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Characteristic Cytokine and Chemokine Profiles in Encephalitis of Infectious, Immune-Mediated, and Unknown Aetiology.
- Source :
-
PloS one [PLoS One] 2016 Jan 25; Vol. 11 (1), pp. e0146288. Date of Electronic Publication: 2016 Jan 25 (Print Publication: 2016). - Publication Year :
- 2016
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Abstract
- Background: Encephalitis is parenchymal brain inflammation due to infectious or immune-mediated processes. However, in 15-60% the cause remains unknown. This study aimed to determine if the cytokine/chemokine-mediated host response can distinguish infectious from immune-mediated cases, and whether this may give a clue to aetiology in those of unknown cause.<br />Methods: We measured 38 mediators in serum and cerebrospinal fluid (CSF) of patients from the Health Protection Agency Encephalitis Study. Of serum from 78 patients, 38 had infectious, 20 immune-mediated, and 20 unknown aetiology. Of CSF from 37 patients, 20 had infectious, nine immune-mediated and eight unknown aetiology.<br />Results: Heat-map analysis of CSF mediator interactions was different for infectious and immune-mediated cases, and that of the unknown aetiology group was similar to the infectious pattern. Higher myeloperoxidase (MPO) concentrations were found in infectious than immune-mediated cases, in serum and CSF (p = 0.01 and p = 0.006). Serum MPO was also higher in unknown than immune-mediated cases (p = 0.03). Multivariate analysis selected serum MPO; classifying 31 (91%) as infectious (p = 0.008) and 17 (85%) as unknown (p = 0.009) as opposed to immune-mediated. CSF data also selected MPO classifying 11 (85%) as infectious as opposed to immune-mediated (p = 0.036). CSF neutrophils were detected in eight (62%) infective and one (14%) immune-mediated cases (p = 0.004); CSF MPO correlated with neutrophils (p<0.0001).<br />Conclusions: Mediator profiles of infectious aetiology differed from immune-mediated encephalitis; and those of unknown cause were similar to infectious cases, raising the hypothesis of a possible undiagnosed infectious cause. Particularly, neutrophils and MPO merit further investigation.
- Subjects :
- Adult
Bacterial Infections blood
Bacterial Infections cerebrospinal fluid
Biomarkers
Cell Adhesion Molecules blood
Cell Adhesion Molecules cerebrospinal fluid
Chemokines cerebrospinal fluid
Chemokines classification
Diagnosis, Differential
Encephalitis etiology
Encephalitis immunology
Encephalitis, Viral blood
Encephalitis, Viral cerebrospinal fluid
Encephalitis, Viral diagnosis
England epidemiology
Female
Humans
Infectious Encephalitis blood
Infectious Encephalitis cerebrospinal fluid
Infectious Encephalitis diagnosis
Leukocyte Count
Male
Multicenter Studies as Topic
Mycoses blood
Mycoses cerebrospinal fluid
Mycoses diagnosis
Paraneoplastic Syndromes, Nervous System blood
Paraneoplastic Syndromes, Nervous System cerebrospinal fluid
Paraneoplastic Syndromes, Nervous System diagnosis
Peroxidase blood
Peroxidase cerebrospinal fluid
Retrospective Studies
Toxoplasmosis, Cerebral blood
Toxoplasmosis, Cerebral cerebrospinal fluid
Toxoplasmosis, Cerebral diagnosis
Cytokines blood
Cytokines cerebrospinal fluid
Encephalitis blood
Encephalitis cerebrospinal fluid
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 26808276
- Full Text :
- https://doi.org/10.1371/journal.pone.0146288