Detection of interleukin 1 beta but not tumor necrosis factor-alpha in cerebrospinal fluid of children with aseptic meningitis
O. Ramilo, M. M. Mustafa, J. Porter, X. Saez-Llorens, J. Mertsola, K. D. Olsen, J. P. Luby, B. Beutler and G. H. McCracken Jr
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas.
Tumor necrosis factor-alpha and interleukin 1 beta have been shown to be
mediators of meningeal inflammation in animal models of bacterial
meningitis. The presence of both cytokines in cerebrospinal fluid (CSF) of
patients with bacterial meningitis has been documented recently. In this
study, we measured concentrations of interleukin 1 beta and tumor necrosis
factor-alpha in CSF samples from 36 patients with nonbacterial (aseptic)
meningitis, 13 of whom had culture-proved enteroviral meningitis, and from
14 control patients. None of the samples from patients with aseptic
meningitis and from the controls had detectable tumor necrosis factor
activity in CSF. Thirty-two (89%) of 36 patients with aseptic meningitis
had detectable interleukin 1 beta in CSF (mean +/- SEM, 48 +/- 11 pg/mL).
These concentrations were significantly smaller than those previously
reported in patients with bacterial meningitis (944 +/- 128 pg/mL). Only 2
of the 14 control patients had detectable CSF interleukin 1 beta
concentrations of 21 and 42 pg/mL. A significant correlation was evident
between interleukin-1 beta concentrations and white blood cell counts in
the CSF of patients with aseptic meningitis. Our data suggest that the
initial events of CSF inflammation in children with aseptic meningitis are
different than those in patients with bacterial meningitis, and the
participation of these two cytokines, especially tumor necrosis
factor-alpha, is less critical to the process.
