Differential diagnostic significance of cytokines in cerebrospinal fluid of children with acute central nervous system infections

Abstract

Objective To investigate the diagnostic value of cytokines in central nervous system infection (CNSI), the levels of interferon gamma (IFN γ), granulocyte colony stimulating factor (G CSF), tumor necrosis factor α(TNF α), interleukin 6 (IL 6) and interleukin 8 (IL 8) in the cerebrospinal fluid (CSF) were measured in the children with CNSI of different etiology Methods The concentrations of IFN γ, G CSF, TNF α, IL 6 and IL 8 were measured in the CSF of 66 children, of whom 14 patients had purulent meningitis (PM), 30 patients had acute viral meningitis (VM), and 22 were control children without CNSI The ages were from 5 months to 13 years The concentrations of cytokines were detected by enzyme linked immunosorbent assay (ELISA) The CSF specimens were analyzed for the white blood cell count, glucose and the concentrations of IFN γ, G CSF, TNF α, IL 6 and IL 8 Results The CSF levels of G CSF and IL 8 were significantly higher in the PM group [(132±41), (2 53±0 56) μg/L] than in the VM group [ (53±22), (0 53±0 46) μg/L] and control group [(41±24), (0 38±0 29) μg/L, P 0 001] The IFN γ concentration was markedly higher in the CSF of patients with VM [(2 0±0 4) μg/L] than patients with PM [(0 8±0 5) μg/L, P 0 01] and control group [(0 6±0 5) μg/L, P 0 001] The TNF α and IL 6 concentrations were obviously higher in the PM group [(3 21±1 36) μg/L] and VM group [(2 23±1 05) μg/L] compared with the control group [(0 45±0 23) μg/L, P 0 001] No significant difference was found between PM group and VM group in TNF α and IL 6 levels in CSF The concentrations of G CSF and IL 8 in the CSF were positively correlated to the neutrophil count ( r =0 182, P =0 022; r =0 201, P =0 032) The IFN γ, TNF α and IL 6 concentrations were not correlated to the neutrophil count, glucose and protein amounts in CSF( r =0 087, r =0 075, r =0 122, P 0 10) Conclusion The cytokines increased in the CSF of patients with CNSI It may contribute to the pathophysiological mechanisms of acute infection of the central nervous system The CSF levels of G CSF and IL 8 may be helpful to distinguish PM from VM The IFN γ concentration in the CSF may be valuable in differential diagnosis between VM and PM The CSF levels variation of TNF α and IL 6 were not significant in the differential diagnosis of CNSI