Pathophysiology and Prognosis in Vietnamese Adults with Tuberculous Meningitis

Guy E. Thwaites, Cameron P. Simmons, Nguyen Than Ha Quyen, Tran Thi Hong Chau, Pham Phuong Mai, Nguyen Thi Dung, Nguyen Hoan Phu, Nicholas P. White, Tran Tinh Hien, Jeremy J. Farrar

Research output: Contribution to journalArticleResearchpeer-review

Abstract

The pathogenesis of tuberculous meningitis remains unclear, and there are few data describing the kinetics of the immune response during the course of its treatment. We measured concentrations of pro- and anti-inflammatory cytokines in serial blood and cerebrospinal fluid (CSF) samples from 21 adults who were being treated for tuberculous meningitis. CSF concentrations of soluble tumor necrosis factor-α receptors and of matrix metalloprotein-9 and its tissue inhibitor were also measured, and blood-brain barrier permeability was assessed by the albumin and IgG partition indices. CSF concentrations of lactate, interleukin-8, and interferon-γ were high before treatment and then decreased rapidly with antituberculosis chemotherapy. However, significant immune activation and blood-brain barrier dysfunction were still apparent after 60 days of treatment. Death was associated with high initial CSF concentrations of lactate, low numbers of white blood cells, in particular neutrophils, and low CSF glucose levels.

Original languageEnglish
Pages (from-to)1105-1115
Number of pages11
JournalJournal of Infectious Diseases
Volume188
Issue number8
DOIs
Publication statusPublished - 15 Oct 2003

Cite this

Thwaites, G. E., Simmons, C. P., Quyen, N. T. H., Chau, T. T. H., Mai, P. P., Dung, N. T., ... Farrar, J. J. (2003). Pathophysiology and Prognosis in Vietnamese Adults with Tuberculous Meningitis. Journal of Infectious Diseases, 188(8), 1105-1115. https://doi.org/10.1086/378642
Thwaites, Guy E. ; Simmons, Cameron P. ; Quyen, Nguyen Than Ha ; Chau, Tran Thi Hong ; Mai, Pham Phuong ; Dung, Nguyen Thi ; Phu, Nguyen Hoan ; White, Nicholas P. ; Hien, Tran Tinh ; Farrar, Jeremy J. / Pathophysiology and Prognosis in Vietnamese Adults with Tuberculous Meningitis. In: Journal of Infectious Diseases. 2003 ; Vol. 188, No. 8. pp. 1105-1115.
@article{ed9380e8adac426bac65b553ffb37c45,
title = "Pathophysiology and Prognosis in Vietnamese Adults with Tuberculous Meningitis",
abstract = "The pathogenesis of tuberculous meningitis remains unclear, and there are few data describing the kinetics of the immune response during the course of its treatment. We measured concentrations of pro- and anti-inflammatory cytokines in serial blood and cerebrospinal fluid (CSF) samples from 21 adults who were being treated for tuberculous meningitis. CSF concentrations of soluble tumor necrosis factor-α receptors and of matrix metalloprotein-9 and its tissue inhibitor were also measured, and blood-brain barrier permeability was assessed by the albumin and IgG partition indices. CSF concentrations of lactate, interleukin-8, and interferon-γ were high before treatment and then decreased rapidly with antituberculosis chemotherapy. However, significant immune activation and blood-brain barrier dysfunction were still apparent after 60 days of treatment. Death was associated with high initial CSF concentrations of lactate, low numbers of white blood cells, in particular neutrophils, and low CSF glucose levels.",
author = "Thwaites, {Guy E.} and Simmons, {Cameron P.} and Quyen, {Nguyen Than Ha} and Chau, {Tran Thi Hong} and Mai, {Pham Phuong} and Dung, {Nguyen Thi} and Phu, {Nguyen Hoan} and White, {Nicholas P.} and Hien, {Tran Tinh} and Farrar, {Jeremy J.}",
year = "2003",
month = "10",
day = "15",
doi = "10.1086/378642",
language = "English",
volume = "188",
pages = "1105--1115",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "8",

}

Thwaites, GE, Simmons, CP, Quyen, NTH, Chau, TTH, Mai, PP, Dung, NT, Phu, NH, White, NP, Hien, TT & Farrar, JJ 2003, 'Pathophysiology and Prognosis in Vietnamese Adults with Tuberculous Meningitis', Journal of Infectious Diseases, vol. 188, no. 8, pp. 1105-1115. https://doi.org/10.1086/378642

Pathophysiology and Prognosis in Vietnamese Adults with Tuberculous Meningitis. / Thwaites, Guy E.; Simmons, Cameron P.; Quyen, Nguyen Than Ha; Chau, Tran Thi Hong; Mai, Pham Phuong; Dung, Nguyen Thi; Phu, Nguyen Hoan; White, Nicholas P.; Hien, Tran Tinh; Farrar, Jeremy J.

In: Journal of Infectious Diseases, Vol. 188, No. 8, 15.10.2003, p. 1105-1115.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Pathophysiology and Prognosis in Vietnamese Adults with Tuberculous Meningitis

AU - Thwaites, Guy E.

AU - Simmons, Cameron P.

AU - Quyen, Nguyen Than Ha

AU - Chau, Tran Thi Hong

AU - Mai, Pham Phuong

AU - Dung, Nguyen Thi

AU - Phu, Nguyen Hoan

AU - White, Nicholas P.

AU - Hien, Tran Tinh

AU - Farrar, Jeremy J.

PY - 2003/10/15

Y1 - 2003/10/15

N2 - The pathogenesis of tuberculous meningitis remains unclear, and there are few data describing the kinetics of the immune response during the course of its treatment. We measured concentrations of pro- and anti-inflammatory cytokines in serial blood and cerebrospinal fluid (CSF) samples from 21 adults who were being treated for tuberculous meningitis. CSF concentrations of soluble tumor necrosis factor-α receptors and of matrix metalloprotein-9 and its tissue inhibitor were also measured, and blood-brain barrier permeability was assessed by the albumin and IgG partition indices. CSF concentrations of lactate, interleukin-8, and interferon-γ were high before treatment and then decreased rapidly with antituberculosis chemotherapy. However, significant immune activation and blood-brain barrier dysfunction were still apparent after 60 days of treatment. Death was associated with high initial CSF concentrations of lactate, low numbers of white blood cells, in particular neutrophils, and low CSF glucose levels.

AB - The pathogenesis of tuberculous meningitis remains unclear, and there are few data describing the kinetics of the immune response during the course of its treatment. We measured concentrations of pro- and anti-inflammatory cytokines in serial blood and cerebrospinal fluid (CSF) samples from 21 adults who were being treated for tuberculous meningitis. CSF concentrations of soluble tumor necrosis factor-α receptors and of matrix metalloprotein-9 and its tissue inhibitor were also measured, and blood-brain barrier permeability was assessed by the albumin and IgG partition indices. CSF concentrations of lactate, interleukin-8, and interferon-γ were high before treatment and then decreased rapidly with antituberculosis chemotherapy. However, significant immune activation and blood-brain barrier dysfunction were still apparent after 60 days of treatment. Death was associated with high initial CSF concentrations of lactate, low numbers of white blood cells, in particular neutrophils, and low CSF glucose levels.

UR - http://www.scopus.com/inward/record.url?scp=0242333163&partnerID=8YFLogxK

U2 - 10.1086/378642

DO - 10.1086/378642

M3 - Article

VL - 188

SP - 1105

EP - 1115

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 8

ER -