TUMOR-NECROSIS-FACTOR-ALPHA PRODUCTION AND IMMUNE CELL ACTIVATION IN TUBERCULOUS MENINGITIS

THE local production of tumour necrosis factor-alpha (TNFalpha) was ev aluated in the cerebrospinal fluid (CSF) from ten patients with tuberc ulous meningitis (TBM). The degree of intrathecal immune activation wa s also studied by assessing the CSF levels of beta2-microglobulin (bet a2-M) and adenosine deaminase activity (ADA). Results indicate that el evated CSF concentrations of TNFalpha, beta2-M and ADA were found in a ll TBM patients. Moreover, TNFalpha is produced and selectively concen trated for a long period of time, while beta2-M and ADA values progres sively decline during the course of TBM. Our findings suggest that in TBM patients, after an early activation of immune cells, there is an e nhanced and continuous production of TNFalpha at the site of infection .