ArticleBMC infectious diseases2016
Cerebrospinal fluid in tuberculous meningitis exhibits only the L-enantiomer of lactic acid.
Article in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 26 citations in OpenAlex.
- Interactions between CNS and immune cells in tuberculous meningitis.Frontiers in immunology · 2024Review
- Indirect Enantioseparations: Recent Advances in Chiral Metabolomics for Biomedical Research.International journal of molecular sciences · 2022Review
- CSF Metabolomics of Tuberculous Meningitis: A Review.Metabolites · 2021Review
- Lactate Metabolism and Signaling in Tuberculosis and Cancer: A Comparative Review.Frontiers in cellular and infection microbiology · 2021Review
- Hydrogen sulfide toxicity in the gut environment: Meta-analysis of sulfate-reducing and lactic acid bacteria in inflammatory processes.Journal of advanced research · 2021Review
- A Novel, Multi-Faceted Perception of Lactate in Neurology.Frontiers in neuroscience · 2020Article
- Mycobacterium tuberculosis requires glyoxylate shunt and reverse methylcitrate cycle for lactate and pyruvate metabolism.Molecular microbiology · 2019Article
- The pathogenesis of tuberculous meningitis.Journal of leukocyte biology · 2019Review
- Butyrate production in patients with end-stage renal disease.International journal of nephrology and renovascular disease · 2019Article
- Article
- A diagnostic biomarker profile for fibromyalgia syndrome based on an NMR metabolomics study of selected patients and controls.BMC neurology · 2017Article
- Lactate Shuttles in Neuroenergetics-Homeostasis, Allostasis and Beyond.Frontiers in neuroscience · 2017Review
- Cerebrospinal Fluid Amino Acid Profiling of Pediatric Cases with Tuberculous Meningitis.Frontiers in neuroscience · 2017Article
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe defining feature of the cerebrospinal fluid (CSF) collected from infants and children with tuberculous meningitis (TBM), derived from an earlier untargeted nuclear magnetic resonance (NMR) metabolomics study, was highly elevated lactic acid. Undetermined was the contribution from host response (L-lactic acid) or of microbial origin (D-lactic acid), which was set out to be determined in this study.
methodsIn this follow-up study, we used targeted ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (UPLC-ESI-MS/MS) to determine the ratio of the L and D enantiomers of lactic acid in these CSF samples.
resultsHere we report for the first time that the lactic acid observed in the CSF of confirmed TBM cases was in the L-form and solely a response from the host to the infection, with no contribution from any bacteria. The significance of elevated lactic acid in TBM appears to be that it is a crucial energy substrate, used preferentially over glucose by microglia, and exhibits neuroprotective capabilities.
conclusionThese results provide experimental evidence to support our conceptual astrocyte-microglia lactate shuttle model formulated from our previous NMR-based metabolomics study - highlighting the fact that lactic acid plays an important role in neuroinflammatory diseases such as TBM. Furthermore, this study reinforces our belief that the determination of enantiomers of metabolites corresponding to infectious diseases is of critical importance in substantiating the clinical significance of disease markers.
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