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Vascular endothelial growth factor in bacterial meningitis: detection in cerebrospinal fluid and localization in
M van der Flier1, G Stockhammer, G J Vonk
1Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Abstract:
Vascular endothelial growth factor (VEGF) is a potent vascular permeability factor and a mediator of brain edema. To assess the role of VEGF during bacterial meningitis, VEGF was measured in cerebrospinal fluid (CSF) and blood of 37 patients with bacterial meningitis and 51 control patients, including 16 patients with viral meningitis. Circulating VEGF levels were similar in bacterial meningitis patients and control patients. VEGF(CSF) was detected in 11 (30%) of 37 of bacterial meningitis patients (range, <25-633 pg/mL) but in none of the control patients. The median VEGF index was 6.2 (range, 0.6-42), indicating intrathecal production. Median CSF cell counts, protein levels, and CSF: serum albumin ratios were higher for patients with detectable VEGF(CSF), although the difference was not statistically significant. VEGF immunoreactivity in autopsy brain specimens was found in the inflammatory infiltrate of patients with bacterial meningitis. These results indicate that inflammatory cells secrete VEGF during bacterial meningitis and that VEGF may contribute to blood-brain barrier disruption.
Insights
Vascular endothelial growth factor (VEGF) is elevated in the cerebrospinal fluid of bacterial meningitis patients, suggesting inflammatory cells produce it and may disrupt the blood-brain barrier.
Area of Science:
- Neuroscience
- Immunology
- Pathology
Background:
- Vascular endothelial growth factor (VEGF) is a key regulator of vascular permeability and a mediator of brain edema.
- Bacterial meningitis is an infection of the central nervous system that can lead to severe neurological complications.
Purpose of the Study:
- To investigate the role of VEGF in the pathogenesis of bacterial meningitis.
- To determine if VEGF is produced intrathecally during bacterial meningitis.
Main Methods:
- VEGF levels were measured in cerebrospinal fluid (CSF) and blood of 37 bacterial meningitis patients and 51 controls (including 16 viral meningitis patients).
- VEGF was detected using immunoassay, and its presence in brain tissue was examined via immunohistochemistry in autopsy specimens.
Main Results:
- Circulating VEGF levels did not differ between bacterial meningitis patients and controls.
- VEGF was detected in the CSF of 30% of bacterial meningitis patients but in none of the controls, indicating intrathecal production.
- Patients with detectable CSF VEGF showed higher, though not statistically significant, CSF cell counts, protein levels, and CSF:serum albumin ratios.
Conclusions:
- Inflammatory cells in the brain secrete VEGF during bacterial meningitis.
- VEGF may contribute to blood-brain barrier disruption in bacterial meningitis.