Bioactive and inactive forms of tumor necrosis factor-alpha in spinal fluid from patients with meningitis

Article Abstract:

Tumor necrosis factor-alpha (TNF-alpha) is a cytokine, a nonantibody protein released by macrophages in response to specific antigenic stimuli. It is important in inflammatory reactions during invasive disease and is believed to be involved in the mediation of cell functions. Receptors in the liver appear to be involved in the rapid removal of TNF-alpha from the circulation. This cytokine reacts differently in various disease processes, and there is no correlation between detectable levels in body fluids and symptoms of disease. Differences reported in the physical properties of the TNF-alpha molecule in vitro (laboratory studies) may be related to varying in vivo (clinical) reactions. Twenty-four patients admitted with fever and symptoms of meningitis were assessed; 3 were diagnosed with aseptic meningitis, 9 with bacterial meningitis, and 12 did not have meningitis (control group). Blood and spinal fluid specimens were collected; levels of TNF-alpha were determined by enzyme linked immunosorbent assays (ELISA). TNF-alpha reactivity was found in the spinal fluid of 10 out of 12 meningitis cases and in only one control case. Blood specimens from seven patients, including five with meningitis, had TNF-alpha activity. TNF-alpha levels in spinal fluid were higher than those in blood. Gel filtration chromatography revealed the presence of both polymeric and oligomeric TNF-alpha in spinal fluid, with only the oligomeric form possessing bioactivity. This form is unstable and may produce inactive polymers. It was also shown that, in cases of meningitis, TNF-alpha is locally produced in the central nervous system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Meningitis, Cerebrospinal fluid

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Tumor necrosis factor and severe malaria

Article Abstract:

Plasmodium falciparum is a parasite that causes malaria, which is characterized by fevers, chills, and sweats. Tumor necrosis factor-alpha (TNF-alpha), one of many cytokines (substances released by cells to regulate other cells) found in the blood at times of infection, is known to play a role in enabling the body to respond to infection. In 1986, elevated TNF-alpha levels were detected in patients with malaria. Since then, interest has focused on the possible relation of TNF-alpha to severe and cerebral (affecting the brain) malaria. Recently, elevated TNF-alpha levels were reported in African children and European travelers with severe P. falciparum infection. To further investigate the ways in which elevated TNF-alpha concentrations affect the presentation of P. falciparum malaria, 61 children from Zaire (average age 3.4 years), who were hospitalized with severe P. falciparum infections, were compared with children with mild malaria (29), and otherwise ill children (26). Blood samples were used for testing levels of TNF-alpha. It was found that high TNF-alpha levels were associated with severe malaria in any number of forms and were not specific to cerebral malaria. Children with other serious illness or mild malaria did not show similarly elevated levels of TNF-alpha. The data provide further confirmation of previous research findings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Malaria, Plasmodium falciparum, Zaire

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Trends in HIV counseling and testing of clients attending a public sexually transmitted disease clinic in Portland, Oregon, 1989-1995

Article Abstract:

HIV counseling and testing (HIV-CT) appears to have gained wider acceptance among patients attending sexually transmitted disease (STD) clinics. The percentage of patients attending a Portland, Oregon STD clinic accepting HIV-CT was compared between 1989 and 1995. Overall, the percentage increased from 28.2% to 60.1% during this time period. The percentage of previously untested patients accepting HIV-CT increased from 28.4% to 60.9%. Similar trends were seen for patients previously testing positive or negative, gay or bisexual men, injection drug users, men and women, young and old patients, and patients of various ethnic backgrounds.

Sexually transmitted diseases, Services, Statistics, Patients, HIV testing, HIV tests

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