334 CEREBROSPINAL FLUID (CSF) 6 INTERFERON (INF) TUMOUR NECROSIS FACTOR-|[alpha]| (TNF) AND INTERLEUKIN-1|[beta]| (1L-l|[beta]|) CONCENTRATIONS IN CHILDREN WITH TUBERCULOUS MENINGITIS (TBM)

摘要

CSF INF concentrations were determined on 76 occasions in 30 children (mean age 27.4 months) with TBM at varying intervals during the first month of treatment. The mean concentration during the 1st week of therapy was 780 pg/ml falling to 554 pg/ml in the 2nd week, 529 pg/ml in the 3rd weak and 269 pg/ml in the 4th week. TNFα and ID-1β concentrations were determined in 23 of these children on 56 occasions. TNFα was present in low, but detectable, concentration throughout the first month of therapy with, mean concentrations of 17.15 pg/ml, 11.39 pg/ml, 11.08 pg/ml and 11.19 pg/ml in the 1st, 2nd, 3rd and 4th weeks respectively. LL-1β concentrations fell from a mean of 51.56 pg/ml to 43.1 pg/ml, 41.7 pg/ml and 17.62 pg/ml in the 2nd, 3rd and 4th weeks of therapy. The persistence of these cytokines in the CSF for a prolonged period after starting therapy indicates an immune response fundamentally different from that in bacterial meningitis. Evaluation of these cytokines and others could provide insights into the molecular pathogenesis and antiinflammatory treatment of TBM.