Metabolomic Study in Body Fluids for differentiation of Meningitis in adults A Pilot Study

Abstract

Meningitis is a life-threatening illness, which is associated with inflammation of meninges covering and protecting the brain. It is a cause of serious infection which ranks among the top ten infectious causes of death. Meningitis, a morbidly infectious Central Nervous System (CNS) pathology is accompanied by acute inflammation of the meninges, causing raised intracranial pressure linked with serious neurological sequelae. The contagion during meningitis does not remain localized to the meninges, but gets propagated throughout the body. Hence, we have attempted to observe the metabolic derangements that may occur in serum and urine along with CSF obtained from adult subjects using 1H NMR spectroscopy, with a possibility of appropriate and timely treatment regimen. Further, this study also attempted to explore the possibility of differentiating meningitis non-invasively by metabolic profiling of serum and urine. To observe the variation in the metabolic profile, that may occur in serum and urine along with CSF in adults using1H NMR spectroscopy, with an attempt of rapid and accurate diagnosis. The work plan of the study was to compare cases vs. healthy control, cases vs. disease control (neurological disease control) and BM vs. TBM. The neurological disease control group comprised patients with no clinico-radiological/ pathological and/or microbiological evidence of meningitis, and in whom CSF was collected when other metabolic abnormalities were suspected. In other words, the neurological disease controls had no evidence of meningitis. This group mainly included patients suffering from migraine, microcytic anaemia, lumbar arachnoiditis, cranial nerve palsy, paraparesis and hemiparesis. This group was included to compare their CSF metabolic profile with those of meningitis cases, as CSF of healthy individuals could not be obtained due to ethical issues. newline