Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

The pathogenesis of tuberculous meningitis remains unclear, and there are few data describing the kinetics of the immune response during the course of its treatment. We measured concentrations of pro- and anti-inflammatory cytokines in serial blood and cerebrospinal fluid (CSF) samples from 21 adults who were being treated for tuberculous meningitis. CSF concentrations of soluble tumor necrosis factor-alpha receptors and of matrix metalloprotein-9 and its tissue inhibitor were also measured, and blood-brain barrier permeability was assessed by the albumin and IgG partition indices. CSF concentrations of lactate, interleukin-8, and interferon-gamma were high before treatment and then decreased rapidly with antituberculosis chemotherapy. However, significant immune activation and blood-brain barrier dysfunction were still apparent after 60 days of treatment. Death was associated with high initial CSF concentrations of lactate, low numbers of white blood cells, in particular neutrophils, and low CSF glucose levels.

Original publication

DOI

10.1086/378642

Type

Journal article

Journal

J Infect Dis

Publication Date

15/10/2003

Volume

188

Pages

1105 - 1115

Keywords

Adult, Antitubercular Agents, Blood-Brain Barrier, Cytokines, Humans, Interferon-gamma, Interleukin-8, Lactates, Matrix Metalloproteinase 9, Prognosis, Tissue Inhibitor of Metalloproteinase-1, Tuberculosis, Meningeal, Tumor Necrosis Factor-alpha, Vietnam