Trial reportPloS one2009
Dexamethasone, cerebrospinal fluid matrix metalloproteinase concentrations and clinical outcomes in tuberculous meningitis.
Trial report in PloS one, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Clinical Efficacy of Dexamethasone in the Treatment of Patients with Tuberculous Meningitis: A Meta-Analysis.Contrast media & molecular imaging · 2022Pooled it
- Adjunctive steroid therapy for managing pulmonary tuberculosis.The Cochrane database of systematic reviews · 2014Pooled it
- Towards host-directed therapy: The role of matrix metalloproteinases in the immunopathogenesis of tuberculosis.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026Review
- Inflammatory biomarkers as predictors of paradoxical reaction in tubercular meningitis: a prospective observational study.BMJ neurology open · 2026Article
- Cohort study exploring the association of cerebrospinal fluid metalloprotease levels and Microbiological characteristics to cerebral vasculitis complication in Pneumococcal meningitis.Scientific reports · 2025Observational
- Inflammatory markers in the cerebrospinal fluid linked to mortality in tuberculous meningitis.Brain communications · 2025Article
- Potential of Neuroinflammation-Modulating Strategies in Tuberculous Meningitis: Targeting Microglia.Aging and disease · 2024Review
- Interactions between CNS and immune cells in tuberculous meningitis.Frontiers in immunology · 2024Review
- Recent advances in understanding the human host immune response in tuberculous meningitis.Frontiers in immunology · 2023Review
- Neutrophil-Mediated Immunopathology and Matrix Metalloproteinases in Central Nervous System - Tuberculosis.Frontiers in immunology · 2021Review
- Therapeutic host-directed strategies to improve outcome in tuberculosis.Mucosal immunology · 2020Review
- Tuberculous meningitis in children is characterized by compartmentalized immune responses and neural excitotoxicity.Nature communications · 2019Article
- MMPs and ADAMs in neurological infectious diseases and multiple sclerosis.Cellular and molecular life sciences : CMLS · 2019Review
- Matrix Metalloproteinases in Pulmonary and Central Nervous System Tuberculosis-A Review.International journal of molecular sciences · 2019Review
- The Activity of Matrix Metalloproteinases (MMP-2, MMP-9) and Their Tissue Inhibitors (TIMP-1, TIMP-3) in the Cerebral Cortex and Hippocampus in Experimental Acanthamoebiasis.International journal of molecular sciences · 2018Article
- Review
- Adjunctive Corticosteroid Therapy in the Treatment of Coccidioidal Meningitis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Matrix Degradation in Human Immunodeficiency Virus Type 1-Associated Tuberculosis and Tuberculosis Immune Reconstitution Inflammatory Syndrome: A Prospective Observational Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Observational
- Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy.Journal of neuroinflammation · 2017Review
- The SIGLEC14 null allele is associated with Mycobacterium tuberculosis- and BCG-induced clinical and immunologic outcomes.Tuberculosis (Edinburgh, Scotland) · 2017Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundAdjunctive dexamethasone reduces mortality from tuberculous meningitis, but how it produces this effect is not known. Matrix metalloproteinases (MMPs) are important in the immunopathology of many inflammatory CNS diseases thus we hypothesized that that their secretion is important in TBM and might be influenced by dexamethasone. METHODOLOGY/PRINCIPAL
findingsThe kinetics of cerebrospinal fluid (CSF) MMP and tissue inhibitors of MMPs (TIMPs) concentrations were studied in a subset of HIV uninfected adults (n = 37) with TBM recruited to a randomized, placebo-controlled trial of adjuvant dexamethasone. Analysis followed a pre-defined plan. Dexamethasone significantly reduced CSF MMP-9 concentrations in early follow up samples (median 5 days (range 3-8) of treatment), but had no significant influence on other MMPs/TIMPs. Additionally CSF MMP-9 concentration was strongly correlated to concomitant CSF neutrophil count. CONCLUSIONS/SIGNIFICANCE: Dexamethasone decreased CSF MMP-9 concentrations early in treatment and this may represent one mechanism by which corticosteroids improve outcome in TBM. The strong correlation between CSF MMP-9 and neutrophil count suggests that polymorphonuclear leukocytes may play a central role in the early pathogenesis of TBM.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.