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Role of Oxidative Stress in Tuberculous Meningitis: a Clinico-Radiological Correlation

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Abstract

Central nervous system infection may be associated with oxidative stress and may influence clinical severity and outcome. We report oxidative stress markers in the patients with tuberculous meningitis (TBM) and correlate these with clinico-radiological severity and outcome. Fifty-six patients with TBM diagnosed on the basis of clinical, cerebrospinal fluid (CSF), and magnetic resonance (MRI) were included. Plasma glutathione (GSH), total antioxidant capacity (TAC), and malondialdehyde (MDA) were measured in the patients and 55 matched healthy controls. Hospital death was noted. Disabilities at 3 and 6 months were categorized using the modified Rankin Scale (mRS) as poor (mRS > 2) or good (mRS ≤ 2). The patients had lower levels of GSH (1.49 ± 0.49 vs 2.57 ± 0.39 mg/dL, p ˂ 0.001) and TAC (0.25 ± 0.17 vs 2.20 ± 0.31 mmol Trolox Eq/L, p ˂ 0.001), and higher level of MDA (6.61 ± 1.72 vs 3.09 ± 0.38 nmol/mL, p < 0.001) compared to controls. Total antioxidant capacity correlated with cranial nerve palsy and CSF pleocytosis. Patients with tuberculoma had lower GSH compared to those without. Six patients died in the hospital, and they had lower GSH (p < 0.01) and TAC (p = 0.02) levels compared to those who survived. Thirty-one and 36 patients had a good outcome at 3 and 6 months respectively. The patients with good outcome had higher GSH level.

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Acknowledgments

We thank Mr. Shakti Kumar for secretarial help.

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Authors and Affiliations

  1. Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226014, India

    Jayantee Kalita, Usha K. Misra & Ashish K. Dubey

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  1. Jayantee Kalita
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  2. Usha K. Misra
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  3. Ashish K. Dubey
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Correspondence to Usha K. Misra.

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We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. This study was approved by the Institute Ethics Committee, SGPGIMS Lucknow, India.

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Highlights

• The patients with tuberculous meningitis have increased oxidative stress.

• The lower level of antioxidant is associated with death and poor outcome.

• Role of augmenting antioxidant or reducing stress may be explored in the outcome of tuberculous meningitis.

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Kalita, J., Misra, U.K. & Dubey, A.K. Role of Oxidative Stress in Tuberculous Meningitis: a Clinico-Radiological Correlation. J Mol Neurosci 68, 287–294 (2019). https://doi.org/10.1007/s12031-019-01304-0

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  • DOI: https://doi.org/10.1007/s12031-019-01304-0

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