LEVELS OF INTERLEUKIN-6, CRP AND ALPHA-2-MACROGLOBULIN IN CEREBROSPINAL-FLUID (CSF) AND SERUM AS INDICATOR OF BLOOD-CSF BARRIER DAMAGE

We measured the levels of interleukin-6 (IL-6), albumin, C-reactive pr otein (CRP) and alpha 2 macroglobulin (alpha 2M), all of which have di fferent spectrums of molecular weight, in the cerebrospinal fluid (CSF ) and serum in 121 patients to evaluate damage to the blood-cerebrospi nal fluid barrier (BCB) in meningitis. There was an extraordinary high level of IL-6 in the CSF when patients had bacterial or viral meningi tis, but the level returned to a normal range within a week in almost all of these cases. There were no significant differences in CSF album in lea els among the different disease groups. The CRP level in CSF is considered to correlate with the serum level, and CSF CRP was higher in bacterial meningitis than in viral meningitis, however, CRP in CSF was increased in some of the infectious diseases without meningitis. T he alpha 2M in CSF, which tends to be at extraordinarily high levels w hen there is damage to the BCB, correlated highly with CSF cell counts . CSF IL-6 seemed to be a useful indicator to identify the acute activ e phase of meningitis. CRP and alpha 2M in CSF are considered to be us eful to differentiate bacterial meningitis, bacterial infection withou t meningitis and viral meningitis. Extraordinarily high levels of alph a 2M, which has a high molecular weight, in CSF is indicative of BCB d amage.