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Low cerebrospinal fluid beta-amyloid 42 in patients with acute bacterial meningitis and normalization after treatment

M Sjögren1, M Gisslén, E Vanmechelen

  • 1Institute of Clinical Neuroscience, Göteborg University, Sahlgrenska University Hospital, Mölndal, SE 431 80 Mölndal, Sweden. magnus.sjogren@medfak.gu.se

Neuroscience Letters
|November 8, 2001
PubMed

Insights

Cerebrospinal fluid (CSF) amyloid-beta 42 (A beta 42) levels decrease significantly in bacterial meningitis, not due to inflammation but possibly impaired clearance. Levels normalize after treatment, suggesting a reversible process distinct from Alzheimer's disease pathology.

Area of Science:

  • Neurology
  • Biochemistry
  • Infectious Diseases

Background:

  • Cerebrospinal fluid (CSF) amyloid-beta 42 (A beta 42) is a potential Alzheimer's disease (AD) biomarker, with decreased levels linked to amyloid plaque deposition.
  • Low CSF A beta 42 is also observed in non-AD conditions like Creutzfeldt-Jakob disease, suggesting other factors influence its levels.

Purpose of the Study:

  • To investigate the relationship between CSF A beta 42 levels and inflammatory processes, specifically in acute meningitis.
  • To determine if bacterial meningitis affects CSF A beta 42 levels and if this is related to inflammation or clearance mechanisms.

Main Methods:

  • Measured CSF A beta 42 levels in patients with acute purulent bacterial meningitis, acute viral meningitis, and age-matched controls.
  • Assessed changes in CSF A beta 42 levels after successful treatment of bacterial meningitis.
  • Investigated potential interference of high protein levels on CSF A beta 42 measurements.

Main Results:

  • Marked reduction (28%) in CSF A beta 42 levels observed in bacterial meningitis (P<0.0001), with no change in viral meningitis.
  • CSF A beta 42 levels increased significantly after treatment for bacterial meningitis (P<0.05) and normalized compared to controls.
  • High protein levels in CSF did not interfere with the measurement of CSF A beta 42.

Conclusions:

  • The reduction in CSF A beta 42 during bacterial meningitis is unlikely a direct result of the inflammatory process itself.
  • The findings suggest that bacterial meningitis may disrupt the clearance of A beta 42 from the brain, leading to decreased CSF levels.
  • This CSF A beta 42 reduction in meningitis is distinct from the pathology seen in Alzheimer's disease.

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