Diagnostic value of neurospecific markers NSE, S-100, GFAP, MBP and BDNF in cerebrospinal fluid in patients with viral meningitis

Abstract

The aim of the work - to determine the diagnostic value of the levels of neurospecific markers NSE, GFAP, S-100, MBP, and BDNF in the CSF of adult patients with viral meningitis. Patients and Methods. 50 cases of acute viral meningitis were analyzed. There were 21 patients with HSV 1,2 infection, 19 patients with EBV infection, 10 patients with enteroviral meningitis. The CSF level of neuro-specific markers was determined in the first and 10-12 days of treatment using the ELISA method. Results. The most significant changes were identified in patients with severe illness. On the first day o f treatment, the levels of NSE, S-100, GFAP, MBP, and BDNF in patients with moderate severity of the disease were lower in patients with enteroviral meningitis (P<0.001). In severe cases NSE, GFAP and BDNF were higher (P<0.05) in patients with HSV neuroinfection. The neuro-specific markers NSE, S-100, GFAP and MBP on the first day of treatment were in direct strong correlation with the severity of neurological symptoms. The strongest (r=0.712) direct correlation is observed between the severity of neurological symptoms and the level of NSE and GFAP. At the same time, we found a strong reverse correlation (r=-0.727) between the level of BDNF and the duration of neurological symptoms. Conclusions. Increased levels of NSE, S-100, GFAP and MBP indicate presents damages of neurons astroglia and myelin nerves in all cases of viral meningitis. Major changes are observed in patients with severe neuroinfection. In patients with severe herpes viral meningitis/meningoencephalitis, the activity of regenerative processes in the tissues of the central nervous system decreases due to a decrease of CSF BDNF level (P<0.05).