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Interleukin-6 in cerebrospinal fluid as a biomarker of acute meningitis
Pablo García-Hernández1, Belén Prieto2, Eduardo Martínez-Morillo2
1Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain pabgaher@gmail.com.
Background:
Microbiological culture of cerebrospinal fluid is the gold standard to differentiate between aseptic and bacterial meningitis, but this method has low sensitivity. A fast and reliable new marker would be of interest in clinical practice.
Objective:
Interleukin-6, secreted by T cells in response to meningeal pathogens and quickly delivered into cerebrospinal fluid, was evaluated as a marker of acute meningitis.
Design And Methods:
A total of 150 cerebrospinal fluid samples were analysed by an electrochemiluminescence method, selected according to patient diagnosis: (a) bacterial meningitis confirmed by positive culture (n = 26); (b) bacterial meningitis with negative culture or not performed (n = 15); (c) viral meningitis confirmed by polymerase chain reaction or immunoglobulin G determination (n = 23); (d) viral meningitis with polymerase chain reaction negative or not performed (n = 42); and (e) controls (n = 44).
Results:
Cerebrospinal fluid interleukin-6 concentration showed significant differences between all pathologic groups and the control group (P < 0.001). As a diagnostic tool for bacterial meningitis, interleukin-6 showed an area under the curve of 0.937 (95% confidence intervals: 0.895-0.978), significantly higher than those of classical biomarkers. An interleukin-6 cutoff of 1418 pg/mL showed 95.5% sensitivity and 77.5% specificity, whereas a value of 15,060 pg/mL showed 63.6% sensitivity and 96.7% specificity, for diagnosis of bacterial meningitis.
Conclusion:
Interleukin-6 measured by electrochemiluminescence method is a promising marker for early differentiation between aseptic and bacterial meningitis. More studies are needed to validate clinical implications for future practice in an emergency laboratory.
Insights
Interleukin-6 (IL-6) in cerebrospinal fluid shows promise for rapidly distinguishing bacterial meningitis from aseptic meningitis. This biomarker offers higher accuracy than traditional methods, aiding early clinical diagnosis.
Area of Science:
- Clinical diagnostics
- Biomarker discovery
- Infectious disease research
Background:
- Cerebrospinal fluid (CSF) culture is standard for meningitis diagnosis but lacks sensitivity.
- A rapid and sensitive diagnostic marker for meningitis is needed in clinical practice.
Purpose of the Study:
- To evaluate Interleukin-6 (IL-6) as a marker for acute meningitis.
- To assess IL-6's utility in differentiating between aseptic and bacterial meningitis.
Main Methods:
- Analyzed 150 CSF samples using electrochemiluminescence.
- Included patient groups with confirmed bacterial meningitis, viral meningitis, and controls.
- Compared IL-6 levels with traditional meningitis biomarkers.
Main Results:
- CSF IL-6 levels significantly differed between all pathological groups and controls (P < 0.001).
- IL-6 demonstrated an AUC of 0.937 for bacterial meningitis diagnosis, outperforming classical biomarkers.
- Specific IL-6 cutoffs showed high sensitivity and specificity for bacterial meningitis detection.
Conclusions:
- IL-6 measured by electrochemiluminescence is a potential early marker for differentiating meningitis types.
- Further research is required to confirm IL-6's clinical utility in emergency laboratory settings.
