Interieukin-1 beta and tumor necrosis factor-alpha in cerebrospinal fluid of children with bacterial meningitis

Certain cytokines may contribute to the sequence of events that lead to men ingeal inflammation in bacterial meningitis. The purpose of this study was to determine the levels of cytokines in the cerebrospinal fluid (CSF) of ch ildren with bacterial meningitis and aseptic meningitis of different etiolo gies. We determined the concentrations of interleukin-1 beta (IL-1 beta) an d tumor necrosis factor (TNF-alpha) in the CSF of 171 specimens of 144 pati ents whose cases were classified as follow: bacterial meningitis (n=23), as eptic meningitis (n=26) and non-meningitis (n=95). The detectable IL-1 beta concentration ( greater than or equal to 20 pg/ml) in the bacterial mening itis, aseptic meningitis and non-meningitis groups were observed with 78.3% , 3.8%, and 8.4%, respectively. Significantly higher serum IL-1 beta concen trations were detected in those with bacterial meningitis than those with a septic meningitis (538.93 +/- 605.32 pg/ml vs 2.52 +/- 11.57 pg/ml; P<0.001 ) or among non-meningitis subjects (2.90 +/- 11.91 pg/ml; P<0.001). The mea n TNF-alpha concentration was 148.74 +/- 338.77 pg/ml. There was significan tly more TNF-alpha than aseptic meningitis (6.85 +/- 17.93 pg/ml; P<0.001) or non-meningitis (7.67 +/- 16.07 pg/ml; P<0.001). With regard to diagnosis , measurement of IL-1 beta and TNF-alpha levels showed sensitivities of 78% and 74%, respectively; specificities of 96% and 81%, respectively. It is s uggested that the levels of these cytokines, especially IL-1 beta and TNF-a lpha, are useful markers for distinguishing bacterial meningitis from asept ic meningitis.