ascorbic-acid and Meningitis--Bacterial

Bacterial meningitis is a common cause of morbidity and mortality in children. The oxidative stress in bacterial meningitis is barely determined. Forty children with bacterial meningitis were studied for their oxidants and antioxidants status in serum and cerebrospinal fluid. Fever (95%) was commonest presentation followed by seizure and vomiting. Neck rigidity and Kernig's sign were present in 37.5% and 27.5% cases, respectively. Plasma and cerebrospinal fluid malondialdehyde, protein carbonyl and nitrite levels were significantly raised in cases (p < 0.001). Plasma and cerebrospinal fluid ascorbic acid, glutathione and superoxide dismutase levels were significantly decreased in children with septic meningitis (p < 0.001). Significantly elevated malondialdehyde, nitrite and protein carbonyl levels reflect increased oxidative stress, whereas decreased concentrations of glutathione, ascorbic acid and superoxide dismutase indicates utilization of the antioxidants in septic meningitis. Thus, changes in oxidants and antioxidants observed suggest production of reactive oxygen species and their possible role in pathogenesis of septic meningitis.

Topics: Antioxidants; Ascorbic Acid; Child; Child, Preschool; Cross-Sectional Studies; Female; Fever; Glutathione; Humans; Male; Malondialdehyde; Meningitis, Bacterial; Nitrites; Oxidants; Oxidative Stress; Prospective Studies; Reactive Oxygen Species; Superoxide Dismutase

This study aimed to determine whether patients with aseptic and bacterial meningitis presented alterations in oxidative stress parameters of cerebrospinal fluid (CSF). A total of 30 patients were used in the research. The CSF oxidative stress status has been evaluated through many parameters, such as lipid peroxidation through thiobarbituric acid reactive substances (TBARS) and antioxidant defense systems such as superoxide dismutase (SOD), glutathione S-transferase (GST), reduced glutathione (GSH) and ascorbic acid. TBARS levels, SOD and GST activity increase in aseptic meningitis and in bacterial meningitis. The ascorbic acid concentration increased significantly in patients with both meningitis types. The reduced glutathione levels were reduced in CSF of patients with aseptic and bacterial meningitis. In present study we may conclude that oxidative stress contributes at least in part to the severe neurological dysfunction found in meningitis.

Topics: Adolescent; Adult; Antioxidants; Ascorbic Acid; Female; Glutathione Transferase; Humans; Male; Meningitis, Aseptic; Meningitis, Bacterial; Middle Aged; Oxidative Stress; Superoxide Dismutase; Thiobarbituric Acid Reactive Substances

The objective of this study was to investigate the antioxidant/oxidant status of serum and cerebrospinal fluid in children with meningismus and acute bacterial meningitis. Twenty-three children (age range, 0.75 to 9 years) with fever and meningeal signs that required analysis of the cerebrospinal fluid, but no cytologic or biochemical evidence of meningitis in their serum and cerebrospinal fluid, constituted the meningismus group. Thirty-one children (age range, 0.5 to 10 years) with acute bacterial meningitis constituted the meningitis group. Twenty-nine healthy children (age range, 0.5 to 11 years) were recruited as control subjects. Antioxidant status (ascorbic acid, albumin, thiol, uric acid, total bilirubin, total antioxidant capacity, catalase and ceruloplasmin concentrations) and oxidant status (lipid hydroperoxide and total oxidant status) were measured. The serum antioxidant status was lower, and oxidant status levels higher in both meningitis and meningismus subjects than in the control children (P < 0.001). Cerebrospinal fluid oxidant status was lower in the meningitis group than in the meningismus group (P < 0.05). These results indicate that serum antioxidant status was lower, and serum oxidant status was higher in children in the meningismus and meningitis groups, whereas cerebrospinal fluid oxidant status was higher in the meningismus group than in the meningitis group.

Topics: Acute Disease; Antioxidants; Ascorbic Acid; Bilirubin; Catalase; Child; Child, Preschool; Female; Glutathione Peroxidase; Humans; Infant; Lipid Peroxides; Male; Malondialdehyde; Meningism; Meningitis, Bacterial; Oxidants; Oxidative Stress; Serum Albumin; Sulfhydryl Compounds; Superoxide Dismutase; Uric Acid

In this study, lipid peroxidation and antioxidant status were investigated in children with acute bacterial meningitis and encephalitis. The aim was to determine whether there was a possible role of free radicals in meningitis and encephalitis in childhood. Our study included 16 children with acute bacterial meningitis, 13 with encephalitis, and 17 control subjects. Serum malondialdehyde (MDA), reduced glutathione (GSH), vitamin C, vitamin E, beta-carotene, and retinol levels were studied in all subjects within 6 h of admission. There was a statistically significant difference for serum MDA, GSH, and vitamin C between the groups. Serum MDA and vitamin C levels were higher, and serum GSH levels were lower in the study groups compared to the control group. Vitamin C levels were similar in both the encephalitis and control groups, but they were significantly lower in the children with encephalitis than the meningitis group. In conclusion, our study showed that serum MDA and GSH levels were affected in children with both meningitis and encephalitis, but vitamin C level was affected only in children with meningitis. Serum vitamin E, beta-carotene, and retinol levels were not changed in childhood meningitis and encephalitis.

