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Relationship between Severity of Aseptic Meningitis and Cerebrospinal Fluid Cytokine Levels
Insights
Mumps meningitis (MM) is more severe than other viral meningitis (EM), indicated by higher cytokine levels in cerebrospinal fluid (CSF). Interferon-gamma (IFN-γ) may serve as a key biomarker for MM severity.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Immunology
Background:
- Severe aseptic meningitis presents challenges in pediatric care, often with prolonged symptoms.
- Current treatment lacks established guidelines, relying on supportive care.
- Biomarker investigation is crucial for understanding disease severity.
Purpose of the Study:
- To investigate the relationship between disease severity and biomarkers in pediatric aseptic meningitis.
- To differentiate severity between mumps meningitis (MM) and other viral meningitis (EM).
Main Methods:
- Retrospective analysis of 32 children (0-14 years) with aseptic meningitis.
- Development of an aseptic meningitis severity score (AMSS).
- Analysis of cytokine profiles in cerebrospinal fluid (CSF).
Main Results:
- Mumps meningitis (MM) showed a significantly higher AMSS compared to other viral meningitis (EM).
- Elevated levels of IL-4, IL-6, IL-8, IL-10, and G-CSF were observed in the CSF of both MM and EM patients compared to controls.
- Interferon-gamma (IFN-γ) levels were significantly higher in MM patients compared to controls and EM patients.
Conclusions:
- Mumps meningitis (MM) is a more severe form of aseptic meningitis than EM.
- Higher CSF cytokine levels, particularly IFN-γ, are associated with MM severity.
- IFN-γ shows potential as a biomarker for identifying severe mumps meningitis.
Background:
Pediatricians sometimes see patients with severe aseptic meningitis and prolonged fever or severe headache, or both. This condition generally has a good prognosis and is usually treated with supportive therapy. However, there is neither guideline nor consensus for the treatment of patients with severe aseptic meningitis. Here, we investigated the relationship between disease severity and biomarkers.
Methods:
The subjects were 32 children aged 0 to 14 years, 23 of whom had aseptic meningitis and 9 of whom were meningitis-free controls. Aseptic meningitis was retrospectively categorized into two subgroups, namely mumps meningitis (MM) and viral meningitis excluding that caused by mumps (EM). We defined a novel aseptic meningitis severity score (AMSS) from the signs and symptoms of aseptic meningitis and thus evaluated disease severity. We analyzed the profiles of cytokines in the patients' cerebrospinal fluid (CSF).
Results:
The AMSS in MM was significantly higher than that in EM. IL-4, IL-6, IL-8, IL-10, and G-CSF levels in MM and EM CSF were higher than those in control CSF. IFN-γ levels were higher in MM than in controls (p<0.01). IL-10 and IFN-γ levels in MM were higher than those in EM.
Conclusions:
MM was more severe than EM. One likely reason is the higher CSF cytokine levels in MM. IFN-γ may be a potentially strong biomarker of MM severity. Our findings would help further understanding
