Evaluation of free radical status in CSF in childhood meningitis

The study was undertaken to investigate the possible role of free radicals and antioxidants in childhood meningitis. Sixty children suffering from acu te bacterial meningitis (ABM) or tuberculous meningitis (TBM) according to their clinical and laboratory findings were enrolled in the study. The prod uction of superoxide anions (O-2(.-)), hydrogen peroxide (H2O2) and malondi aldehyde (MDA) and the activities of xanthine oxidase (XO), superoxide dism utase (SOD) and glutathione peroxidase (GPx) were monitored in the study gr oups and findings compared with those in 20 age-matched controls. Children with ABM and TBM who died registered significant increases in the productio n of O-2(.-) and MDA and in the activities of SOD and CPK compared with sur vivors. The rate of production of oxidants and MDA and the activities of XO , SOD and CPK were of a much higher magnitude in deceased ABM and in ABM su rvivors than in fatal TBM and survivors, respectively. The abnormalities in most of the biochemical parameters investigated were more marked in the ch ildren with ABM than in TBM and controls (p < 0.001). Increased MDA product ion and creatine phosphokinase (CPK) activity of different magnitudes in th e two study groups suggest varying degrees of tissue damage. The alteration s observed in 20 children who died (14 from ABM, 6 from TBM) revealed eleva ted levels of oxidants, antioxidants and toxicity markers, particularly in ABM patients, which suggests the possibility that natural or synthetic anti oxidants might prevent disease progression and tissue damage in childhood m eningitis.