Adhesion molecule levels in serum and cerebrospinal fluid in children with bacterial meningitis and sepsis

Abstract

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.

Elevated Pro-Inflammatory Cell-Free MicroRNA Levels in Cerebrospinal Fluid of Premature Infants after Intraventricular Hemorrhage

“…Substantial decrease in IL-8 and VCAM-1 was shown for up to 60 days of IVH, while ICAM-1 did not change significantly [ 27 ]. This type of cytokine and the adhesion molecules above have been considered as sensitive markers of neuroinflammation and cell activation events not only in IVH [ 27 , 28 ] but also in SAH [ 15 ] and in bacterial sepsis with meningitis [ 16 ]. Based on a recent meta-analysis, chorioamnionitis was described as a risk factor for the development of IVH in very preterm infants [ 43 ].…”

“…Inflamed choroid plexus epithelium adhesion receptors, such as intercellular adhesion molecule-1 (ICAM-1), have been found to be upregulated [ 13 ], which regulates trafficking of immune cells with the help of P-selectin into the cerebral ventricles [ 14 ]. Clinically, the importance of this inflammatory mechanism has been further supported by previous observations of elevated ICAM-1, vascular adhesion molecule-1 (VCAM-1), and E-selectin levels in CSF in patients with subarachnoid hemorrhage (SAH) [ 15 ] and bacterial sepsis with meningitis [ 16 ].…”

Cerebral inflammation is an underlying mechanism of early death in Alzheimer’s disease: a 13-year cause-specific multivariate mortality study

“…We chose to measure cerebral inflammation by using sVCAM-1 levels in the CSF, based on previous validating studies [ 45 - 50 ]. sVCAM-1 is a cell-surface molecule that regulates leukocyte migration and is activated by proinflammatory factors such as cytokines and interleukins [ 49 ].…”

“…Moreover, it has been associated with glial activation (expressed on astrocytes) [ 47 ]. Numerous studies have associated increased levels of sVCAM-1 with several neuroinflammatory conditions, and it has been significantly correlated with inflammatory cerebral lesions assessed by using contrast MRI [ 45 - 50 ]. sVCAM-1 is also a well-proven marker of endothelial dysfunction and has been associated with atherosclerosis [ 51 ] and small-vessel disease [ 52 ].…”

Elevated levels of serum sICAM-1 in asphyxiated low birth weight newborns

“…The results of previous studies on the activation of intercellular adhesion molecules during hypoxia or during inflammation in response to infection in infants are controversial. Intercellular adhesion plays a significant role in the activation of the neonatal immune system, and measuring the concentrations of sICAM-1 can be used as a highly sensitive diagnostic tool in newborns suspected of infection 13 14 24 25 . Xanthou et al detected increases in the serum levels of sICAM-1 and other inflammatory markers in neonates who had experienced perinatal asphyxia 26 .…”