This study was performed to test the hypothesis that the levels of neurotrophic growth factors, bFGF and TGF-βlin CSF are increased in children with bacterial meningitis, and also related with their outcome. The levels of bFGF and TGF-β1 were measured by a sandwich enzyme immunoassay in children aged below 15 years, with bacterial meningitis (BM) (n=18), aseptic meningitis (AM) (n=12), encephalitis (EN) (n=8), and control (CN) children (n=18). At a mean duration of follow-up of 17 months was performed to determine their neurodevelopmental sequelae. Both CSF bFGF and TGF-β1 were significantly higher in children with BM than those with AM, EN, or CN. There was no significant difference in CSF bFGF or TGF-β1 between patients with AM, EN and CN. Except for two patients with acute fatality, the CSF bFGF decreased significantly after 24-48 hours of antibiotic treatment(p<0.0005) in patients with BM. All 3 patients who had CSF bFGF above 20 pg/ml, died. Patients of BM with major sequelae had significantly higher levels of CSF bFGF than those without (p<0.05); this difference between the groups was not seen in TGF-β1. Our results demonstrated that CSF bFGF and TGF-β1 are elevated during acute bacterial meningitis, and bFGF is associated with the severity of the disease, especially fatality. The production and release of neurotrophic factors appear to play an important role in the pathophysiology of bacterial meningitis in children.Table

Table 1