A diagnostic test based on cytokine profile could help distinguish between infection and other diseases.
A rapid test involving cerebrospinal fluid (CSF) cytokine analysis could be used as one of the first diagnostic tests to rapidly differentiate serious brain infections from other disorders affecting the brain.
Cytokines are substances produced by the patient’s immune system in response to pathogens and other injury processes.
This new test from CSF – which is the fluid that keeps the three-layered covering of the brain lubricated – could help in early diagnosis and treatment in serious infections of the brain. These include meningitis (inflammation of the coverings of the brain) and encephalitis ( inflammation in the brain cells).
WORLDWIDE, MENINGITIS AND ENCEPHALITIS AFFECT MORE THAN FOUR MILLION ADULTS AND CHILDREN EACH YEAR
Time is of essence in brain infections as patients can deteriorate rapidly within hours and may suffer irreversible brain damage, if not quickly treated with appropriate drugs. This diagnostic test could prove particularly useful in infants and young children.
The results were published in the journal PLOS ONE.
“Infectious agents activate a multi-pronged inflammatory response, a key component of which is the release of different combinations of cytokines tailored to combat pathogens. Changes in cytokine levels of cerebrospinal fluid offer a very early measurable sign of infection,” said Mark Curtis, MD, PhD, Associate Professor of Pathology, Anatomy and Cell Biology.
In this analysis, the investigators looked at samples collected from 43 patients who had received spinal taps during their hospital stays. The researchers then tested the CSF for the presence of 41 different cytokines and noticed that patients with confirmed infection of the central nervous system had a different cytokine fingerprint from those confirmed as having tumors or autoimmune disease. Additionally, the CSF cytokine fingerprint was different in cases of viral infection compared to those with non-viral pathogens, such as bacteria or fungi.
“With only a small amount of spinal fluid needed, CSF cytokine analysis could be used as one of the first diagnostic tests to rapidly triage serious central nervous system disorders and guide immediate intervention,” said first author, Danielle Fortuna, MD, an Assistant Professor, in the Department of Pathology and Laboratory Medicine, at the Hospital of the University of Pennsylvania.
Worldwide, Meningitis and encephalitis affect more than four million adults and children each year. “In addition, the test could distinguish viral from non-viral infections, a distinction that could spare a child with a viral infection from an unnecessary course of antibiotics, and tailor the care toward antiviral and supportive measures as needed,” added Dr. Curtis.
Further validation of the findings in a large study that includes both adults and children is planned.
