alpha-Melanocyte-stimulating hormone (alpha-MSH) has potent anti-inflammatory effects in several experimental models of inflammation. It inhibits both the actions and production of proinflammatory cytokines and neutrophil migration. We investigated whether alpha-MSH in cerebrospinal fluid (CSF) increases during the acute stage in patients with bacterial and aseptic meningitis by measuring alpha-MSH in CSF via radioimmunoassay. The alpha-MSH concentrations in CSF from the children with bacterial meningitis who survived (n = 8), those with aseptic meningitis (n = 16), and the control subjects (n = 23) were all below the detection limit. However, CSF alpha-MSH was elevated in four of the five children with bacterial meningitis who had neurological sequelae. We speculate that elevated alpha-MSH levels in CSF during acute bacterial meningitis reflect negative feedback in response to severe inflammation associated with neurological sequelae induced by proinflammatory cytokines.
Conclusion: CSF alpha-MSH is elevated in children with severe bacterial meningitis who had neurological sequelae.