Adhesion molecules profile in children with bacterial meningitis and sepsis

Abstract

Adhesion molecules play a role in leukocyte recruitment during central nervous system (CNS) inflammation. This study was designed to investigate the serum and cerebrospinal fluid (CSF) concentrations of adhesion molecules in children with bacterial meningitis for better understanding of their potential role in the pathophysiology of meningitis. Serum and CSF were collected on admission from 40 children who carried the diagnosis of bacterial meningitis. For comparison, age and sex matched 20 children with sepsis and 20 normal children were included as diseased and healthy control subjects, respectively. Endothelial (E) selectin, leukocyte (L) selectin, platelet (P) selectin, intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecules-1 (VCAM-1) were measured. CSF/serum of measured parameters was calculated to estimate ratio. In meningitis, serum soluble (s) sE-selectin, sL-selectin, sP-selectin, sICAM-1, sVCAM-1 was elevated than controls. Compared to sepsis, serum sE-selectin, sL-selectin, s-ICAM, sVCAM-1, CSF-sL-selectin, CSF-sVCAM-1 and sVCAM-1 ratio were elevated while serum sP-selectin was decreased in meningitis. In meningitis, positive correlation was found between CSF-protein and CSF-leukocytes, CSF-sICAM-1, CSF-sVCAM-1; between CSF-sE-selectin and CSF-sICAM-1. This study supports the role for adhesion molecules especially sL-selectin, sVCAM-1 in the pathophysiology of meningitis and suggests their use as biomarkers for meningitis. Presence of discrepancy of CSF/serum ratios for molecules of same molecular weight suggests intrathecal synthesis in addition to diffusion through the disrupted blood-brain barrier.