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Endogenously formed cytokines may play an important role in the development of meningitis, and it is necessary to understand in more detail inflammatory cascades involved in the disease process. We were interested to investigate biochemical changes which are inducible by interferon gamma. Therefore, we exa­mined concentrations of neopterin, tryptophan, kynurenine and interferon gamma in cerebrospinal fluid (CSF) of 11 children with bacterial or viral meningitis and of 20 children with febrile convulsions, who suffered from viral or bacterial disease not involving the central nervous system. Concentrations of neopterin (mean ± S.D.: 43.9 ± 34.6 nmol/l) kyunrenine (0.41 ± 0.56 μmol/l) and interferon gamma (0.64 ± 0.81 U/ml) levels were higher in CSF of children with meningitis than in those with febrile convulsions (all p&lt;0.01). In addition, positive correlations resulted between increase of neopterin and changes of tryptophan metabolism in the CSF. Interestingly no difference was found between viral and bacterial meningitis. Our findings indicate that intrathecal immune activation takes place as part of the pathogenesis of meningitis.

pteridines

Interferon Gamma-induced Formation of Neopterin and Degradation of Tryptophan in Cerebrospinal Fluid of Children with Meningitis but Not with Febrile Convulsions