Expression Changes Of Substance P,IL-17,IL-6 In Purulent Meningitis And Viral Encephalitis

Background and ObjectiveInfection of Central Nervous System(ICNS)is a common and frequentlyoccurring disease.Purulent meningitis(PM)and viral encephalitis(VE)are common central nervous system infectious diseases,and have high mortality and sequelae rate.Purulent meningitis is always a central nervous system disease which makes harm on children' health,although following with the application of antibiotics on PM,the death rate decreased,while the incidence of neurologic sequelae is still stay in high level.Foreign studies have reported that acute bacterial meningitis mortality was 22% in 1980 s,as the development of medical technology,it was decreased to 6.6% in 1990 s,however,the incidence of neurological sequelae were changed very little within 10 years,still as high as 25.5% and 23.5% respectively.Viral encephalitis such as herpes simplex virus encephalitis,enterovirus encephalitis,vector encephalitis and other encephalitis,following with acute onset,progress quickly,make sever harm on patient,most of patient still have sequelae after therapy.Early diagnosis of purulent meningitis and viral encephalitis,timely and effective treatment is the key to prognosis.But at present due to the widespread use of antibiotics,it's difficult to identify PM or VE from several cerebrospinal fluid(CSF)parameters.Therefore,in recent years,the study of central nervous system infection in the brain immune mechanism to find a simple and feasible method to identify PM and VE has become a research hotspot.Through measure the density of substance-P(SP),Interleukin 17(IL-17)and Interleukin 6(IL-6)from cerebrospinal fluid of children with acute stage of purulent meningitis and viral encephalitis,this research compared the expression level of these indexes in early stage of purulent meningitis and viral encephalitis,discussed its clinical meaning and the related of Immunology mechanism,to provide a theoretical basis for clinical identification of purulent meningitis and viral encephalitis.Methods23 children(15 males and 8 females,age 1 month to 4 years 6 months,(2.3 ± 1.7years)were selected from December,2014 to April,2016,who were diagnosed as purulent meningitis(diagnosis standard conformed to the seventh edition of Zhufu Tang Pediatrics).At the same period,25 cases [16 males and 9 females age from 3 month to 8 years,(3.7 ± 2.4)years],which diagnosed as viral meningitis disease(the diagnostic criteria accorded with the seventh edition of Zhu Fu Tang Pediatrics)were selected;control group: 30 cases [19 males and 11 females,age from 3 months to 6 years,(2.6 ± 1.8)years],were excluded from intracranial infection,non-neurological diseases child at the same period.There were no significant differences in age,sex and weight between the three groups(P> 0.05).All the 3 groups were lumbar punctured within 24 hours after admission.5ml CSF was collected,3ml were sent to the laboratory for biochemical,routine,staining,2ml in sterile EP tube,placed at-80 ? environment waiting for check.The levels of SP,IL-17 and IL-6 in CSF were measured by enzyme-linked immunosorbent assay(ELISA).Use SPSS21.0 statistical software package for data analysis,With ? = 0.05 for the test criteria.ResultsSP level in CSF of PM group,VE group and Control group are(1176.33±249.03)pg/ml,(562.57±40.81)ug/L,(95.60±43.50)ug/L respectively,the level of IL-17 are(463.54±152.05)ug/L,(59.46±26.12)ug/L,(8.87±5.96)ug/L respectively,the level of IL-6 are(283.97±74.07)ug/L,(132.81±39.78)ug/L,(6.62±2.02)ug/L respectively.There were significant differences among the three groups(P <0.05).There was significant difference between the two groups(P <0.05).The levels of SP,IL-17 and IL-6 in CSF of PM groups were significantly higher than those in the VE groups and control groups,and the levels of SP,IL-17 and IL-6 in CSF of VE groups were significantly higher than those in the control groups.Conclusions1.The expression of SP,IL-17 and IL-6 in cerebrospinal fluid was increased in the acute stage of purulent meningitis and viral encephalitis,and the expression of SP?IL-17 and IL-6 was increased apparently in the PM groups.2.IL-17 and IL-6 may be involved in the development of the disease,and to some extent can be used as a reference index for the identification of PM and VE in children with acute central nervous system infection.