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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Total concentrations of amino acids, as measured by fluorometry of primary amino nitrogen with the use of fluorescamine, were determined in the cerebrospinal fluid (CSF) of 50 patients with purulent meningitis, 40 patients with aseptic meningitis, and 36 control subjects. On admission total concentrations of amino acids in the CSF were significantly higher in patients with purulent meningitis (mean +/- SEM, 2.27 +/- 0.27 mM) than in patients with aseptic meningitis (1.07 +/- 0.03 mM, P less than 0.001) or in control subjects (1.16 +/- 0.04 mM, P less than 0.001). This value was higher when the patients with purulent meningitis were reexamined one to two days later and reached a maximum after three to four days of illness. The fluorometry method proved to be simple, rapid, and precise and may be used as an additional test in diagnosing bacterial meningitis, especially in patients who are treated with antibiotics before admission. For patients with bacterial meningitis, a high concentration of amino acids in the CSF on admission may indicate a poor outcome.
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PMID:Increased total concentration of amino acids in the cerebrospinal fluid of patients with purulent meningitis. 706 80

Morbidity and mortality associated with bacterial meningitis remain high, although antibiotic therapy has improved during recent decades. The major intracranial complications of bacterial meningitis are cerebrovascular arterial and venous involvement, brain edema, and hydrocephalus with a subsequent increase of intracranial pressure. Experiments in animal models and cell culture systems have focused on the pathogenesis and pathophysiology of bacterial meningitis in an attempt to identify the bacterial and/or host factors responsible for brain injury during the course of infection. An international workshop entitled "Bacterial Meningitis: Mechanisms of Brain Injury" was organized by the Department of Neurology at the University of Munich and was held in Eibsee, Germany, in June 1993. This conference provided a forum for the exchange of current information on bacterial meningitis, including data on the clinical spectrum of complications, the associated morphological alterations, the role of soluble inflammatory mediators (in particular cytokines) and of leukocyte-endothelial cell interactions in tissue injury, and the molecular mechanisms of neuronal injury, with potential mediators such as reactive oxygen species, reactive nitrogen species, and excitatory amino acids. It is hoped that a better understanding of the pathophysiological events that take place during bacterial meningitis will lead to the development of new therapeutic regimens.
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PMID:Mechanisms of brain injury in bacterial meningitis: workshop summary. 781 66

IL-10, a potent immunosuppressive cytokine, leads to macrophage/monocyte deactivation, inhibiting the production of cytokines and the release of reactive oxygen species and reactive nitrogen intermediates, which are known to be involved in the pathophysiology of bacterial meningitis. We investigated the effect of IL-10 on regional cerebral blood flow, intracranial pressure, cerebrospinal fluid (CSF) white blood cell count, and brain water content within 6 h after intracisternal (i.c.) pneumococcal challenge in a rat model of meningitis. Compared with IL-10 vehicle-injected infected rats, i.p. administration of 5 microg of IL-10 significantly attenuated the increase in regional cerebral blood flow, brain water content, intracranial pressure, and CSF white blood cell count, whereas a lower dosage of IL-10 (0.5 microg) was ineffective. The inhibitory effect of IL-10 (5 microg) was observed irrespective of time of IL-10 administration: just before, 1 h after, or 4 h after pneumococcal challenge. In contrast, i.c. application of IL-10 (5 microg) did not modulate these pathophysiologic parameters, and even augmented CSF pleocytosis. Moreover, i.c. injection of IL-10 alone induced meningeal inflammation in uninfected rats. IL-10 injected i.p., but not i.c., markedly inhibited the increase in IL-6 levels, as determined in CSF of infected animals. IL-10 suppressed the increase of nitrite concentration in cell culture supernatant of primary rat cerebral endothelial cells when stimulated with heat-killed pneumococci. The possible modes of action of IL-10 in pneumococcal meningitis may involve its interference with the production of nitric oxide or IL-6.
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PMID:Systemically (but not intrathecally) administered IL-10 attenuates pathophysiologic alterations in experimental pneumococcal meningitis. 894 31

