Meningitis is a disease resulting from the inflammation of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. Injuries, cancer, or certain drugs can also cause meningitis. In almost all cases, meningitis is identified by an abnormal number of white blood cells in the cerebrospinal fluid and specific clinical signs/symptoms. Onset may be acute or chronic, and clinical symptoms of the acute disease develop over hours to days. It is important to know the specific cause of meningitis because the treatment differs depending on the causes.
- Bacterial meningitis is very serious and can be deadly. Death can occur in as short as a few hours. Most people can recover from bacterial meningitis. However, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection.
- Viral meningitis, the most common type of meningitis, is often less severe than bacterial meningitis. Most people get better on their own without any treatment.
- Fungal meningitis is relatively rare. It can develop after a fungus spreads in the body to the brain or spinal cord.
- Various parasites can also cause meningitis or affect the brain or nervous system in other ways. Parasitic meningitis is much less common than viral and bacterial meningitis.
Recent studies have identified several determinants for bacterial translocation of the blood-brain barrier using several host inflammatory markers associated with neuronal injury in animal models of induced bacterial meningitis. These markers provide important targets for the research of bacterial meningitis, including but not limited to the following: cytokines such as IL-1β and TNFα, chemokines, matrix metalloproteinases (MMPs), TNF-αconverting enzyme (TACE), excitatory amino acids, peroxynitrite, arachidonic acid metabolites, proinflammatory neuropeptides, caspases, bacterial opacity (Opa) proteins, bacterial outer membrane proteins (OMPs), bacterial lipopolysaccharide (LPS), etc.
Fig.1 Summary of novel therapeutic targets in bacterial meningitis. (Iovino, 2019)
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Summary of Popular Targets in Meningitis
|Interleukin-8 (IL-8)||Interleukin-10 (IL-10)||Interleukin-34 (IL-34)||Toll-like receptor 4 (TLR4)|
|Matrix metalloproteases 9 (MMP-9)||Macrophage inflammatory protein 2 (MIP-2)||Macrophage inflammatory protein 2 (MIP-1α)||Palmitoylethanomide (PEA)|
|Opacity (Opa) protein||Outer membrane protein (OMP)||Antimicrobials||Lipopolysaccharide (LPS)|
|TNF-α converting enzyme||Transforming growth factor β (TGF-β)||Granulocyte colony-stimulating factor (G-CSF)|
- Iovino, F.; et al. The role of microglia in bacterial meningitis: inflammatory response, experimental models and new neuroprotective therapeutic strategies. Frontiers in Microbiology. 2019, 10: 576.