Tuberculous meningitis in infants and children: Insights from nuclear magnetic resonance metabolomics

South African Journal of Science

Carolus J. Reinecke¹  Shayne Mason¹  A. Marceline van Furth²  Regan Solomons³ 

[1]Centre for Human Metabonomics, Faculty of Natural Sciences, North-West University, Potchefstroom Campus, Potchefstroom, South Africa

[2]Department of Paediatric Infectious Diseases and Immunology, VU University Medical Center, Amsterdam, the Netherlands

[3]Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa

关键词: TBM;    NMR spectroscopy;    cerebrospinal fluid;    CSF;    hypothesis;   

DOI  :  10.17159/sajs.2016/20150086

来源: DOAJ

【 摘 要 】

Tuberculous meningitis (TBM) is a prevalent form of central nervous system tuberculosis (CNS-TB) and the most severe common form of bacterial meningitis in infants and children below the age of 13 years, especially in the Western Cape Province of South Africa. Research to identify markers for timely and accurate diagnosis and treatment outcomes remains high on the agenda for TBM, in respect of which the field of metabolomics is as yet largely unexploited. However, the national Department of Science and Technology (DST) recently established several biotechnology platforms at South African institutions, including one for metabolomics hosted at North-West University. We introduce this national platform for nuclear magnetic resonance (NMR) metabolomics by providing an overview of work on TBM. We focus on selected collaborative multidisciplinary approaches to this disease and conclude with the outcomes of an untargeted NMR metabolomics study of cerebrospinal fluid from TBM patients. This study enabled the formulation of a conceptual shuttle representing the unique metabolic plasticity of CNS metabolism towards the energy requirements for the microglia-driven neuroinflammatory responses, of which TBM is one example. From insights generated by this explorative NMR metabolomics investigation, we propose directions for future in-depth research strategies to address this devastating disease. In our view, the timely initiative of the DST, the operational expertise in metabolomics now available and the potential for involving national and international networks in this field of research offers remarkable opportunities for the future of metabolomics in South Africa and for an ever greater understanding of disease mechanisms.

【 授权许可】

Unknown