Do Intracerebral Cytokine Responses Explain the Harmful Effects of Dexamethasone in Human Immunodeficiency Virus–associated Cryptococcal Meningitis? | Zendy

Justin Beardsley | Zendy; Nhat Le Thanh Hoang | Zendy; Freddie Kibengo | Zendy; Nguyen Le Nhu Tung | Zendy; Trần Quang Bình | Zendy; Le Quoc Hung | Zendy; Wirongrong Chierakul | Zendy; Guy Thwaites | Zendy; Nguyễn Văn Vĩnh Châu | Zendy; Thuong Thuong Nguyen | Zendy; Ronald B. Geskus | Zendy; Jeremy Day | Zendy

Open Access

Do Intracerebral Cytokine Responses Explain the Harmful Effects of Dexamethasone in Human Immunodeficiency Virus–associated Cryptococcal Meningitis?

Author(s) -

Justin Beardsley,

Nhat Le Thanh Hoang,

Freddie Kibengo,

Nguyen Le Nhu Tung,

Trần Quang Bình,

Le Quoc Hung,

Wirongrong Chierakul,

Guy Thwaites,

Nguyễn Văn Vĩnh Châu,

Thuong Thuong Nguyen,

Ronald B. Geskus,

Jeremy Day

Publication year - 2018

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1093/cid/ciy725

Subject(s) - dexamethasone , medicine , immunology , proinflammatory cytokine , cytokine , meningitis , context (archaeology) , cerebrospinal fluid , inflammation , biology , surgery , paleontology

The CryptoDex trial showed that dexamethasone caused poorer clinical outcomes and slowed fungal clearance in human immunodeficiency virus-associated cryptococcal meningitis. We analyzed cerebrospinal fluid (CSF) cytokine concentrations from participants over the first week of treatment to investigate mechanisms of harm and test 2 hypotheses: (1) dexamethasone reduced proinflammatory cytokine concentrations, leading to poorer outcomes and (2) leukotriene A4 hydrolase (LTA4H) genotype influenced the clinical impact of dexamethasone, as observed in tuberculous meningitis.

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