化膿性髄膜炎患児の髄液中インターロイキン12の検討

Abstract

We measured IL-12 concentrations in the CSF of patients with purulent meningitis. Twenty-three infants who were admitted between 1997 and 2003 and diagnosed as having purulent meningitis were included in this study. All patients in this study were admitted by the 3rd day of illness. After admission, appropriate antibiotics were administered to all infants. Two infants died and two other infants developed cerebral palsy and mental retardation (adverse outcome group). None of the other patients showed any neurologic abnormalities at discharge (good outcome group). As a control group, 16 infants who were diagnosed with diseases other than purulent meningitis were also investigated. The CSF IL-12 p40 concentrations in meningitis infants on admission (median [range], 1,890 [< 15-7,770] pg/ml) were significantly higher compared with those in the control group (p < 0.001). Among infants with meningitis, there were no significant differences on admission between patients with adverse outcome group and those with good outcome group. Consecutive measurements were performed in 17 infants with meningitis including the 2 infants with adverse outcome group. The concentration in the infants with adverse outcome group seemed to decrease more gradually than that in those with good outcome group. IL-12 induces production of interferon-gamma, which enhances the function of polymorphonuclear leukocytes. IL-12 may contribute to local host defenses in the subarachnoid space.