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Guy E. Thwaites, Cameron P. Simmons, Nguyen Than Ha Quyen, Tran Thi Hong Chau, Pham Phuong Mai, Nguyen Thi Dung, Nguyen Hoan Phu, Nicholas P. White, Tran Tinh Hien, Jeremy J. Farrar, Pathophysiology and Prognosis in Vietnamese Adults with Tuberculous Meningitis, The Journal of Infectious Diseases, Volume 188, Issue 8, 15 October 2003, Pages 1105–1115, https://doi.org/10.1086/378642
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Abstract
The pathogenesis of tuberculous meningitis remains unclear, and there are few data describing the kinetics of the immune response during the course of its treatment. We measured concentrations of pro- and anti-inflammatory cytokines in serial blood and cerebrospinal fluid (CSF) samples from 21 adults who were being treated for tuberculous meningitis. CSF concentrations of soluble tumor necrosis factor–α receptors and of matrix metalloprotein–9 and its tissue inhibitor were also measured, and blood-brain barrier permeability was assessed by the albumin and IgG partition indices. CSF concentrations of lactate, interleukin-8, and interferon-γ were high before treatment and then decreased rapidly with antituberculosis chemotherapy. However, significant immune activation and blood-brain barrier dysfunction were still apparent after 60 days of treatment. Death was associated with high initial CSF concentrations of lactate, low numbers of white blood cells, in particular neutrophils, and low CSF glucose levels
- anti-inflammatory agents
- cytokine
- tumor necrosis factors
- albumins
- immune response
- chemotherapy regimen
- glucose
- adult
- antitubercular agents
- blood-brain barrier
- interferons
- interleukin-8
- lactates
- leukocytes
- metalloproteins
- neutrophils
- permeability
- tuberculous meningitis
- immunoglobulin g
- cerebrospinal fluid
- kinetics
- human leukocyte interferon