ASSESSMENT OF A POSSIBLE IMBALANCE BETWEEN TUMOR-NECROSIS-FACTOR (TNF) AND SOLUBLE TNF RECEPTOR FORMS IN TUBERCULOUS INFECTION OF THE CENTRAL-NERVOUS-SYSTEM

Distributions of tumor necrosis factor (TNF) and its soluble receptor forms, R55-BP and R75-BP, were analyzed in the cerebrospinal fluid of patients with severe acute or chronic central nervous system infection s. Tuberculous infections were associated with high ratios of R55-BP a nd R75-BP to TNF, 27.2 and 28.0, respectively, suggesting a small biol ogically active fraction of TNF. The opposite was found in subjects wi th acute bacterial meningitis: They had large fractions of biologicall y active TNF and thus low ratios of R55-BP and R75-BP to TNF, 3.7 and 4.0, respectively. It is hypothesized that chronic infectious diseases , such as tuberculous infections, may be associated with inadequate pr oduction of TNF and a concomitant relative increase of soluble TNF rec eptors, which may prolong the disease.