Interleukin-6 in cerebrospinal fluid as a biomarker of acute meningitis.

Abstract

BACKGROUND:

Microbiological culture of cerebrospinal fluid is the gold standard to differentiate between aseptic and bacterial meningitis, but this method has low sensitivity. A fast and reliable new marker would be of interest in clinical practice.

OBJECTIVE:

Interleukin-6, secreted by T cells in response to meningeal pathogens and quickly delivered into cerebrospinal fluid, was evaluated as a marker of acute meningitis.

DESIGN AND METHODS:

A total of 150 cerebrospinal fluid samples were analysed by an electrochemiluminescence method, selected according to patient diagnosis: (a) bacterial meningitis confirmed by positive culture (n = 26); (b) bacterial meningitis with negative culture or not performed (n = 15); (c) viral meningitis confirmed by polymerase chain reaction or immunoglobulin G determination (n = 23); (d) viral meningitis with polymerase chain reaction negative or not performed (n = 42); and (e) controls (n = 44).

RESULTS:

Cerebrospinal fluid interleukin-6 concentration showed significant differences between all pathologic groups and the control group (P < 0.001). As a diagnostic tool for bacterial meningitis, interleukin-6 showed an area under the curve of 0.937 (95% confidence intervals: 0.895-0.978), significantly higher than those of classical biomarkers. An interleukin-6 cutoff of 1418 pg/mL showed 95.5% sensitivity and 77.5% specificity, whereas a value of 15,060 pg/mL showed 63.6% sensitivity and 96.7% specificity, for diagnosis of bacterial meningitis.

CONCLUSION:

Interleukin-6 measured by electrochemiluminescence method is a promising marker for early differentiation between aseptic and bacterial meningitis. More studies are needed to validate clinical implications for future practice in an emergency laboratory.

• Authors: Pablo García-Hernández, Belén Prieto, Eduardo Martínez-Morillo, Verónica Rodríguez, Francisco V Álvarez
• Journal: Annals of clinical biochemistry (Ann Clin Biochem) Vol. 53 Issue Pt 1 Pg. 155-63 (Jan 2016) ISSN: 1758-1001 [Electronic] England
• PMID: 25977573 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2015.

Chemical References

• Biomarkers
• IL6 protein, human
• Interleukin-6

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biomarkers (cerebrospinal fluid)
• Child
• Child, Preschool
• Diagnosis, Differential
• Female
• Humans
• Infant
• Infant, Newborn
• Interleukin-6 (cerebrospinal fluid)
• Male
• Meningitis (cerebrospinal fluid, diagnosis, microbiology, virology)
• Middle Aged
• Young Adult