Changes of Neopterin in Cerebrospinal Fluid and Serum in Children with Meningitis.

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概要

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• Neopterin is synthesized mainly by monocytes/macrophages and is considered to be a marker for activation of the cellular immune system. In patients with bacterial or aseptic meningitis, elevated neopterin levels in cerebrospinal fluid (CSF) have been demonstrated.<BR>We studied the time courses of CSF and serum neopterin in children with meningitis. The CSF neopterin levels on admission were significantly higher in patients with bacterial meningitis (82.4 ± 37.0 nmol/L) than in those with aseptic meningitis (32.3 ± 22.1 nmol/L) or in those with non- pleocytotic CSF (6.9 ± 4.4 nmol/L).<BR>The CSF neopterin levels in the patients with bacterial meningitis were remarkably increased (234.5 ± 100.2 nmol/L) one day after admission, but the serum neopterin levels were not increased.<BR>There was no correlation between CSF neopterin levels and CSF cell count or CSF protein, nor between serum neopterin levels and serum C-reactive protein or peripheral leukocyte count. But the CSF neopterin levels one day after admission were related to the period of positive serum C-reactive protein.<BR>CSF neopterin levels in patients with bacterial meningitis were increased one day after admission. The levels in two patients with high levels of CSF IFN-γ and TNF-α were remarkably increased. All patients with bacterial meningitis had received treatment with antibiotics and dexamethasone. It has been reported that TNF-α enhances the effect of IFN-γ for neopterin release by macrophages in vitro and that dexamethasone has the same effect on IFN-γ as TNF-α.<BR>The present study suggests that elevation of CSF neopterin in bacterial meningitis results from monocytes/macrophages costimulated with IFN-γ, TNF-α and dexamethasone used in treatment.

• 一般社団法人 日本小児神経学会の論文

一般社団法人 日本小児神経学会 | 論文

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