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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 Jul;61(1):57–61. doi: 10.1136/jnnp.61.1.57

Inflammatory cytokines in CSF in bacterial meningitis: association with altered blood flow velocities in basal cerebral arteries.

K Fassbender 1, S Ries 1, U Schminke 1, S Schneider 1, M Hennerici 1
PMCID: PMC486459  PMID: 8676162

Abstract

OBJECTIVE--To investigate the association between release of humoral inflammatory mediators in CSF and blood and alterations of cerebral blood flow in patients with bacterial meningitis. METHODS--Immunomodulatory (interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF alpha)) and vasoactive (thromboxane A, prostacyclin, endothelin-1) molecules of probable or confirmed leucocyte origin were determined in CSF and venous blood from 20 patients with bacterial meningitis, and matched control subjects. Their concentrations were related to the presence of increased blood flow velocities in the middle cerebral arteries, as recorded by transcranial Doppler sonography. RESULTS--Concentrations of proinflammatory cytokines and prostacyclin and leucocyte counts were significantly increased in meningitis, but concentrations of the vasoconstrictors thromboxane and endothelin-1 were not. Patients with high blood flow velocities ( > 140 cm/s) had significantly increased concentrations of IL-1 beta and IL-6 and raised cell counts in CSF. CONCLUSION--The increases of key mediators of inflammation and immunoactivation and of leucocyte count in the CSF of patients with high cerebral blood flow velocities suggest a role of excessive compartmentalised host defence in pathogenesis of disorders of cerebral blood flow in bacterial meningitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaslid R., Huber P., Nornes H. Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound. J Neurosurg. 1984 Jan;60(1):37–41. doi: 10.3171/jns.1984.60.1.0037. [DOI] [PubMed] [Google Scholar]
  2. Akira S., Hirano T., Taga T., Kishimoto T. Biology of multifunctional cytokines: IL 6 and related molecules (IL 1 and TNF). FASEB J. 1990 Aug;4(11):2860–2867. [PubMed] [Google Scholar]
  3. Asano T., Ikegaki I., Suzuki Y., Satoh S., Shibuya M. Endothelin and the production of cerebral vasospasm in dogs. Biochem Biophys Res Commun. 1989 Mar 31;159(3):1345–1351. doi: 10.1016/0006-291x(89)92258-4. [DOI] [PubMed] [Google Scholar]
  4. Bode H., Harders A. Transient stenoses and occlusions of main cerebral arteries in children--diagnosis and control of therapy by transcranial Doppler sonography. Eur J Pediatr. 1989 Feb;148(5):406–411. doi: 10.1007/BF00595898. [DOI] [PubMed] [Google Scholar]
  5. De Caterina R., Sicari R., Giannessi D., Paggiaro P. L., Paoletti P., Lazzerini G., Bernini W., Solito E., Parente L. Macrophage-specific eicosanoid synthesis inhibition and lipocortin-1 induction by glucocorticoids. J Appl Physiol (1985) 1993 Dec;75(6):2368–2375. doi: 10.1152/jappl.1993.75.6.2368. [DOI] [PubMed] [Google Scholar]
  6. Ehrenreich H., Anderson R. W., Fox C. H., Rieckmann P., Hoffman G. S., Travis W. D., Coligan J. E., Kehrl J. H., Fauci A. S. Endothelins, peptides with potent vasoactive properties, are produced by human macrophages. J Exp Med. 1990 Dec 1;172(6):1741–1748. doi: 10.1084/jem.172.6.1741. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Endo T., Uchida Y., Matsumoto H., Suzuki N., Nomura A., Hirata F., Hasegawa S. Regulation of endothelin-1 synthesis in cultured guinea pig airway epithelial cells by various cytokines. Biochem Biophys Res Commun. 1992 Aug 14;186(3):1594–1599. doi: 10.1016/s0006-291x(05)81590-6. [DOI] [PubMed] [Google Scholar]
  8. Haring H. P., Rötzer H. K., Reindl H., Berek K., Kampfl A., Pfausler B., Schmutzhard E. Time course of cerebral blood flow velocity in central nervous system infections. A transcranial Doppler sonography study. Arch Neurol. 1993 Jan;50(1):98–101. doi: 10.1001/archneur.1993.00540010092024. [DOI] [PubMed] [Google Scholar]
  9. Hennerici M., Rautenberg W., Sitzer G., Schwartz A. Transcranial Doppler ultrasound for the assessment of intracranial arterial flow velocity--Part 1. Examination technique and normal values. Surg Neurol. 1987 May;27(5):439–448. doi: 10.1016/0090-3019(87)90251-5. [DOI] [PubMed] [Google Scholar]
  10. Ide K., Yamakawa K., Nakagomi T., Sasaki T., Saito I., Kurihara H., Yosizumi M., Yazaki Y., Takakura K. The role of endothelin in the pathogenesis of vasospasm following subarachnoid haemorrhage. Neurol Res. 1989 Jun;11(2):101–104. doi: 10.1080/01616412.1989.11739870. [DOI] [PubMed] [Google Scholar]
