Efficacy of anti-tumor necrosis factor-alpha antibody as an adjunctive therapy in experimental Escherichia coli meningitis in the newborn piglet

This study was done to evaluate the efficacy of anti-tumor necrosis factor alpha (anti-TNF-alpha) antibody as an adjunctive therapy in neonatal bacter ial meningitis. Newborn piglets were divided into three groups: 8 in the co ntrol group, 13 in the meningitis group (MG), and 10 in the meningitis with anti-TNF-alpha antibody group (AG). Meningitis was induced by intracistern al injection of 10(8) colony-forming units of Escherichia coli in 100 mu l of saline. In the AG, 200 mu l of anti-TNF-alpha antibody was also given in tracisternally. In the AG, the elevated cerebrospinal fluid TNF-a level obs erved in the MG was completely abolished, and increased intracranial pressu re, hypoglycorrhachia, and CSF pleocytosis observed in the MG were downmodu lated. But blood, brain, and CSF lactate levels remained elevated in both M G and AG. Increased brain cell membrane lipid peroxidation products and dec reased Na+,K+-ATPase activity observed in the MG were not attenuated in the AG. These results indicate that anti-TNF-a antibody was not particularly e ffective as an adjunctive therapy in attenuating acute inflammatory respons es and ameliorating brain damage in neonatal bacterial meningitis.