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Meta-analysis identifies tumor necrosis factor-alpha and interleukin-1 beta as diagnostic biomarkers for bacterial
Ana Paula Ronzani Panato, Luiza Trajano Tomasi, Carla Sasso Simon
1Rua Cruz e Souza, 510, Bairro Pio Correa- CEP 88811-550, Criciúma-SC- Brazil. mir@unesc.net.
Background:
Meningitis is a complex and severe acute infectious disease of the central nervous system and is caused mainly by bacteria and viruses. However, the distinction between aseptic and bacterial meningitis can be difficult for clinicians because the symptoms and the results of laboratory assays are often similar and overlapping, particularly when the use of antibiotics is administered prior to examining the cerebrospinal fluid.
Methods:
We determined the accuracy of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) for the differential diagnosis between bacterial and aseptic meningitis. A comprehensive search was performed for papers published from January 1989 to July 2013. Prospective or retrospective studies and cerebrospinal fluid (CSF) TNF-α and/or IL-1β cytokine concentrations for differential diagnosis distinguishing bacterial from aseptic meningitis were included.
Results:
A statistical analysis was performed using Revman and Meta-Disc. This systematic review showed that TNF-α has a sensitivity of 80.5%, specificity of 94.9%, diagnostic odds ratio (DOR) of 71.7, and area under the curve (AUC) = 0.942; IL-1β showed a sensitivity of 86.0%, specificity of 92.3%, DOR of 53.5, and AUC = 0.975.
Conclusion:
Therefore, TNF-α and IL-1β are useful markers for the prediction of the bacterial meningitis and levels may represent an accurate method that is useful for the differentiation between bacterial and aseptic meningitis.
Insights
Tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) show high accuracy in distinguishing bacterial meningitis from aseptic meningitis. These cytokines offer a reliable diagnostic method for differentiating these severe CNS infections.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Meningitis is a severe central nervous system infection, often difficult to differentiate between bacterial and aseptic causes.
- Overlapping symptoms and pre-examination antibiotic use complicate diagnosis.
- Accurate differential diagnosis is crucial for appropriate treatment.
Purpose of the Study:
- To determine the diagnostic accuracy of TNF-α and IL-1β for differentiating bacterial from aseptic meningitis.
- To evaluate the utility of these cytokines as biomarkers in cerebrospinal fluid (CSF).
Main Methods:
- Systematic review and meta-analysis of studies published between January 1989 and July 2013.
- Inclusion of prospective or retrospective studies measuring CSF TNF-α and/or IL-1β concentrations.
- Statistical analysis using Revman and Meta-Disc.
Main Results:
- TNF-α demonstrated 80.5% sensitivity, 94.9% specificity, a diagnostic odds ratio (DOR) of 71.7, and an area under the curve (AUC) of 0.942.
- IL-1β showed 86.0% sensitivity, 92.3% specificity, a DOR of 53.5, and an AUC of 0.975.
- Both cytokines exhibited strong performance in differential diagnosis.
Conclusions:
- TNF-α and IL-1β are valuable predictive markers for bacterial meningitis.
- CSF levels of these cytokines provide an accurate method for differentiating bacterial from aseptic meningitis.
- These findings support the use of TNF-α and IL-1β in clinical diagnostics.
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