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dc.contributor.authorAl-Mekhlafi, Amani
dc.contributor.authorSühs, Kurt-Wolfram
dc.contributor.authorSchuchardt, Sven
dc.contributor.authorKuhn, Maike
dc.contributor.authorMüller-Vahl, Kirsten
dc.contributor.authorTrebst, Corinna
dc.contributor.authorSkripuletz, Thomas
dc.contributor.authorKlawonn, Frank
dc.contributor.authorStangel, Martin
dc.contributor.authorPessler, Frank
dc.date.accessioned2021-07-19T15:03:01Z
dc.date.available2021-07-19T15:03:01Z
dc.date.issued2021-05-06
dc.identifier.citationCells. 2021 May 6;10(5):1115. doi: 10.3390/cells10051115. PMID: 34066349.en_US
dc.identifier.pmid34066349
dc.identifier.doi10.3390/cells10051115
dc.identifier.urihttp://hdl.handle.net/10033/622945
dc.description.abstractThe identification of CSF biomarkers for bacterial meningitis can potentially improve diagnosis and understanding of pathogenesis, and the differentiation from viral CNS infections is of particular clinical importance. Considering that substantial changes in CSF metabolites in CNS infections have recently been demonstrated, we compared concentrations of 188 metabolites in CSF samples from patients with bacterial meningitis (n = 32), viral meningitis/encephalitis (n = 34), and noninflamed controls (n = 66). Metabolite reprogramming in bacterial meningitis was greatest among phosphatidylcholines, and concentrations of all 54 phosphatidylcholines were significantly (p = 1.2 × 10-25-1.5 × 10-4) higher than in controls. Indeed, all biomarkers for bacterial meningitis vs. viral meningitis/encephalitis with an AUC ≥ 0.86 (ROC curve analysis) were phosphatidylcholines. Four of the five most accurate (AUC ≥ 0.9) phosphatidylcholine biomarkers had higher sensitivity and negative predictive values than CSF lactate or cell count. Concentrations of the 10 most accurate phosphatidylcholine biomarkers were lower in meningitis due to opportunistic pathogens than in meningitis due to typical meningitis pathogens, and they correlated most strongly with parameters reflecting blood-CSF barrier dysfunction and CSF lactate (r = 0.73-0.82), less so with CSF cell count, and not with blood CRP. In contrast to the elevated phosphatidylcholine concentrations in CSF, serum concentrations remained relatively unchanged. Taken together, these results suggest that increased free CSF phosphatidylcholines are sensitive biomarkers for bacterial meningitis and do not merely reflect inflammation but are associated with local disease and a shift in CNS metabolism.en_US
dc.language.isoenen_US
dc.publisherMDPIen_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectbiomarkeren_US
dc.subjectcell membraneen_US
dc.subjectcentral nervous systemen_US
dc.subjectenterovirusen_US
dc.subjectherpes simplex virusen_US
dc.subjectinfectionen_US
dc.subjectmeningitisen_US
dc.subjectmetabolismen_US
dc.subjectvaricella zoster virusen_US
dc.titleElevated Free Phosphatidylcholine Levels in Cerebrospinal Fluid Distinguish Bacterial from Viral CNS Infections.en_US
dc.typeArticleen_US
dc.identifier.eissn2073-4409
dc.contributor.departmentTWINCORE, Zentrum für experimentelle und klinische Infektionsforschung GmbH,Feodor-Lynen Str. 7, 30625 Hannover, Germany.; HZI,Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7,38124 Braunschweig, Germany.en_US
dc.identifier.journalCellsen_US
dc.source.volume10
dc.source.issue5
refterms.dateFOA2021-07-19T15:03:02Z
dc.source.journaltitleCells
dc.source.countrySwitzerland


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Attribution 4.0 International
Except where otherwise noted, this item's license is described as Attribution 4.0 International