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Clinical and Diagnostic Laboratory Immunology, May 2002, p. 598-604, Vol. 9, No. 3
1071-412X/02/$04.00+0     DOI: 10.1128/CDLI.9.3.598-604.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

YKL-40 Is Elevated in Cerebrospinal Fluid from Patients with Purulent Meningitis

Christian Østergaard,1* Julia S. Johansen,2 Thomas Benfield,3 Paul A. Price,4 and Jens D. Lundgren3

Division of Microbiology, Department of Research and Development, Statens Serum Institut, Copenhagen,1 Department of Infectious Diseases,3 Department of Rheumatology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark,2 Department of Biology, University of California-San Diego, La Jolla, California4

Received 30 October 2001/ Returned for modification 14 December 2001/ Accepted 1 February 2002

YKL-40, a member of the family 18 glycosyl hydrolases, is secreted by activated neutrophils and macrophages. It is a growth factor for connective tissue cells and a potent migration factor for endothelial cells and may function in inflammation and tissue remodeling. YKL-40 was determined in 134 cerebrospinal fluid (CSF) samples taken on admission from patients suspected of having meningitis (48 with purulent meningitis, 49 with lymphocytic meningitis, 5 with encephalitis, and 32 without evidence of meningitis). YKL-40 levels in CSF were significantly higher in patients with purulent meningitis (median, 663 µg/liter [range, 20 to 8,960]) and encephalitis (5,430 µg/liter [620 to 11,600]) than in patients with lymphocytic meningitis (137 µg/liter [41 to 1,865]) or patients without meningitis (167 µg/liter [24 to 630]) (Kruskal-Wallis and Dunn multiple comparison tests, P < 0.001). CSF YKL-40 levels were also determined for 26 patients with purulent meningitis having a repuncture, and patients who died (n = 5) had significantly higher YKL-40 levels than patients who survived (n = 21) (2,100 µg/liter [1,160 to 7,050] versus 885 µg/liter [192 to 15,400], respectively; Mann-Whitney test, P = 0.018). YKL-40 was most likely locally produced, since patients with infections of the central nervous system had CSF YKL-40 levels that were at least 10-fold higher than the corresponding levels in serum (2,033 µg/liter [470 to 11,600] versus 80 µg/liter [19 to 195]). The CSF neopterin level was the biochemical parameter in CSF and blood that correlated best with CSF YKL-40 levels, indicating that YKL-40 may be produced by activated macrophages within the central nervous system. In conclusion, high levels of YKL-40 in CSF are found in patients with purulent meningitis.

* Corresponding author. Mailing address: Department of Research and Development, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark. Phone: 45 32683642. Fax: 45 32683887. E-mail: coa{at}ssi.dk.

Clinical and Diagnostic Laboratory Immunology, May 2002, p. 598-604, Vol. 9, No. 3
1071-412X/02/$04.00+0     DOI: 10.1128/CDLI.9.3.598-604.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.





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