Changes Of Caveolin-1,MMP-9,IL-1β In Cerebrospinal Fluid Of Children With Bacterial Meningitis And Viral Encephalitis

Background and ObjectiveBacterial meningitis(BM)and viral encephalitis(VE)are common diseases of central nervous system infection in children,with high the mortality and disability rate,which seriously affected the health of children.The pathogenesis and pathological process of central nervous system infection are complex.Blood-brain barrier(BBB)injury plays an important role in the pathogenesis of brain edema,secondary intracranial pressure increases,and exacerbates brain injury.Caveolin-1 is widely found in microvascular endothelial cells.Recent studies have shown that Caveolin-1 plays an important role in the integrity of tight junction(TJ)and the permeability of vascular endothelium,which may be a factor that determines the permeability of BBB.Matrix metalloproteinase-9(MMP-9)is a matrix metalloproteinase that can destroy the blood-brain barrier and increase its permeability by degrading extracellular matrix.Interleuki-1β(IL-1β)is an important pro-inflammatory cytokine released by macrophages and plays an important role in the immune response.The levels of Caveolin-1,MMP-9 and IL-1β in cerebrospinal fluid(CSF)of children with central nervous system infection at different stages were detected,and the correlation analysis was carried,to explore the relationship between Caveolin-1,MMP-9,IL-1β and the pathogenesis of central nervous system infection and its effect on blood-brain barrier permeability for early clinical diagnosis and treatment.Methods78 children with central nervous system infection were selected from September 2016 to June 2018,including 36 cases in bacterial meningitis group and 42 cases in viral encephalitis group.36 children(20 males and 16 females,age [3.9 ± 2.3)years]were diagnosed as bacterial meningitis,divided into 19 cases in mild disease group and 17 cases in severe disease group according to clinical manifestation and related examination.42 children(23 males and 19 females,age [4.5 ± 2.8)years)]were diagnosed as viral encephalitis,divided into 24 cases in mild disease group and 18 cases in severe disease group according to clinical manifestation and related examination.20 children [11 males and 9 females,age(3.7 ± 2.0)years],were excluded from intracranial infection,non-neurological diseases child at the same period,which were as control group.There was no significant difference in sex,and age among the three groups(P > 0.05).Cerebrospinal fluid(CSF)samples were collected from BM group and VE group with in 48 hours after admission and 10-14 days after treatment,and the same amount of CSF samples were taken from control group with in 48 hours after admission.The levels of Caveolin-1,MMP-9 and IL-1β in cerebrospinal fluid(CSF)were detected by ELISA method.SPSS21.0 software was used to analyze,with α = 0.05 for the test criteria.Results.1.In the acute phase,the levels of Caveolin-1,MMP-9,IL-1β in CSF of BM group and VE group were higher than control group(P < 0.05).Compared with VE group,the levels of Caveolin-1,MMP-9 and IL-1β in CSF of BM group were higher than those of VE group(P < 0.05).2.After treatment,the levels of Caveolin-1,MMP-9,IL-1β in CSF of BM group and VE group were significantly lower than those of acute phase,but still higher than control group(P < 0.05).There was no significant difference in the levels of Caveolin-1,MMP-9,IL-1β between the BM groups and VE group after treatment(P > 0.05).3.In the acute phase,the levels of Caveolin-1,MMP-9,IL-1β in CSF of mild group and severe group were higher than control group(P <0.05),but there was no significant difference between severe group and mild group(P > 0.05).4.Pearson correlation analysis showed that there was a positive correlation between Caveolin-1 and MMP-9 in CSF in BM group and VE group(r=0.489,P<0.05),and a positive correlation between Caveolin-1 and IL-1β in CSF(r=0.495,P<0.05).There was a significant positive correlation between MMP-9 and IL-1β levels in CSF of BM group and VE group in acute phase(r=0.875,P<0.05).Conclusions 1.The expression of Caveolin-1,MMP-9,IL-1β in CSF was significantly increased in the acute stage of bacterial meningitis and viral encephalitis, increased significantly in the bacterial meningitis group,and decreased gradually after treatment.2.Caveolin-1,MMP-9 and IL-1β involved in the pathogenesis of central nervous system infection in children,in different pathogens caused by the degree of infections may be different.