TY - JOUR
T1 - Cerebrospinal Fluid Prostaglandins, Interleukin 1β, and Tumor Necrosis Factor in Bacterial Meningitis
T2 - Clinical and Laboratory Correlations in Placebo-Treated and Dexamethasone-Treated Patients
AU - Mustafa, M. M.
AU - Ramillo, O.
AU - Saez-Llorens, X.
AU - Olsen, K. D.
AU - Magness, R. R.
AU - McCracken, G. H.
PY - 1990/8
Y1 - 1990/8
N2 - • Prostaglandins (PGs), interleukin 1β (IL-1β), and tumor necrosis factor α (TNFα) are likely mediators of local inflammatory reactions. We measured PGE2, PGI2, IL-1β, and TNF concentrations in paired cerebrospinal fluid (CSF) samples (on admission, CSF1, and 18 to 30 hours later, CSF2) from 80 infants and children with bacterial meningitis. Forty patients received dexamethasone sodium (0.6 mg/kg per day in four intravenous doses) and 40 received an intravenous saline placebo. In CSF1, PGE2, PGI2, IL-1β, and TNF were detected in 90%, 56%, 98%, and 71% of specimens with mean (± SEM) concentrations of 462±65, 377±62, 1266±242, and 799±227 pg/mL, respectively. Concentrations of PGE2 correlated significantly with PGI2, IL-1β, TNF, and lactate and inversely correlated with glucose concentrations in the first CSF specimens. The PGE2, PGI2, IL-1β, and TNF were still detected in 40%, 18%, 97%, and 60%, respectively, of second CSF specimens obtained from placebo-treated patients. Compared with patients who had detectable PGI2 or TNFα concentrations in CSF2 specimens, those placebo-treated patients with no detectable PGI2 or TNFα activity in CSF2 had a lower incidence of neurological sequelae. Dexamethasone-treated patients had significantly lower PGE2, IL-1β, and lactate concentrations and higher glucose concentrations in CSF 18 to 30 hours later, shorter duration of fever, and a lower incidence of neurological sequelae than did placebo-treated patients.
AB - • Prostaglandins (PGs), interleukin 1β (IL-1β), and tumor necrosis factor α (TNFα) are likely mediators of local inflammatory reactions. We measured PGE2, PGI2, IL-1β, and TNF concentrations in paired cerebrospinal fluid (CSF) samples (on admission, CSF1, and 18 to 30 hours later, CSF2) from 80 infants and children with bacterial meningitis. Forty patients received dexamethasone sodium (0.6 mg/kg per day in four intravenous doses) and 40 received an intravenous saline placebo. In CSF1, PGE2, PGI2, IL-1β, and TNF were detected in 90%, 56%, 98%, and 71% of specimens with mean (± SEM) concentrations of 462±65, 377±62, 1266±242, and 799±227 pg/mL, respectively. Concentrations of PGE2 correlated significantly with PGI2, IL-1β, TNF, and lactate and inversely correlated with glucose concentrations in the first CSF specimens. The PGE2, PGI2, IL-1β, and TNF were still detected in 40%, 18%, 97%, and 60%, respectively, of second CSF specimens obtained from placebo-treated patients. Compared with patients who had detectable PGI2 or TNFα concentrations in CSF2 specimens, those placebo-treated patients with no detectable PGI2 or TNFα activity in CSF2 had a lower incidence of neurological sequelae. Dexamethasone-treated patients had significantly lower PGE2, IL-1β, and lactate concentrations and higher glucose concentrations in CSF 18 to 30 hours later, shorter duration of fever, and a lower incidence of neurological sequelae than did placebo-treated patients.
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U2 - 10.1001/archpedi.1990.02150320047024
DO - 10.1001/archpedi.1990.02150320047024
M3 - Article
C2 - 2116086
AN - SCOPUS:0025341682
SN - 0002-922X
VL - 144
SP - 883
EP - 887
JO - American Journal of Diseases of Children
JF - American Journal of Diseases of Children
IS - 8
ER -