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Abstract：
The status of vascular endothelial-derived growth factor (VEGF) in the pathogenesis of tuberculous meningitis (TBM) remains far from clear. We prospectively evaluated the role of serum and cerebrospinal fluid (CSF) VEGF in TBM.
This prospective study was conducted at a tertiary care center in North India from January 2018 to June 2019. Consecutive drug-naive patients (n = 82) of TBM diagnosed on the basis of modified Ahuja\'s criteria were included in the study. The results were compared with 49 control subjects (n = 49). Serum and CSF VEGF were done in all the cases and controls. Follow-up serum VEGF levels were done in 34 patients after 3 months of completion of antitubercular therapy. The VEGF levels were estimated using the human VEGF enzyme-linked immunosorbent assay kit.
The mean age was 29.9 ± 13.1 years. The study group consisted of 33 (40.2%) men and 49 (59.8%) women. BACTEC MGIT960 was positive in 15 (18%) patients while multiplex tuberculosis polymerase chain reaction was positive in 73 (89%) patients. Levels of VEGF in serum and CSF of TBM patients were not elevated when compared to controls. There was no association between final outcome in TBM and decrease in serum levels of VEGF at follow-up.
VEGF may not be playing a significant role in the pathogenesis of TBM. Future studies with larger sample size may clarify the status of VEGF further in TBM.
This prospective study was conducted at a tertiary care center in North India from January 2018 to June 2019. Consecutive drug-naive patients (n = 82) of TBM diagnosed on the basis of modified Ahuja\'s criteria were included in the study. The results were compared with 49 control subjects (n = 49). Serum and CSF VEGF were done in all the cases and controls. Follow-up serum VEGF levels were done in 34 patients after 3 months of completion of antitubercular therapy. The VEGF levels were estimated using the human VEGF enzyme-linked immunosorbent assay kit.
The mean age was 29.9 ± 13.1 years. The study group consisted of 33 (40.2%) men and 49 (59.8%) women. BACTEC MGIT960 was positive in 15 (18%) patients while multiplex tuberculosis polymerase chain reaction was positive in 73 (89%) patients. Levels of VEGF in serum and CSF of TBM patients were not elevated when compared to controls. There was no association between final outcome in TBM and decrease in serum levels of VEGF at follow-up.
VEGF may not be playing a significant role in the pathogenesis of TBM. Future studies with larger sample size may clarify the status of VEGF further in TBM.
摘要：
背景：血管内皮衍生生长因子（VEGF）在结核性脑膜炎（TBM）发病机制中的地位尚不清楚。我们前瞻性评估了血清和脑脊液（CSF）VEGF在TBM中的作用。
方法：这项前瞻性研究于2018年1月至2019年6月在印度北部的三级护理中心进行。本研究包括根据改良的Ahuja标准诊断的连续未接受药物治疗的TBM患者（n=82）。将结果与49名对照受试者(n=49)进行比较。所有病例和对照组均进行血清和CSFVEGF检测。在完成抗结核治疗3个月后，对34例患者的血清VEGF水平进行了随访。使用人VEGF酶联免疫吸附测定试剂盒估计VEGF水平。
结果：平均年龄为29.9±13.1岁。研究组由33名（40.2%）男性和49名（59.8%）女性组成。BACTECMGIT960在15例（18％）患者中呈阳性，而多重结核聚合酶链反应在73例（89％）患者中呈阳性。与对照组相比，TBM患者血清和CSF中的VEGF水平没有升高。TBM的最终结果与随访时血清VEGF水平的降低之间没有关联。
结论：VEGF可能在TBM的发病机制中没有发挥重要作用。未来更大样本量的研究可能会进一步阐明TBM中VEGF的状态。
方法：这项前瞻性研究于2018年1月至2019年6月在印度北部的三级护理中心进行。本研究包括根据改良的Ahuja标准诊断的连续未接受药物治疗的TBM患者（n=82）。将结果与49名对照受试者(n=49)进行比较。所有病例和对照组均进行血清和CSFVEGF检测。在完成抗结核治疗3个月后，对34例患者的血清VEGF水平进行了随访。使用人VEGF酶联免疫吸附测定试剂盒估计VEGF水平。
结果：平均年龄为29.9±13.1岁。研究组由33名（40.2%）男性和49名（59.8%）女性组成。BACTECMGIT960在15例（18％）患者中呈阳性，而多重结核聚合酶链反应在73例（89％）患者中呈阳性。与对照组相比，TBM患者血清和CSF中的VEGF水平没有升高。TBM的最终结果与随访时血清VEGF水平的降低之间没有关联。
结论：VEGF可能在TBM的发病机制中没有发挥重要作用。未来更大样本量的研究可能会进一步阐明TBM中VEGF的状态。
