Detection of Granulocyte-Macrophage Colony-Stimulating Factor in Cerebrospinal Fluid of Patients with Aseptic Meningitis

Abstract

The level of granulocyte-macrophage colony-stimulating factor (GM-CSF) in the cerebrospinal fluid from 14 infants and children with meningitis and 6 patients who suffered other diseases besides meningitis was measured by our sensitive enzyme linked immunosorbent assay for GM-CSF. The minimal detection level of GM-CSF was 40 pg/ml. Six of 9 patients (67%) with aseptic meningitis had detectable GM-CSF in cerebrospinal fluid and the concentrations of GM-CSF ranged from 49 to 114 pg/ml (mean 72 pg/ml), whereas none of 5 patients with bacterial meningitis or 6 patients with other diseases besides meningitis had detectable GM-CSF levels. There was no clear correlation between the GM-CSF levels in cerebrospinal fluid and the leukocyte count in either peripheral blood or cerebrospinal fluid, or the concentration of protein or glucose in cerebrospinal fluid.

Transient Elevation of Granulocyte Colony-Stimulating Factor Levels in Cerebrospinal Fluid at the Initial Stage of Aseptic Meningitis in Children

“…However, it is difficult at the initial stage to distinguish aseptic meningiti s from purulent meningitis by neutrophil counts alone. G-CSF in the cerebrospinal fluid increases in aseptic meningiti s. The peak levels reach 386 ng/L as shown in our study or 366 ng/L as reported by others (25). We also measured G-CSF levels in the cerebrospinal fluid in a case of pneumococcal purulent meningitis.…”

“…The G-CSF levels were 4700 ng/L on the third day of illness, 111 ng/L on the fifth day, and below sensitivity on the seventh day, when meningeal symptoms had disappeared. Shimoda et al (25) reported that G-CSF levels in the cerebrospinal fluid markedly increased and averaged 1500 ng/L in 10 of 11 cases of purulent meningitis. These levels-in both their investigation (25) and ours-in patients with purulent meningitis were significantly higher (p < 0.05) than those in our patient s with aseptic meningitis.…”

Intravenous Granulocyte Colony‐Stimulating Factor Increases the Release of Tumour Necrosis Factor and Interleukin‐1β into the Cerebrospinal Fluid, But Does Not Inhibit the Growth of Streptococcus pneumoniae in Experimental Meningitis

“…Unlike other cytokines such as TNF-␣ or IL-1 in another experiment [23], G-CSF injected i.c. did not cause migration of leucocytes into the subarachnoid space, although the concentrations which were presumably present in the CSF in this study (Ϸ 5 g/ml and 1 g/ml) assuming a CSF volume of 2 ml, were substantially higher than those observed in humans with bacterial meningitis (mean Ϸ 1500 pg/ml [6]). For this reason, G-CSF in CSF appears not to be directly involved in granulocyte recruitment or at least will not be the only substance being responsible for the recruitment of granulocytes.…”

“…G-CSF, and after migration into the central nervous system, release larger amounts of TNF and IL-1␤ into the CSF than leucocytes not activated by G-CSF. In humans, in the CSF increased levels of G-CSF were observed both in bacterial [6,21] and viral [22] central nervous system infections. Unlike other cytokines such as TNF-␣ or IL-1 in another experiment [23], G-CSF injected i.c.…”

“…It facilitates leucocyte adhesion [3] and diapedesis [4]. In humans, G-CSF is elevated in blood during systemic bacterial infections [5], and in the cerebrospinal fluid (CSF) during bacterial meningitis [6].…”