  11. Igarashi M., Gilmartin R. C., Gerald B., Wilburn F., Jabbour J. T. Cerebral arteritis and bacterial meningitis. Arch Neurol. 1984 May;41(5):531–535. doi: 10.1001/archneur.1984.04050170077022. [DOI] [PubMed] [Google Scholar]
  12. Inoue A., Yanagisawa M., Takuwa Y., Mitsui Y., Kobayashi M., Masaki T. The human preproendothelin-1 gene. Complete nucleotide sequence and regulation of expression. J Biol Chem. 1989 Sep 5;264(25):14954–14959. [PubMed] [Google Scholar]
  13. Katabami T., Shimizu M., Okano K., Yano Y., Nemoto K., Ogura M., Tsukamoto T., Suzuki S., Ohira K., Yamada Y. Intracellular signal transduction for interleukin-1 beta-induced endothelin production in human umbilical vein endothelial cells. Biochem Biophys Res Commun. 1992 Oct 30;188(2):565–570. doi: 10.1016/0006-291x(92)91093-6. [DOI] [PubMed] [Google Scholar]
  14. Lebel M. H., Freij B. J., Syrogiannopoulos G. A., Chrane D. F., Hoyt M. J., Stewart S. M., Kennard B. D., Olsen K. D., McCracken G. H., Jr Dexamethasone therapy for bacterial meningitis. Results of two double-blind, placebo-controlled trials. N Engl J Med. 1988 Oct 13;319(15):964–971. doi: 10.1056/NEJM198810133191502. [DOI] [PubMed] [Google Scholar]
  15. Mackinnon S. E., Hudson A. R., Llamas F., Dellon A. L., Kline D. G., Hunter D. A. Peripheral nerve injury by chymopapain injection. J Neurosurg. 1984 Jul;61(1):1–8. doi: 10.3171/jns.1984.61.1.0001. [DOI] [PubMed] [Google Scholar]
  16. Mathiesen T., Andersson B., Loftenius A., von Holst H. Increased interleukin-6 levels in cerebrospinal fluid following subarachnoid hemorrhage. J Neurosurg. 1993 Apr;78(4):562–567. doi: 10.3171/jns.1993.78.4.0562. [DOI] [PubMed] [Google Scholar]
  17. McAllister C. K., O'Donoghue J. M., Beaty H. N. Experimental pneumococcal meningitis. II. Characterization and quantitation of the inflammatory process. J Infect Dis. 1975 Oct;132(4):355–360. doi: 10.1093/infdis/132.4.355. [DOI] [PubMed] [Google Scholar]
  18. McMenamin J. B., Volpe J. J. Bacterial meningitis in infancy: effects on intracranial pressure and cerebral blood flow velocity. Neurology. 1984 Apr;34(4):500–504. doi: 10.1212/wnl.34.4.500. [DOI] [PubMed] [Google Scholar]
  19. Morita T., Kurihara H., Yoshizumi M., Maemura K., Sugiyama T., Nagai R., Yazaki Y. Human polymorphonuclear leukocytes have dual effects on endothelin-1: the induction of endothelin-1 mRNA expression in vascular endothelial cells and modification of the endothelin-1 molecule. Heart Vessels. 1993;8(1):1–6. [PubMed] [Google Scholar]
  20. Pfister H. W., Borasio G. D., Dirnagl U., Bauer M., Einhäupl K. M. Cerebrovascular complications of bacterial meningitis in adults. Neurology. 1992 Aug;42(8):1497–1504. doi: 10.1212/wnl.42.8.1497. [DOI] [PubMed] [Google Scholar]
  21. Prasad K., Haines T. Dexamethasone treatment for acute bacterial meningitis: how strong is the evidence for routine use? J Neurol Neurosurg Psychiatry. 1995 Jul;59(1):31–37. doi: 10.1136/jnnp.59.1.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Ristimäki A., Garfinkel S., Wessendorf J., Maciag T., Hla T. Induction of cyclooxygenase-2 by interleukin-1 alpha. Evidence for post-transcriptional regulation. J Biol Chem. 1994 Apr 22;269(16):11769–11775. [PubMed] [Google Scholar]
  23. Thomas V. H., Hopkins I. J. Arteriographic demonstration of vascular lesions in the study of neurologic deficit in advanced Haemophilus influenzae meningitis. Dev Med Child Neurol. 1972 Dec;14(6):783–787. doi: 10.1111/j.1469-8749.1972.tb03321.x. [DOI] [PubMed] [Google Scholar]
  24. Waage A., Halstensen A., Shalaby R., Brandtzaeg P., Kierulf P., Espevik T. Local production of tumor necrosis factor alpha, interleukin 1, and interleukin 6 in meningococcal meningitis. Relation to the inflammatory response. J Exp Med. 1989 Dec 1;170(6):1859–1867. doi: 10.1084/jem.170.6.1859. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Yamashima T., Kashihara K., Ikeda K., Kubota T., Yamamoto S. Three phases of cerebral arteriopathy in meningitis: vasospasm and vasodilatation followed by organic stenosis. Neurosurgery. 1985 Apr;16(4):546–553. [PubMed] [Google Scholar]
  26. Zervas N. T., Liszczak T. M., Mayberg M. R., Black P. M. Cerebrospinal fluid may nourish cerebral vessels through pathways in the adventitia that may be analogous to systemic vasa vasorum. J Neurosurg. 1982 Apr;56(4):475–481. doi: 10.3171/jns.1982.56.4.0475. [DOI] [PubMed] [Google Scholar]

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