Cerebrospinal fluid biomarkers in patients with central nervous system infections: a retrospective study
Autor: | Filippo Lipani, Maria Grazia Milia, Daniele Imperiale, Giovanni Di Perri, Alessandro Di Stefano, Chiara Alcantarini, Lorenzo Mighetto, Elisa Burdino, Cristiana Atzori, Andrea Calcagno, Sabrina Audagnotto |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male CNS infection meningitis neopterin neuromarkers tau tau Proteins S100 Calcium Binding Protein beta Subunit medicine.disease_cause Neopterin 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Cerebrospinal fluid Central Nervous System Infections medicine Humans 030304 developmental biology 0303 health sciences Amyloid beta-Peptides business.industry Neisseria meningitidis Varicella zoster virus Meningoencephalitis Middle Aged medicine.disease Survival Analysis Psychiatry and Mental health chemistry 14-3-3 Proteins Immunology Enterovirus Female Neurology (clinical) business Meningitis 030217 neurology & neurosurgery Encephalitis Biomarkers |
Zdroj: | CNS spectrums. 25(3) |
ISSN: | 1092-8529 |
Popis: | BackgroundCentral nervous system (CNS) may be infected by several agents, resulting in different presentations and outcomes. Analysis of cerebrospinal fluid (CSF) markers could be helpful to differentiate specific conditions and setting an appropriate therapy.MethodsPatients presenting with signs and symptoms were enrolled if, before receiving a diagnostic lumbar puncture, signed a written informed consent. We analyzed CSF indexes of blood–brain barrier permeability (CSF to serum albumin ratio or CSAR), inflammation (CSF to serum IgG ratio, neopterin), amyloid deposition (1–42 β-amyloid), neuronal damage (Total tau (T-tau), Phosphorylated tau (P-tau), and 14.3.3 protein) and astrocyte damage (S-100β).ResultsTwo hundred and eighty-one patients were included: they were mainly affected by herpesvirus encephalitis, enterovirus meningoencephalitis, bacterial meningitis (Neisseria meningitidis and Streptococcus pneumoniae), and infection by other etiological agents or unknown pathogen. Their CSF features were compared with HIV-negative patients and native HIV-positive individuals without CNS involvement. 14.3.3 protein was found in bacterial and HSV infections while T-tau and neopterin were abnormally high in the herpesvirus group. P-tau, instead, was elevated in enterovirus meningitis. S-100β was found to be high in patients with HSV-1 and HSV-2 infections but not in those with Varicella Zoster Virus (VZV). Thirty-day mortality was unexpectedly low (2.7%): patients who died had higher levels of T-tau and, significantly, lower levels of Aβ1–42.ConclusionThis work demonstrates that CSF biomarkers of neuronal damage or inflammation may vary during CNS infections according to different causative agents. The prognostic value of these biomarkers needs to be assessed in prospective studies. |
Databáze: | OpenAIRE |
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