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Pediatr Neurol. 2014 Jan;50(1):60-5. doi: 10.1016/j.pediatrneurol.2013.08.016. Epub 2013 Oct 15.

Cerebrospinal fluid TNF-α, IL-6, and IL-8 in children with bacterial meningitis.

Author information

1
Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Electronic address: rajnitip@gmail.com.
2
Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
3
Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
4
Department of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

Abstract

OBJECTIVE:

We evaluated the levels of cerebrospinal fluid concentrations of tumor necrosis factor-α, interleukin-6, and interleukin-8 in bacterial meningitis in children.

METHODS:

The study included children up to 14 years of age admitted to a pediatric ward with fever, headache, vomiting, and seizures. The diagnosis of bacterial meningitis was based on clinical features: physical examination, blood and cerebrospinal fluid cytochemical findings, Gram stain, and bacterial culture. The cerebrospinal fluid levels of tumor necrosis factor-α, interleukin-6, and interleukin-8 were measured in 57 children with bacterial meningitis, 15 with viral meningitis, and 15 controls by enzyme-linked immunosorbent assay methods.

RESULTS:

The mean concentrations of cerebrospinal fluid, tumor necrosis factor-α, interleukin-6, and interleukin-8 were 1108 ± 183, 652 ± 287, and 442 ± 120 pg/mL, respectively, in children with bacterial meningitis and were significantly increased in those in the viral meningitis group (tumor necrosis factor-α : 711 ± 105, IL-6 : 272 ± 161, IL-8 : 175 ± 62 pg/mL; P < 0.001) or control (390 ± 37, 59 ± 17, 19 ± 13 pg/mL, respectively, P < 0.001). At optimum cutoff level based on the receiver operating characteristic curve, cerebrospinal fluid cytokines (tumor necrosis factor-α, interleukin-6, and interleukin-8) showed sensitivity and specificity of 100% for the diagnosis of bacterial meningitis. For differentiation of bacterial from viral meningitis, cerebrospinal fluid level of tumor necrosis factor-α, IL-6, and IL-8 showed sensitivity and specificity of 94.7% and 86.7%, 80.7% and 53.3%, and 89.5% and 86.7%, respectively.

CONCLUSION:

The increased concentration of cerebrospinal fluid tumor necrosis factor-α, interleukin-6, and interleukin-8 in children with meningitis suggests a role in the pathogenesis of bacterial meningitis and these levels might prove to be useful in children whose diagnosis is in question.

KEYWORDS:

cerebrospinal fluid; interleukin-6 (IL-6); interleukin-8 (IL-8); meningitis; tumor necrosis factor-alpha (TNF-α)

[Indexed for MEDLINE]

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