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High concentrations of intrathecal interleukin-6 in human bacterial and nonbacterial meningitis
P Chavanet1, B Bonnotte, M Guiguet
1University Hospital (Hôpital du Bocage), Dijon, France.
Abstract:
Interleukin-6 (IL-6) is multipotent cytokine that acts in a network of factors directing the inflammatory reaction of purulent bacterial meningitis (PBM). However, little is known about the role of IL-6 in aseptic or "viral" meningitis (AM). IL-6 was assayed by RIA in cerebrospinal fluid (CSF) and serum samples obtained from patients with AM (n = 65), PBM (n = 8), and lymphocytic bacterial meningitis (LBM, n = 11). Of patients with AM, 89% had detectable IL-6 in CSF, with high IL-6 titers (median, 2160 pg/mL; 95% confidence interval [CI], 1320-2540 pg/mL) compared with 100% in patients with PBM (median, 6575 pg/mL; 95% CI, 450-32,000 pg/mL) and 90.9% in patients with LBM (median, 875 pg/mL; 95% CI, 150-2180 pg/mL). There was a highly symmetrical correlation between IL-6 and the percentage of polymorphonuclear cells in CSF of patients with PBM (r = .97, P = .01) and AM (r = .49, P = .002). In conclusion, this study shows evidence that IL-6 is released into the meningeal space in aseptic meningitis and is correlated with the local acute inflammatory response.
Insights
Interleukin-6 (IL-6) is present in aseptic meningitis (AM) and purulent bacterial meningitis (PBM). This study found IL-6 correlates with inflammation in AM, suggesting a role in this condition.
Area of Science:
- Neuroscience
- Immunology
- Infectious Diseases
Background:
- Interleukin-6 (IL-6) is a key cytokine in purulent bacterial meningitis (PBM) inflammatory responses.
- The specific role of IL-6 in aseptic meningitis (AM) remains largely uncharacterized.
Purpose of the Study:
- To investigate the presence and significance of IL-6 in cerebrospinal fluid (CSF) of patients with aseptic meningitis (AM).
- To compare IL-6 levels in AM with those in purulent bacterial meningitis (PBM) and lymphocytic bacterial meningitis (LBM).
- To determine the correlation between IL-6 and polymorphonuclear cells in CSF for different meningitis types.
Main Methods:
- Radioimmunoassay (RIA) was used to measure IL-6 levels in CSF and serum samples.
- Samples were collected from patients diagnosed with AM (n=65), PBM (n=8), and LBM (n=11).
- Statistical analysis included calculating median titers, confidence intervals, and correlation coefficients.
Main Results:
- Detectable IL-6 was found in the CSF of 89% of AM patients (median 2160 pg/mL), 100% of PBM patients (median 6575 pg/mL), and 90.9% of LBM patients (median 875 pg/mL).
- A significant positive correlation was observed between IL-6 levels and the percentage of polymorphonuclear cells in CSF for both AM (r=0.49, P=0.002) and PBM (r=0.97, P=0.01).
Conclusions:
- IL-6 is released into the meningeal space during aseptic meningitis.
- The presence of IL-6 in AM is associated with the local acute inflammatory response, similar to its role in bacterial meningitis.