Interferon-gamma inducing factor [IL-18], interferon-gamma and cystatin C levels of children with meningitis

The objective of this study was to measure the levels of interleukin [IL]-18, interferon [IFN]- gamma and cystatin C in the cerebrospinal fluid [CSF] of children with meningitis. The study was carried out on 30 patients [12 males and 18 females] admitted to in-patient pediatric department in El Minya fever hospital and EL-Minya University hospital, for evaluation and treatment from meningitis during the period from January 2004 to December 2004. Within the entire group of the study the most common signs of meningitis were included. Thirteen children had septic meningitis [positive CSF culture] and 17 children had aseptic meningitis [negative CSF culture and lymphomonocytic pleocytosis in CSF analysis]. Twenty children of matched age and sex, having normal CSF during evaluation for meningitis, served as a control group. All CSF samples were obtained under aseptic conditions. CSF samples were cultured, analyzed for glucose, protein and WBCs. Another part from CSF samples assayed were immediately frozen at-70°C unit cystatin C, IFN-gamma and IL-18 in CSF were assaved by using a two -site enzyme linked immunosorbent assayed for cystatin C, IL-18 and IFN-gamma. The results showed that septic meningitis group had significantly higher CSF WBCs and protein levels than in aseptic meningitis and control groups [P<0.005]. IL-18 was significantly higher in septic group, it was detected in 95% of children with septic meningitis and only in the CSF of 48% of aseptic meningitis group. In control subjects, 10% had detectable levels of IL-18 in the CSF. IFN-gamma was significantly higher in aseptic group, it was detected in 96% of aseptic meningitis and 35% of children with septic meningitis, while 21% was detected in CSF of control subjects. cystatin C was detected in 44% of children with septic and aseptic meningitis, compared with control children [P<0.001], While cystatin C was significantly decreased in septic and aseptic groups. No significant correlation was found between IL-18,IFN-Y and cystatin C levels and total leukocyte count in the CSF of children with meningitis. Our data suggest that IL18, IFN-gamma and cystatin C are significantly changed in the CSF of children with meningitis. IL18 had greatest elevations while cystatin C was significantly decreased in those children with septic meningitis. IFN-gamma had greatest elevation seen in those children with aseptic meningitis. So, cystatin C and IL18 could be considered as sensitive and specific parameters for detection of septic meningitis, while IFN-gamma could be considered as sensitive and specific parameter for detection of aseptic meningitis

Interleukin-5 and interleukin-10 are major cytokines in cerebrospinal fluid from patients with active neurocysticercosis

Neurocysticercosis (NCC) is a common neurological disorder especially in developing countries, caused by infection of the brain with encysted larvae of the tapeworm Taenia solium. Seizures are a common finding associated with this disease. The objective of the present study was to evaluate the correlation between the levels of various cytokines present in the cerebrospinal fluid (CSF) of patients with NCC and the severity of the disease. The levels of the cytokines IL-1î, TNF-alpha, IL-5, IL-10 and IFN-gamma were determined in the CSF of 22 patients with active NCC, 13 patients with inactive NCC and 15 control subjects. CSF from patients with active NCC presented significantly higher IL-5 levels compared to control subjects. IL-5 and IL-10 levels in CSF from NCC patients with inflammatory CSF were significantly higher than those detected in non-inflammatory CSF. These results show a predominant Th2 lymphocyte activation in human NCC and also indicate the possible use of cytokines in the CSF as a marker for the differential diagnosis between inactive disease and the active form of NCC