Fifty years after the advent of antibiotics for clinical use, the rates of morbidity and mortality associated with bacterial meningitis remain high. The unfavourable clinical outcome is often due to intracranial complications including cerebrovascular insults, raised intracranial pressure, hydrocephalus, and brain edema. Reactive oxygen species (ROS) are known effector molecules in the antimicrobial armature of polymorphonuclear and mononuclear phagocytes. However, over the last decade, there has been a substantial body of work implicating a central role of ROS in the development of intracranial complications and brain damage in bacterial meningitis. Recently, it also became evident that reactive nitrogen species (RNS), especially nitric oxide, are important mediators of meningitis-associated pathophysiological changes, at least during the early phase of the disease. There is now substantial evidence that much of the oxidative injury associated by simultaneous production of superoxide and nitric oxide is mediated by the strong oxidant peroxynitrite. ROS and peroxynitrite can be cytotoxic via a number of independent mechanisms. Their cytotoxic effects include initiation of lipid peroxidation and induction of DNA single strand breakage. Damaged DNA activates poly(ADP-ribose) polymerase (PARP). Recent experimental data propose a role of lipid peroxidation and PARP activation in the development of meningitis-associated intracranial complications and brain injury. Agents which interfere with the production of ROS and peroxynitrite, as well as with PARP activation and lipid peroxidation may represent novel, therapeutic strategies to limit meningitis-associated brain damage, and, thus, to improve the outcome of this serious disease.
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PMID:Oxidative stress in bacterial meningitis. 998 52

Recent major epidemiologic trends in bacterial meningitis include a dramatic decline in the incidence of Haemophilus influenzae meningitis since the introduction of the protein-conjugated H. influenzae vaccines, and a worldwide increase in infections with antibiotic-resistant strains of bacterial pathogens. Cases of meningitis caused by resistant strains require an alternative therapeutic strategy. Animal studies have identified inflammatory mediators, eg, chemokines, excitatory amino acids, and endothelins, which are involved in the pathophysiology of bacterial meningitis. There is increasing evidence that reactive oxygen species (ROS), reactive nitrogen species, peroxynitrite, and matrix metalloproteinases contribute to brain damage during bacterial meningitis. The cytotoxic effects of ROS and peroxynitrite include the initiation of lipid peroxidation and the induction of DNA single-strand breakage. Damaged DNA activates poly(ADP-ribose) polymerase (PARP). Recent experimental data suggest that lipid peroxidation and PARP activation play a role in the development of meningitis-associated intracranial complications and brain injury. Agents that interfere with the production of ROS and peroxynitrite, and interfere with lipid peroxidation and PARP activation, may represent novel, therapeutic strategies by which meningitis-associated brain damage can be limited, therefore improving the outcome of this serious disease.
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PMID:Acute Meningitis. 1109 82

Sensorineural hearing damage is a frequent complication of bacterial meningitis, affecting as many as 30% of survivors of pneumococcal meningitis. There is a substantial body of evidence that oxidants, such as reactive nitrogen species (RNS), are central mediators of brain damage in experimental bacterial meningitis. In the present study, we investigated whether RNS also contribute to the pathophysiology of suppurative labyrinthitis in our well-established rat model of pneumococcal meningitis. In all infected rats, but not in uninfected controls, we observed suppurative labyrinthitis. Cochlear inflammation was accompanied by severe blood-labyrinth barrier (BLB) disruption as evidenced by increased Evans Blue extravasation. Furthermore, increased cochlear expression of endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) was detected by immunohistochemistry. Colocalization of iNOS and tyrosine nitration (a marker of RNS attack) indicated that nitric oxide (NO) produced by iNOS contributes to oxidative cochlear damage through the action of RNS. To determine the pathophysiological role of RNS in BLB disruption, rats were treated with peroxynitrite scavengers (MnTBAP and uric acid, UA). Six h after adjunctive treatment with 300 mg/kg i.p. UA or 15 mg/kg i.p. MnTBAP+100 mg/kg i.p. ceftriaxone, BLB disruption was significantly reduced compared with that in infected animals treated only with ceftriaxone. Therefore, we conclude that RNS are involved in the breaching of the BLB during meningogenic pneumococcal labyrinthitis.
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PMID:Reactive nitrogen species contribute to blood-labyrinth barrier disruption in suppurative labyrinthitis complicating experimental pneumococcal meningitis in the rat. 1140 18

