Levels Of MMP-9 And TIMP-1 In Cerebro Spinal-fluid Of Children During Bacterial Meningitis And Viral Meningitis

ObjectiveCentral nervous system(CNS) infection is a severe disease to endanger the children's life because of its high morbidity and disability rate.The pathogenesis and path physiology of the CNS infection are very complicated.Purely from the CSF cytology and biochemical characteristics and clinical manifestations of the distinction between purulent meningitis and viral encephalitis more difficult.Etiological diagnosis but are not optimistic.Therefore,we need look for an early diagnosis and differential diagnosis of central nervous system a reliable indicator of infection,so that the central nervous system infection can be accurate diagnosis and timely treatment.The impairment of blood-brain barrier(BBB) plays unimportant role in the CNS infection, and is a focus of medicalresearch.The present study aimed to explore the contribution of matrix metalloproteinase(Mumps) in the impairment of BBB in the CNS infection, through measuring the levels of Mumps(MMP-9 and TIMP-1) in cerebrospinal-fluid (CSF) in children with purulent meningitis(PM),viral encephalitis(VE) and control. Evaluation of MMP-9,TIMP-1 on the central nervous system infection in the early diagnosis,differential diagnosis,early treatment of the practical value。Materials and MethodsExperiment group:The group of PM consisted of 14 children with age from 2 months to 12 years in which 9male and 5female.Positive bacterial culture of cerebrospinal fluid has four cases,cerebrospinal fluid culture-negative but the clinical diagnosis of purulent meningitis has 10 cases.The group of VE consisted of 23 children with age from6 months to 14 years in which 13 male and 10female.The control group consisted of 17 children with age from 6 months to 12.5 years in which 11 male and 6 female,without CNS infection.Measuring index:Measuring index included MMPs(MMP-9 and TIMP-1) in CSF.ResultsThe changes of MMPs(MMP-9 and TIMP-1) in CSF among PM,VE and control: CSF MMP-9 in PM,VE and control were 139.06(26-312.16)ng/ml,16.67(0.49-58.5) ng/ml,0.335(0.02-0.845)ng/ml,respectively.There was significant different among the three groups.There was marked difference between PM and VE(P＜0.05),between PM and control(P＜0.01),and between VE and control(P＜0.01).CSF TIMP-1 in PM,VE and control were369.39(106.23-543.56) ng/ml,170.75(4.9-612.3) ng/ml,5.93 (0.86-81.8) ng/ml,respectively.There was marked difference between PM and VE(P＜0.05),between PM and control(P＜0.01),and between VE and control(P＜0.01).CSF MMP-9/TIMP-1 Ratio in PM,VE and control were 0.414(0.035-1.6),0.098 (0.059-0.193),0.063(0.014-0.28).There was marked difference between PM and VE(P＜0.05),between PM and control(P＜0.01),and between VE and control(P＜0.01)MMP-9andTIMP-1 of cerebrospinal fluid in Viral encephalitis group was positively correlated(r=0.8368,p＜0.05)。The correlation analysis is between Levels of MMP-9,TIMP-1 and the cell count and Protein content in the Cerebrospinal Fluid with PM and VE:MMP-9of cerebrospinal fluid in Purulent meningitis group was positively correlated with Europhile count and Protein content(r=0.5507,p＜0.05;r=0.6408,p＜0.05); MMP-9/TIMP-1 ratio and Protein content of cerebrospinal fluid in Purulent meningitis group was positively correlated(r=0.5940;p＜0.05);MMP-9 and Protein content of cerebrospinal fluid in Viral meningitis group was positively correlated(r=0.7210,p＜0.01);MMP-9/TIMP-1 ratio and Protein content of cerebrospinal fluid in Viral meningitis group was positively correlated(r=0.5994,p＜0.05).Conclusion1.MMP-9 and TIMP-1 participate in the path physiologic course of Brain Injury in the CNS infection。Monitoring of cerebrospinal fluid MMP-9,TIMP-1 levels can be used as purulent meningitis and viral encephalitis in early diagnosis,differential diagnosis indicators2.MMP-9/TIMP-1 ratio in cerebrospinal fluid may be more favorable to determine the degree of BBB injury,evaluating the prognosis and efficacy indicators in the CNS infection3.Metal matrix protein inhibitors may provide a new way of thinking in infected of central nervous system with the clinical treatment,and more become promising therapeutic tool in future.