[Chemokines in meningitis of different etiologies]

Chemokines constitute a group of cytokines with strong chemotactic activity towards different populations of leukocytes, playing significant role in the pathogenesis of inflammatory responses. The chemokines of the alpha subfamily act mainly on neutrophiles, while beta subfamily chemokines attract primarily monocytes and lymphocytes. Research conducted within the last few years suggests chemokines to be the main factors responsible for the attraction of leukocytes to the cerebrospinal fluid (CSF) in the course of both bacterial and viral meningitis. In cerebrospinal fluid from patients with meningitis of different etiologies significant concentrations of both alpha and beta chemokines were observed, which tended to decrease after the introduction of the treatment, with the relationship to the clinical improvement. It was also confirmed in in vitro experiments that the chemotactic properties of the inflammatory CSF mainly depend on the presence of chemokines. The most important chemokines in the pathophysiology of the meningitis in humans are probably interleukin 8 (IL-8), monocyte chemoattractant protein (MCP-1) and INF-gamma inducible protein (IP-10). They seem to be responsible for the attraction to the cns of, respectively, neutrophiles, monocytes and activated T lymphocytes. Differences between the chemokine profiles observed in meningitides of different etiologies are to some degree relevant to coexisting differences in type and extent of pleocytosis. In future, measurements of concentrations of certain chemokines may become of some importance in diagnostics of meningitis and monitoring its clinical course.