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Divergent cerebrospinal fluid cytokine network induced by non-viral and different viral infections on the central nervous system.

Bastos MS, Coelho-Dos-Reis JG, Zauli DA, Naveca FG, Monte RL, Pimentel JP, Macário VM, da Silva NL, Peruhype-Magalhães V, Pascoal-Xavier MA, Guimaraes A, Carvalho AT, Malheiro A, Martins-Filho OA, Mourão MP - BMC Infect. Dis. (2015)

Bottom Line: The results demonstrate that an altered biochemical profile alongside increased cellularity in the cerebrospinal fluid is a feature of patients with meningoencephalitis that are not associated with the detection of virus in the CNS (P < 0.05).In the case of Enterovirus infection (n = 13), meningoencephalitis elicits robust intrathecal pro-inflammatory cytokine pattern and elevated cellularity when compared to herpesvirus (n = 15) and Arbovirus (n = 5) viral infections (P < 0.05).Differences in the cytokine profile of the CSF may be unique if distinct, viral or presumably non-viral pathways initially trigger the inflammatory response in the CNS.

View Article: PubMed Central - PubMed

Affiliation: Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, AM, Brazil. michelebastos01@gmail.com.

ABSTRACT

Background: Meningoencephalitis is one of the most common disorders of the central nervous system (CNS) worldwide. Viral meningoencephalitis differs from bacterial meningitis in several aspects. In some developing countries, bacterial meningitis has appropriate clinical management and chemotherapy is available. Virus-associated and virus not detected meningoencephalitis are treatable, however, they may cause death in a few cases. The knowledge of how mediators of inflammation can induce disease would contribute for the design of affordable therapeutic strategies, as well as to the diagnosis of virus not detected and viral meningoencephalitis. Cytokine-induced inflammation to CNS requires several factors that are not fully understood yet.

Methods: Considering this, several cytokines were measured in the cerebrospinal fluid (CSF) of patients with undiagnosed and viral meningoencephalitis, and these were correlated with cellularity in the CSF.

Results: The results demonstrate that an altered biochemical profile alongside increased cellularity in the cerebrospinal fluid is a feature of patients with meningoencephalitis that are not associated with the detection of virus in the CNS (P < 0.05). Moreover, HIV-positive patients (n = 10) that evolve with meningoencephalitis display a distinct biochemical/cytological profile (P < 0.05) in the cerebrospinal fluid. Meningoencephalitis brings about a prominent intrathecal cytokine storm regardless of the detection of virus as presumable etiological agent. In the case of Enterovirus infection (n = 13), meningoencephalitis elicits robust intrathecal pro-inflammatory cytokine pattern and elevated cellularity when compared to herpesvirus (n = 15) and Arbovirus (n = 5) viral infections (P < 0.05).

Conclusion: Differences in the cytokine profile of the CSF may be unique if distinct, viral or presumably non-viral pathways initially trigger the inflammatory response in the CNS.

No MeSH data available.


Related in: MedlinePlus

Biochemical profile of cerebrospinal fluid (CSF) in meningoencephalitis patients. Levels of protein (a) glucose (b), lactate (c), and cellularity (d) were measured in the CSF of control samples (white), virus not detected or undiagnosed (light gray) and virus-positive (black) patients with meningoencephalitis as indicated in material and methods. Virus-positive patients were subdivided according to the type of viral infection: Herpersvirus, Enterovirus, Arbovirus and Lentivirus (dark gray). Results are expressed as bars that represent median values with interquartile range as error bars. Horizontal connecting lines represent statistical differences between groups when p < 0.05
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Fig1: Biochemical profile of cerebrospinal fluid (CSF) in meningoencephalitis patients. Levels of protein (a) glucose (b), lactate (c), and cellularity (d) were measured in the CSF of control samples (white), virus not detected or undiagnosed (light gray) and virus-positive (black) patients with meningoencephalitis as indicated in material and methods. Virus-positive patients were subdivided according to the type of viral infection: Herpersvirus, Enterovirus, Arbovirus and Lentivirus (dark gray). Results are expressed as bars that represent median values with interquartile range as error bars. Horizontal connecting lines represent statistical differences between groups when p < 0.05

Mentions: In order to understand the biochemical profile of patients with meningoencephalitis with virus-positive (n = 43) or undiagnosed (virus not detected) (n = 80) patients, the levels of protein, glucose and lactate along with cellularity were tested in the cerebrospinal fluid samples of those patients and healthy controls. Cellularity above 5 cells/field was considered as positive. Results are presented in Fig. 1. The results indicate that despite increased protein and lactate levels alongside influx of mononuclear cells to the cerebrospinal fluid of patients with meningoencephalitis, these altered parameters are unable to distinguish statistically patients with or without viral infection.Fig. 1


Divergent cerebrospinal fluid cytokine network induced by non-viral and different viral infections on the central nervous system.

