Infection with H. pylori seems to occur early in life and its prevalence increased with age in Jeddah, Saudi Arabia. The risk of H. pylori infection was significantly increased within children suffering from chronic hemolytic anemia; neurological impairment compared to controls and was significantly related to severity of the chronic disease.

Background:Adhesion molecules play a role in leukocyte recruitment during central nervous system (CNS) inflammation.Aim:This study was designed to compare serum, cerebrospinal fluid (CSF) concentrations of adhesion molecules in children with meningitis and sepsis, and to evaluate their sources.Setting:This study was carried out at Pediatric Department, King Abdulaziz University Hospital from January 2007 to June 2008.Design:Serum and CSF samples were collected on admission from meningitis (n = 40), sepsis (n = 20) patients, and sera from controls (n = 20).Materials and Methods:Endothelial (E), leukocyte (L), platelet (P) selectins intercellular cell adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecules-1 (VCAM-1) were measured using ELISA.Statistics:ANOVA and Spearman's correlations were used. Adhesion molecules with albumin concentration were estimated in CSF/serum to calculate concentration quotients.Results:In meningitis, serum sE-, sL-, sP-selectins sICAM-1, sVCAM-1 levels were higher than controls. Compared to sepsis, serum sE-selectin, sL-selectin, sVCAM-1, CSF-sL-selectin, CSF-sVCAM-1, VCAM-1 ratio and index were higher, while serum sP-selectin was lower than meningitis. sE-selectin ratio, CSF sICAM-1 were higher in meningitis with positive than negative culture. The sE-selectin index was higher in meningitis with neurological complication than those without it. In meningitis, correlation was found between CSF protein and CSF white blood cell counts (WBCs), CSF sICAM-1, CSF sVCAM-1 and between CSF sE-selectin and CSF sICAM-1.Conclusions:This study supports the role of adhesion molecules especially sL-selectin, sVCAM-1 in meningitis and suggests further research to determine their use as biomarkers for meningitis and use of their antagonists as therapeutic for CNS inflammation. The presence of discrepancy of CSF/serum ratios for molecules of same molecular weight suggest intrathecal shedding in addition to diffusion through the blood-CSF barrier.

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.