The major aetiological agent of human bacterial meningitis is Neisseria meningitidis. During the course of disease and host colonization, the bacterium has to withstand limited oxygen availability. Nitrogen oxide and nitrogen oxyanions are thought to be present, which may constitute an alternative sink for electrons from the N. meningitidis respiratory chain. A partial denitrification pathway is encoded by the aniA nitrite reductase gene and the norB nitric oxide reductase gene. Analysis of the completed genome sequences of two N. meningitidis strains is used to generate a model for the membrane-associated respiratory chain of this organism. Analysis of aniA expression indicates it to be controlled primarily by oxygen and secondarily by nitrite. The ability of N. meningitidis to denitrify relies on microaerobic growth conditions. Here we show that under microaerobic conditions nitrite supplements oxygen as an alternative respiratory substrate.
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PMID:Microaerobic denitrification in Neisseria meningitidis. 1566 85

Reactive oxygen and nitrogen species are produced by the human immune system in response to infection. Methods to detoxify these reactive species are vital to the survival of human pathogens, such as Neisseria meningitidis, which is the major aetiological agent of bacterial meningitis. Following activation, macrophages produce superoxide (O(2)(-)), hydrogen peroxide (H(2)O(2)) and nitric oxide (NO). The toxicity of O(2)(-), generated using X/Xo (xanthine/xanthine oxidase), and H(2)O(2) was investigated in the presence and absence of the NO donor DEA-NONOate [2-(N,N-diethylamino)-diazenolate-2-oxide diethylammonium salt]. Most of the toxicity from X/Xo was due to H(2)O(2). In N. meningitidis, NO decreased the toxicity of the H(2)O(2). In contrast, in the enteric bacterium Escherichia coli, NO increased the toxicity of the H(2)O(2).
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PMID:Effect of combined oxidative and nitrosative stress on Neisseria meningitidis. 1641 21

In bacterial meningitis, chemokines lead to recruitment of polymorphonuclear leucocytes (PMN) into the CNS. At the site of infection in the subarachnoid space, PMN release reactive oxygen species, reactive nitrogen intermediates (RNI) and interleukin-1beta (IL-1beta). Although these immune factors assist in clearance of bacteria, they also result in neuronal injury associated with meningitis. Transforming growth factor beta (TGFbeta) is a potent deactivator of PMN and macrophages since TGFbeta suppresses the production of ROI, RNI and IL-1. Here, we report that the deletion of the TGFbeta receptor II gene in PMN enhances PMN recruitment into the CNS of mice with Streptococcus pneumoniae meningitis. This was associated with more efficient clearance of bacteria, and almost complete prevention of intracerebral necrotizing vasculitis. Differences in PMN in the CNS of infected control mice and mice lacking TGFbeta receptor II were not explained by altered expression of chemokines acting on PMN. Instead, TGFbeta was found to impair the expression of L (leucocyte)-selectin on PMN from control mice but not from mice lacking TGFbeta receptor II. L-selectin is known to be essential for PMN recruitment in bacterial meningitis. We conclude that defective TGFbeta signalling in PMN is beneficial in bacterial meningitis by ameliorating migration of PMN and bacterial clearance.
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PMID:TGFbeta receptor II gene deletion in leucocytes prevents cerebral vasculitis in bacterial meningitis. 1689 35

Despite antibiotic therapy, supportive intensive care, and adjunctive treatment with dexamethasone, the mortality and morbidity remain high in patients with bacterial meningitis. The intracranial complications that mainly contribute to the poor outcome are in part a result of the production of reactive oxygen and nitrogen species. Experimental studies have shown that the prognosis for bacterial meningitis can be improved by the administration of antioxidants. Especially adjunctive therapy with N-acetyl-L-cystein (NAC) was shown to have mainly positive effects. Since NAC is already in clinical use in high doses for treating other diseases (e.g., acetaminophen intoxication) and only minor side effects have been observed, there is justified hope that adjunctive therapy with NAC could improve the prognosis of patients with bacterial meningitis.
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PMID:[N-acetyl-L-cysteine as a therapeutic option in bacterial meningitis]. 1723 23


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