Bastos MS, Coelho-Dos-Reis JG, Zauli DA, Naveca FG, Monte RL, Pimentel JP, Macário VM, da Silva NL, Peruhype-Magalhães V, Pascoal-Xavier MA, Guimaraes A, Carvalho AT, Malheiro A, Martins-Filho OA, Mourão MP - BMC Infect. Dis. (2015)

Biochemical profile of cerebrospinal fluid (CSF) in meningoencephalitis patients. Levels of protein (a) glucose (b), lactate (c), and cellularity (d) were measured in the CSF of control samples (white), virus not detected or undiagnosed (light gray) and virus-positive (black) patients with meningoencephalitis as indicated in material and methods. Virus-positive patients were subdivided according to the type of viral infection: Herpersvirus, Enterovirus, Arbovirus and Lentivirus (dark gray). Results are expressed as bars that represent median values with interquartile range as error bars. Horizontal connecting lines represent statistical differences between groups when p < 0.05
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4541733&req=5

Fig1: Biochemical profile of cerebrospinal fluid (CSF) in meningoencephalitis patients. Levels of protein (a) glucose (b), lactate (c), and cellularity (d) were measured in the CSF of control samples (white), virus not detected or undiagnosed (light gray) and virus-positive (black) patients with meningoencephalitis as indicated in material and methods. Virus-positive patients were subdivided according to the type of viral infection: Herpersvirus, Enterovirus, Arbovirus and Lentivirus (dark gray). Results are expressed as bars that represent median values with interquartile range as error bars. Horizontal connecting lines represent statistical differences between groups when p < 0.05
Mentions: In order to understand the biochemical profile of patients with meningoencephalitis with virus-positive (n = 43) or undiagnosed (virus not detected) (n = 80) patients, the levels of protein, glucose and lactate along with cellularity were tested in the cerebrospinal fluid samples of those patients and healthy controls. Cellularity above 5 cells/field was considered as positive. Results are presented in Fig. 1. The results indicate that despite increased protein and lactate levels alongside influx of mononuclear cells to the cerebrospinal fluid of patients with meningoencephalitis, these altered parameters are unable to distinguish statistically patients with or without viral infection.Fig. 1

Bottom Line: The results demonstrate that an altered biochemical profile alongside increased cellularity in the cerebrospinal fluid is a feature of patients with meningoencephalitis that are not associated with the detection of virus in the CNS (P < 0.05).In the case of Enterovirus infection (n = 13), meningoencephalitis elicits robust intrathecal pro-inflammatory cytokine pattern and elevated cellularity when compared to herpesvirus (n = 15) and Arbovirus (n = 5) viral infections (P < 0.05).Differences in the cytokine profile of the CSF may be unique if distinct, viral or presumably non-viral pathways initially trigger the inflammatory response in the CNS.

View Article: PubMed Central - PubMed

Affiliation: Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, AM, Brazil. michelebastos01@gmail.com.

ABSTRACT

Background: Meningoencephalitis is one of the most common disorders of the central nervous system (CNS) worldwide. Viral meningoencephalitis differs from bacterial meningitis in several aspects. In some developing countries, bacterial meningitis has appropriate clinical management and chemotherapy is available. Virus-associated and virus not detected meningoencephalitis are treatable, however, they may cause death in a few cases. The knowledge of how mediators of inflammation can induce disease would contribute for the design of affordable therapeutic strategies, as well as to the diagnosis of virus not detected and viral meningoencephalitis. Cytokine-induced inflammation to CNS requires several factors that are not fully understood yet.

Methods: Considering this, several cytokines were measured in the cerebrospinal fluid (CSF) of patients with undiagnosed and viral meningoencephalitis, and these were correlated with cellularity in the CSF.

Results: The results demonstrate that an altered biochemical profile alongside increased cellularity in the cerebrospinal fluid is a feature of patients with meningoencephalitis that are not associated with the detection of virus in the CNS (P < 0.05). Moreover, HIV-positive patients (n = 10) that evolve with meningoencephalitis display a distinct biochemical/cytological profile (P < 0.05) in the cerebrospinal fluid. Meningoencephalitis brings about a prominent intrathecal cytokine storm regardless of the detection of virus as presumable etiological agent. In the case of Enterovirus infection (n = 13), meningoencephalitis elicits robust intrathecal pro-inflammatory cytokine pattern and elevated cellularity when compared to herpesvirus (n = 15) and Arbovirus (n = 5) viral infections (P < 0.05).

Conclusion: Differences in the cytokine profile of the CSF may be unique if distinct, viral or presumably non-viral pathways initially trigger the inflammatory response in the CNS.

No MeSH data available.


Related in: MedlinePlus