Macrophage migration inhibitory factor in cerebrospinal fluid from patients with central nervous system infection.
Crit Care. 2009 Jun 26;13(3):R101
Authors: Ostergaard C, Benfield T
ABSTRACT: INTRODUCTION: Macrophage Migration Inhibitory Factor (MIF) plays an essential pathophysiological role in septic shock; however, its role in central nervous system infection (CNS) remains to be defined. METHODS: The aim of the present study was to investigate cerebrospinal fluid (CSF) levels of MIF in 171 patients clinically suspected of having meningitis on admission. Of these, 31 were found to have purulent meningitis with a known aetiology, 20 to have purulent meningitis with an unknown aetiology, 59 to have lymphocytic meningitis, and 11 to have encephalitis, whereas 50 were suspected of but had no evidence of CNS infection. RESULTS: CSF MIF levels were significantly higher in patients with purulent meningitis of known aetiology (8639 ng/L (3344-20600)) as compared to patients with purulent meningitis of unknown aetiology (2209 ng/L (1516-6550), Mann Whitney test, P=0.003), to patients with lymphocytic meningitis (1912 ng/L (1302-4105), P< 0.001), and to patients suspected but without evidence of CNS infection (1472 ng/L (672-3447), P< 0.001), respectively. Also, patients with encephalitis (6937 ng/L (3961-8353) had higher CSF MIF levels than patients without CNS infection (P<0.01). Among patients with purulent meningitis, CSF MIF levels were significantly higher in patients infected with pneumococci as compared to infection due to meningococci (11569 ng/L (8615-21935) vs. 5006 ng/L (1717-10905) respectively, P=0.02), in patients requiring assisted ventilation (10493 ng/L (5961-22725) vs. 3240ng/L (1563-9302), respectively, P=0.003), and in patients with impaired consciousness (8614 ng/L (3344-20935) vs. 2625 ng/L (1561-7530), respectively, P=0.02). CSF MIF levels correlated significantly to the meningeal inflammation (P<0.05), but not to the systemic inflammatory response (P>0.05) in patients with purulent meningitis of known aetiology, in patients with lymphocytic meningitis, and in patients with encephalitis. CONCLUSIONS: MIF was significantly increased in the CSF of patients with purulent meningitis and encephalitis and was to some degree associated with disease severity of the infection. Our results indicate that MIF may play an important role in CNS infection.
PMID: 19558639 [PubMed - as supplied by publisher]