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Substances which modulate leukocyte migration are present in CSF during meningitis
Abstract:
We studied the effects on in vitro leukocyte migration of cerebrospinal fluid from 14 patients with and 7 patients without meningitis. Meningitic CSF, but not control CSF, contained activity that was chemotactic for peripheral blood leukocytes. In an unusual case of staphylococcal meningitis associated with a blunted CSF pleocytosis and a poor clinical response to antibiotics, an inhibitor of leukocyte chemotaxis was identified in the CSF. This inhibitor may have diminished local leukocyte accumulation in vivo and thereby adversely affected host defense mechanisms and clinical outcome. No inhibitors were found in other CSF samples tested. Soluble mediators present in CSF may modulate the local accumulation of leukocytes and therefore affect host defenses in meningitis.
Insights
Cerebrospinal fluid from meningitis patients attracts leukocytes. An unusual case revealed a leukocyte chemotaxis inhibitor in CSF, potentially impairing host defenses against staphylococcal meningitis.
Area of Science:
- Immunology
- Neuroscience
- Infectious Diseases
Background:
- Meningitis involves inflammation of the membranes surrounding the brain and spinal cord.
- Leukocyte migration to the central nervous system is crucial for combating infection.
- Cerebrospinal fluid (CSF) composition can reflect inflammatory and infectious processes.
Purpose of the Study:
- To investigate the effects of cerebrospinal fluid (CSF) from meningitis patients on leukocyte migration in vitro.
- To identify potential chemotactic factors or inhibitors within CSF that influence leukocyte behavior.
- To explore the role of CSF mediators in host defense mechanisms during meningitis.
Main Methods:
- Collected CSF samples from 14 patients with meningitis and 7 control individuals without meningitis.
- Assessed the chemotactic activity of CSF on peripheral blood leukocytes using in vitro migration assays.
- Screened CSF samples for the presence of inhibitors of leukocyte chemotaxis.
Main Results:
- CSF from meningitis patients demonstrated chemotactic activity for peripheral blood leukocytes.
- Control CSF did not exhibit significant chemotactic activity.
- An inhibitor of leukocyte chemotaxis was identified in the CSF of one patient with staphylococcal meningitis, characterized by blunted pleocytosis and poor antibiotic response.
Conclusions:
- Meningitic CSF contains factors that promote leukocyte migration, suggesting a role in the inflammatory response.
- The identified CSF inhibitor may impair leukocyte accumulation, potentially compromising host defense in specific meningitis cases.
- Soluble mediators in CSF can modulate leukocyte accumulation, significantly impacting host defense and clinical outcomes in meningitis.