value of determining TNF-alpha concentrations in the CSF in the course of neuroinfections. Analyses were performed in 15 patients with purulent, bacterial meningitis (group A) and in 15 patients with lymphocytic meningitis (group B). CSF's concentrations of TNF-alpha were measured by the ELISA method (Genzyme Diagnostic, Cambridge, USA), on the day of admission and on the fourteenth day of treatment. In group A mean TNF-alpha concentration in CSF on admission was 285.73 pg/ml and in group B 4.07 pg/ml. On the fourteenth day of treatment mean TNF-alpha concentrations were 1.14 pg/ml and 0 pg/ml, respectively. The highest CSF TNF-alpha levels were observed in the most severely ill patients (group A). In several cases in this group there were positive correlations between TNF-alpha concentration and CSF white blood cell counts and protein concentration. Correlation of high levels of TNF-alpha with the severity of clinical course was observed in group B as well. Examination of CSF for TNF-alpha concentration could be useful in the differential diagnosis of CNS inflammations. TNF-alpha concentrations in CSF correlate with the severity of clinical course of meningitis and could have a prognostic value.