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Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory cytokine that is increased in the CSF of patients with bacterial meningitis. [1,2] Its biologic activity has been the subject of debate. [3] Human urine and serum contain proteins that can interfere with the functions of TNF-alpha. [4] Characterization of these inhibitors revealed two immunologically distinct TNF-alpha binding proteins; the same structures were part of the extramembranous fragments of two TNF-alpha receptors with apparent molecular weights of 55,000 to 60,000 and 75,000 to 80,000. [5] We investigated whether shedding of p60 soluble TNF receptor (sTNF-R) into CSF increases during acute bacterial and aseptic meningitis. In addition, we compared the p60 sTNF-R levels in the CSF of bacterial meningitis patients with and without neurologic sequelae.
Methods.
CSF samples were obtained from 13 children with bacterial meningitis (6 boys and 7 girls aged 8 days to 9 yr; mean, 1.7 yr), 13 children with aseptic meningitis (11 boys and 2 girls aged 1 mo to 11 yr; mean, 5.5 yr), and 12 afebrile children with nonpleocytotic CSF (6 boys and 6 girls aged 9 mo to 12 yr; mean, 4.8 yr) on admission to our hospital between 1984 and 1994. The day of onset …
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