TIME-COURSE OF CHEMOKINES IN THE CEREBROSPINAL-FLUID AND SERUM DURINGHERPES-SIMPLEX TYPE-1 ENCEPHALITIS

Chemokines (chemoattractant cytokines) attract and activate specific l eukocyte subsets. With regard to their expression by brain parenchymal cells, they may represent the key molecules that control leukocyte en try into the subarachnoid space. In order to evaluate the contribution of chemokines in vivo, we determined the levels of MCP-I, MIP-1 alpha , RANTES, IL-8, as well as of the sIL-2R in three patients with proven herpes simplex encephalitis type 1 (HSE-1). CSF samples were drawn by a subarachnoid catheter system throughout the time course of hospital isation. Results were compared to chemokine levels in serum drawn in p arallel. The clinical status was documented by the Modified Barthel In dex and correlated with chemokine levels in the CSF. The results were compared with the chemokine levels in the CSF of 17 control patients w ith normal CSF routine parameters. High chemokine levels were detectab le in the CSF of all HSE-patients. MCP-1 peak levels were found at the time of admission, while maximal IL-8 levels occurred 4 to 8 h later. The levels of MIP-1 alpha and RANTES were lower than those of MCP-1 w ith a maximum at the time of admission. In all patients the levels of the sIL-2R increased later in the time course, at 14 to 20 h after adm ission. When the levels of MCP-1 were compared with the clinical statu s by Modified Barthel Index, we found a high reciprocal correlation (r =-0.82). Routine CSF parameters, such as leukocytes, albumin and immun oglobulins did not correlate with the clinical status. Chemokine level s in serum were found to be close to the detection limits of the ELISA systems. Our data suggest that chemokines play an important role in t he pathogenesis of HSE. They may be useful parameters to monitor the s tage and severity of the disease. The late increase of sIL2-R levels m ay indicate the beginning of the reconstitution phase. (C) 1998 Elsevi er Science B.V.