Tuberculous Meningitis: Immune Reactions within the Central Nervous System

Abstract

CSF lymphocytes from 2 patients with tuberculous meningitis [TM] proliferated stronger than the corresponding peripheral blood lymphocytes (PBL) when stimulated with tuberculin purified protein derivative (PPD) in the lymphocyte transformation test after 3 days of culture. This might indicate an accumulation of specifically primed lymphocytes within the CNS. CSF lymphocytes and PBL from 9 or 10 patients with acute aseptic meningitis investigated as controls showed no or low responses when stimulated with PPD; the remaining patient displayed a significant proliferation of CSF lymphocytes, which was more pronounced than that of PBL. Stimulation with the mitogens phytohemagglutinin, concanavalin A and pokeweed mitogen gave lower proliferation of CSF lymphocytes compared with PBL in tuberculous and aseptic meningitis. Evaluation of the proliferative response of CSF lymphocytes compared with PBL on stimulation with PPD might be a useful complement in the TM diagnosis.