Interieukin-1β and tumor necrosis factor-α in cerebrospinal fluid of children with bacterial meningitis

Certain cytokines may contribute to the sequence of events that lead to meningeal inflammation in bacterial meningitis. The purpose of this study was to determine the levels of cytokines in the cerebrospinal fluid (CSF) of children with bacterial meningitis and aseptic meningitis of different etiologies. We determined the concentrations of interleukin-1 beta (IL-1 beta) and tumor necrosis factor (TNF-alpha) in the CSF of 171 specimens of 144 patients whose cases were classified as follow: bacterial meningitis (n=23), aseptic meningitis (n=26) and non-meningitis (n=95). The detectable IL-1 beta concentration ( greater than or equal to 20 pg/ml) in the bacterial meningitis, aseptic meningitis and non-meningitis groups were observed with 78.3%, 3.8%, and 8.4%, respectively. Significantly higher serum IL-1 beta concentrations were detected in those with bacterial meningitis than those with aseptic meningitis (538.93 +/- 605.32 pg/ml vs 2.52 +/- 11.57 pg/ml; P<0.001) or among non-meningitis subjects (2.90 +/- 11.91 pg/ml; P<0.001). The mean TNF-alpha concentration was 148.74 +/- 338.77 pg/ml. There was significantly more TNF-alpha than aseptic meningitis (6.85 +/- 17.93 pg/ml; P<0.001) or non-meningitis (7.67 +/- 16.07 pg/ml; P<0.001). With regard to diagnosis, measurement of IL-1 beta and TNF-alpha levels showed sensitivities of 78% and 74%, respectively; specificities of 96% and 81%, respectively. It is suggested that the levels of these cytokines, especially IL-1 beta and TNF-alpha, are useful markers for distinguishing bacterial meningitis from aseptic meningitis.