Topics: Analysis of Variance; Antioxidants; Ascorbic Acid; beta Carotene; Case-Control Studies; Chi-Square Distribution; Child; Child, Preschool; Encephalitis; Female; Glutathione; Humans; Lipid Peroxidation; Male; Malondialdehyde; Meningitis, Bacterial; Spectrophotometry; Vitamin A

The loss of soluble brain antioxidants and protective effects of radical scavengers implicate reactive oxygen species in cortical neuronal injury caused by bacterial meningitis. However, the lack of significant oxidative damage in cortex [J. Neuropathol. Exp. Neurol. 61 (2002) 605-613] suggests that cortical neuronal injury may not be due to excessive parenchymal oxidant production. To see whether this tissue region exhibits a prooxidant state in bacterial meningitis, we examined the state of the major cortical antioxidant defenses in infant rats infected with Streptococcus pneumoniae. Adenine nucleotides were co-determined to assess possible changes in energy metabolism. Arguing against heightened parenchymal oxidant production, the high NADPH/NADP(+) ratio ( approximately 3:1) and activities of the major antioxidant defense and pentose phosphate pathway enzymes remained unchanged at the time of fulminant meningitis. In contrast, cortical ATP, ADP and total adenine nucleotides were on average decreased by approximately 25%. However, energy depletion did not lead to a significant decrease in adenylate energy charge (AEC). ATP depletion was likely a consequence of metabolic degradation, since it correlated with both the loss of total adenine nucleotides and accumulation of purine degradation products. Furthermore, the loss of ATP and decrease in AEC correlated significantly with the extent of neuronal injury. These results strongly suggest that energy depletion rather than parenchymal oxidative damage is involved in the observed cortical neuronal injury.

Topics: Adenosine Triphosphate; Animals; Antioxidants; Ascorbic Acid; Cerebral Cortex; Disease Models, Animal; Energy Metabolism; Free Radicals; Meningitis, Bacterial; NAD; NADP; Oxidative Stress; Pentose Phosphate Pathway; Rats; Rats, Wistar; Streptococcal Infections; Streptococcus pneumoniae

Topics: Allantoin; Animals; Ascorbic Acid; Brain; Cerebrospinal Fluid; Free Radical Scavengers; Humans; Meningitis, Bacterial; Prognosis; Suppuration; Treatment Outcome; Tyrosine; Uric Acid

To study reactive nitrogen species-mediated oxidative brain damage and antioxidant defenses in patients with acute bacterial meningitis.. Nitrotyrosine (a widely used marker for the formation of reactive nitrogen species, such as peroxynitrite) and the lipid peroxidation product 4-hydroxynonenal were detected by immunohistochemistry in brain specimens obtained at autopsy. CSF concentrations of nitrotyrosine were quantified by ELISA. CSF and serum concentrations of ascorbic acid, uric acid, and its oxidation product allantoin were determined by high-pressure liquid chromatography.. Tyrosine nitration was strongly increased during meningitis. It was most evident in inflammatory cells and blood vessels in the subarachnoid space. The same cell types stained positive for the lipid peroxidation marker 4-hydroxynonenal, suggesting that reactive nitrogen species contribute to oxidative brain damage during meningitis. High CSF nitrotyrosine concentrations were associated with an unfavorable outcome according to the Glasgow Outcome Score. In the CSF, the increase of nitrotyrosine was accompanied by a depletion of the antioxidant ascorbic acid and an increased oxidation of the natural peroxynitrite scavenger uric acid to allantoin.. These findings indicate that oxidative stress due to reactive nitrogen species and altered antioxidant defenses are involved in the pathophysiology of bacterial meningitis in humans.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aldehydes; Allantoin; Ascorbic Acid; Brain; Cysteine Proteinase Inhibitors; Female; Free Radical Scavengers; Glasgow Outcome Scale; Humans; Immunohistochemistry; Male; Meningitis, Bacterial; Middle Aged; Neurons; Oxidative Stress; Reactive Nitrogen Species; Statistics as Topic; Treatment Outcome; Tyrosine; Uric Acid