Effect of dexamethasone on the inflammation and TNF α in experimental rabbit pneumococcal meningitis

J Korean Neurol Assoc > Volume 15(1); 1997 > Article

Journal of the Korean Neurological Association 1997;15(1): 176-185.

실험적 토끼 폐렴구균성 수막염에서 스테로이드가 염증 및 종양괴상인자에 미치는 영향

최영빈, 나정호, 김영인, 이광수, 김범생

가톨릭대학교 의대 신경과

Effect of dexamethasone on the inflammation and TNF α in experimental rabbit pneumococcal meningitis

Young-Bin Choi, M.D., Joung-Ho Rha, M.D., Yeong-In Kim, M.D., Kwang-Soo Lee, M.D, and Beum-Saeng Kim, M.D.

Department of Neurology, Catholic University Medical College, Seoul, Korea

Abstract

It is generally believed that tumor necrosis factor alpha (TNF a) plays an crucial role in the pathogenesis of bacterial meningitis through various mechanisms such as endothelial damage, induction of adhesion molecule on the endothelial cell, recruitment of leukocytes in the cerebrospinal fluid(CSF). We performed this study to analyze the relationship of TNF α level with the severity of inflammation in the CSF. In a rabbit meningitis model, we attempted to evaluate whether antibiotics induced bacteriolysis can induce the elevation of the TNF α level and pleocytosis in CSF, and whether dexamethasone can suppress this elevation of TNF α. We also tried to assess the effective administation timing of dexamethasone. Meningitis was induced by intracistemal inoculation of Streptococcus pneumoniae. We designed four groups : Group 1. Untreated conrol (N=5); Group 2. Lone ceftriaxone at 6 hours after inoculation (N=5) ; Group 3. Dexamethasone at 30 minutes before ceftriaxone treatment (N=5); Group 4. Dexamethasone at 30 min. after ceftriaxone treatment (N=5). CSF TNF α level and cell count was assessed with regular time interval. The results were as follows : First, the CSF bacterial counts (measured by colony forming units) of group 1 was significantly higher than the other groups after ceftriaxone treatment (P<0. 05). Second, the CSF WBC counts of group 3 and 4 were significantly lower than those of group 1 and 2 at 6 and 14 hours after ceftriaxone treatment (P<0.05). Third, the CSF TNF α titers of group 1 and 3 were significantly lower than those of group 2 and 4 at 2 hours after ceftriaxone treatment (P<0.05). Fourth, after 14 hours, the CSF TNF α titers of group 1 kept on rising and became significantly higher than those of other groups (P