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The role of the immune response in the pathophysiology of infectious meningitis
Beran, Ondřej ; Holub, Michal (advisor) ; Bartošová, Drahomíra (referee) ; Langmeier, Miloš (referee)
CNS infections continue to be associated with a high morbidity and mortality. Thus, it is neccessary to improve current diagnostic and therapeutical approaches. Better understanding to the pathophysiology of CNS infections is crucial for this process. In this thesis, the results of 4 clinical studies and 1 experimental study were presented. The overall aim of the studies was to expand knowledge about the immunopathophysiology of infectious meningitis (IM). For this purpose, we analysed several parameters of cellular immunity, cytokine production and activation of endogenous endocrine response during IM. Also, a potential use of new biomarkers in differential diagnostics of IM was evaluated. The results documented that the immune response during acute bacterial meningitis (BM) as well as aseptic meningitis (AM) is compartmentalized to the CNS. The most important changes take place in the subarachnoideal space; however, several alterations of the innate and adaptive immunity were found in peripheral blood as well. Novel findings observed in our studies are as follows: The presense of activated macrophages (HLA-DR+) is associated with a favorable outcome of in patients with BM. In patients with BM, a high inflammatory response in the CNS which is associated with elevated cytokine and chemokine...
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