Summary
Rabbit models of bacterial meningitis have contributed substantially to our understanding of the disease, although the technical characteristics of these models only allow the study of specific aspects of the disease. Bacterial multiplication in the subarachnoidal space is not substantially influenced by host defense mechanisms, mainly because of the lack of sufficient amounts of specific antibodies and functional complement in infected CSF. The multiplying bacteria induce profound changes in the blood-brain barrier, an influx of serum proteins into the CSF and the invasion of polymorphonuclear leukocytes at the site of the infection. The presence of polymorphonuclear leukocytes in CSF not only appears to be of limited value in combating the infection, but also seems to produce deleterious effects on the central nervous system. Components of the leukocytes, such as unsaturated fatty acids, arachidonic metabolites and free oxygen radicals, may contribute to the profound hydrodynamic, structural and metabolic changes that are currently under study in experimental models of the disease. A better understanding of the pathophysiology of bacterial meningitis may allow us to design more effective therapeutic strategies and improve the outcome of this disease.
Zusammenfassung
Experimentelle Untersuchungen der bakteriellen Meningitis unter Verwendung von Kaninchenmodellen haben wesentlich zu unserem Verständnis dieser Erkrankung beigetragen, obwohl sich Kaninchenmodelle aus technischen Gründen nur zum Studium ganz spezifischer Aspekte eignen. Die Vermehrung von Bakterien im Subarachnoidalraum bleibt von der körpereigenen Immunabwehr weitgehend unbeeinflußt, in erster Linie, weil im infizierten Liquor ungenügende Mengen von spezifischen Antikörpern und funktionsfähigem Complement vorhanden sind. Die sich vermehrenden Bakterien zerstören die Integrität der Blut-Hirnschranke und führen zum Einstrom von Serumeiweiß und zur Invasion polymorphkerniger Leukozyten an den Ort der Entzündung. Die Gegenwart von Leukozyten im Subarachnoidalraum ist unzureichend, um mit der Infektion fertig zu werden; vielmehr scheinen Leukozyten schädigende Wirkungen auf das Zentralnervensystem zu haben. Verschiedene Stoffwechselprodukte der Leukozyten, so zum Beispiel ungesättigte Fettsäuren, Arachidonsäuremetaboliten und freie Sauerstoffradikale, kommen als Mediatoren für die tiefgreifenden hydrodynamischen, strukturellen und metabolischen Veränderungen in Frage, die derzeit in experimentellen Modellen untersucht werden. Dank vertieftem Verständnis der pathophysiologischen Zusammenhänge der bakteriellen Meningitis wird es möglicherweise in Zukunft gelingen, therapeutische Strategien zu entwickeln, welche die Prognose dieser Krankheit weiter verbessern.
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Täuber, M.G., Sande, M.A. Pathogenesis of bacterial meningitis: Contributions by experimental models in rabbits. Infection 12 (Suppl 1), S3–S8 (1984). https://doi.org/10.1007/BF01641732
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DOI: https://doi.org/10.1007/BF01641732