Cerebrospinal fluid and serum cytokine profiling to detect immune control of infectious and inflammatory neurological and psychiatric diseases.

The present study aimed at profiling inflammatory cytokines for
neurological and psychiatric diseases. A total of 86 patients with
meningitis, multiple sclerosis, tension-type headache, idiopathic facial
nerve palsy (IFNP), affective and schizophrenic disorders were tested
for both, serum and cerebrospinal fluid (CSF) using a multiplexed
cytokine ELISA for IFN-γ, TNF-α, IL-1β, IL-2, IL-4, IL-5, IL-8/CXCL8,
IL-10, IL12p70, IL-13 and IL-17. Cases with viral and bacterial
meningitis had unequivocally higher cytokine concentrations in the CSF
when compared with serum. Bacterial meningitis was unique by extremely
elevated IL-17, TNF-α and IL-1β, indicating a plethora of inflammatory
pathways, selectively activated in the CSF. In relapsing multiple
sclerosis, IFN-γ and IL-10 were elevated in both, serum and CSF, but
IL-12p70, IL-5, IL-13, and TNF-α were more prominent in serum than in
CSF. Qualitatively similar biomarker patterns were detected in patients
with idiopathic facial nerve palsy and tension-type cephalgia. Affective
and schizophrenic disorders clearly present with an inflammatory
phenotype in the CSF and also serum, the cytokines determined were in
general higher in schizophrenia. Except IFN-γ, schizophrenic patients
had higher IL-12p70 and a trend of higher IL-10 and IL-13 in serum
suggesting a more prominent TH2-type counter regulatory immune response
than in affective disorders. These differences were also mirrored in the
CSF. Elevated IL-8 appears to be the most sensitive marker for
inflammation in the CSF of all diseases studied, whereas TNF-α was
restricted to peripheral blood. With the exception of IL-8, all but
viral and bacterial meningitis, studied, displayed higher means of
elevated lymphokine concentrations in the serum than in the CSF. This
observation supports the concept of immunological crosstalk between
periphery and intrathecal immunity in neurological and psychiatric

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