muramidase and Meningitis--Meningococcal

N-acetylmuramyl-L-alanine amidase (NAMLAA) specifically degrades peptidoglycan, a major component of bacterial cell walls. Lysozyme degrades peptidoglycan differently by hydrolyzing the aminosugar backbone of peptidoglycan. In another study, it was shown that the two enzymes act synergistically to inactivate the inflammatory properties of peptidoglycan. The presence of lysozyme and NAMLAA was determined in serum and cerebrospinal fluid (CSF) of patients with bacterial meningitis. High concentrations of lysozyme were found in CSF while, surprisingly, NAMLAA was not present. To explain this phenomenon, the degranulation pattern of neutrophils in CSF was compared with that of neutrophils from blood. Specific granules contain lysozyme and the azurophil granules contain both lysozyme and NAMLAA. CD66b expression on the cell surface, indicative for fusion of the specific granules with the cell membrane, was higher in CSF than in blood, while the marker for the azurophil granules was lower.

Topics: Adolescent; Adult; Aged; Antigens, CD; Antigens, Neoplasm; Cell Adhesion Molecules; Cell Degranulation; Cell Membrane; Child; Child, Preschool; Female; Flow Cytometry; GPI-Linked Proteins; Haemophilus Infections; Humans; Infant; Male; Membrane Glycoproteins; Meningitis, Bacterial; Meningitis, Meningococcal; Middle Aged; Muramidase; N-Acetylmuramoyl-L-alanine Amidase; Neutrophil Activation; Neutrophils; Pneumococcal Infections

The course of meningococcal infection and nonspecific and specific immunity in children subjected to different regimens of pathogenetic therapy were studied. It was shown that the clinico-immunological indices were more favourable in children treated with lasix as a diuretic agent. Recovery with defects was observed in 6.8 per cent of the children of this group, while in patients subjected to routine treatment the respective value amounted to 14.6 per cent. The use of lasix in combination with penicillin increased the efficacy of penicillin therapy and shortened the recovery period by 8.4 +/- 0.2 days as compared to that of routine treatment. No unfavourable effect of elevated penicillin concentrations on the lysozyme activity, blood bactericidal characteristics and composition of immunoglobulins A, M and G in the children was recorded.

Topics: Adolescent; Blood Bactericidal Activity; Child; Child, Preschool; Drug Therapy, Combination; Furosemide; Humans; Immunoglobulins; Infant; Meningitis, Meningococcal; Meningococcal Infections; Muramidase; Penicillins; Sepsis; Syndrome

Local and humoral immunity factors have been studied in 152 patients with different forms of meningococcal infection. The peculiar pattern of the time course of changes in these factors, depending on the clinical form of the disease, has been revealed. In the generalized form of infection changes in the immunological characteristics of the saliva and blood serum (lysozyme, secretory immunoglobulin, immunoglobulins of the main classes and specific antimeningococcal antibodies) have been shown to be more essential than in the localized form.

Topics: Adolescent; Adult; Antibodies, Bacterial; Antibody Formation; Female; Humans; Immunity, Innate; Immunoglobulins; Male; Meningitis, Meningococcal; Meningococcal Infections; Muramidase; Nasopharyngitis; Pharyngitis; Polysaccharides, Bacterial; Saliva; Time Factors

The concentration of lysozyme (LZM) in cerebrospinal fluid was determined in 25 patients with bacterial meningitis, in 18 patients with viral meningitis and in 25 control patients who had other fibrile illnesses. The concentration of LZM was less than 1.5 microgram/ml in all control patients, and slightly to markedly raised in 10 patients with viral meningitis and in 11 out of 13 patients with untreated bacterial meningitis. The concentration of LZM was significantly different in the viral and bacterial meningitis patients (p less than 0.001). Most raised concentrations of cerebrospinal fluid LZM persisted for at least one week after the start of antibiotic treatment. The concentrations of LZM correlated well with concentrations of lactic dehydrogenase. These results show that the determination of cerebrospinal fluid LZM is a useful tool in the differential diagnosis of meningitis, particularly when the prehospital treatment with antibiotics may be responsible for a diagnostically misleading negative bacterial culture of the cerebrospinal fluid and altered cerebrospinal fluid cytology.

Topics: Diagnosis, Differential; Echovirus Infections; Humans; L-Lactate Dehydrogenase; Meningitis, Meningococcal; Meningitis, Pneumococcal; Meningitis, Viral; Mumps; Muramidase

Topics: Clinical Enzyme Tests; Diagnosis, Differential; Humans; Meningitis; Meningitis, Meningococcal; Meningitis, Viral; Methods; Muramidase