**6. References**


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in LPS-induced experimental meningitis [61].

categorization of bacterial meningitis.

*Department of Neurosurgery, Hospital of Neurosciences, Baghdad, Iraq* 

[1] http://en.wikipedia.org/wiki/C-reactive\_protein

Moneer Faraj and Nihaya Salem

**Author details** 

**6. References** 

diagnosis.

**positive and gram-negative bacterial meningitis** 

**5. C - reactive protein concentrations in cerebral spinal fluid in gram-**

Several reports have shown an ability of CRP to discriminate between patients with bacterial meningitis and patients with aseptic (viral) meningitis. Although a recent Metaanalysis suggested that a negative CRP test in either cerebrospinal fluid (CSF) or serum can be used with a very high probability to rule out bacterial meningitis, a more recent report suggested that serum concentrations are a better screening tool for this differential

The substantial increase in CSF CRP, as well as the trend of an increased CSF/blood ratio of CRP, suggests that infection with gram-negative bacteria enhances permeability of CRP through the blood-brain barrier. It is possible that these findings reflect the ability of the endotoxin lipopolysaccharide-s, present in gram-negative but not in gram-positive bacteria, to affect the permeability of the blood-brain barrier [57][58]. CSF nitric oxide (NO) may be involved in this mechanism because its concentration in CSF is higher in gram-negative meningitis. This possibility is supported by the higher potency of gram-negative bacteria to promote macrophage NO production [59], the enhanced production of NO in the CSF of septic meningitis [60], and the role of NO in permeability changes of the blood-brain barrier

Another interesting potential explanation for the present observation is that lipopolysaccharide-s produced by gram-negative bacteria could induce local CRP synthesis in the central nervous system. CRP can be produced in neurons [62], and lipopolysaccharide-s can induce CRP in extrahepatic sites [63]. This may also explain the increase, albeit nonsignificant, in serum CRP in the gram-negative cases. There is currently no single test to diagnose the etiology of meningitis promptly and accurately. Given its high sensitivity and easy measurability, CRP may be a useful supplement for rapid diagnosis and

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[48] Kim JS, Kang TS, Kim JB, Seo HS, Park S, Kim C, Ko YG, Choi D, Jang Y, and Chung N (2007) Significant association of C-reactive protein with arterial stiffness in treated non-

[49] Vainas T, Lubbers T, Stassen FR, Herngreen SB, van Dieijen-Visser MP, Bruggeman CA, Kitslaar PJ, and Schurink GW (2003) Serum C-reactive protein level is associated with abdominal aortic aneurysm size and may be produced by aneurysmal tissue.

[50] Jabs WJ, Theissing E, Nitschke M, Bechtel JF, Duchrow M, Mohamed S, Jahrbeck B, Sievers HH, Steinhoff J, and Bartels C (2003) Local generation of C-reactive protein in diseased coronary artery venous bypass grafts and normal vascular tissue. Circulation

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[56] Vitamin C treatment reduces elevated C-reactive protein.(Gladys Block a, Christopher D. Jensen a, Tapashi B. Dalvi a, Edward P. Norkus b, Mark Hudes a, Patricia B. Crawford a, Nina Holland a, Ellen B. Fung c, Laurie Schumacher c, Paul Harmatz) Free

[58] Wispelwey B, Lesse AJ, Hansen EJ, Scheld WM. Haemophilus influenzae lipopolysaccharide-induced blood-brain barrier induced permeability during

[59] Jungi TW*, Valentin-Weigand P, Brcic M. Differential induction of NO synthesis by grampositive and gram-negative bacteria and their components in bovine monocyte-derived* 

[60] Tsukahara H, Haruta T, Hata I, Mayumi M. Nitric oxide in septic and aseptic meningitis

[61] Boje KMK*. Inhibition of nitric oxide synthase attenuates blood-brain barrier disruption during* 

[62] Yasojima K*, Schwab C, McGeer EG, McGeer PL. Human neurons generate C-reactive protein* 

*and amyloid P: upregulation in Alzheimer's disease.* Brain Res 2000*;*887*:*80*-89.*

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[63] Introna M, Alles VV, Castellano M, Picardi G, De Gioia L, et al. Cloning of mouse ptx3, a new member of the pentraxin gene family expressed at extrahepatic sites. Blood 1996;87:1862-1872.

**Chapter 6** 

© 2012 Takahashi et al., licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2012 Takahashi et al., licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2012 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

Use of whole blood was intended on two accounts. First, RNA expression and degradation is susceptible to artificial manipulation such as cell separation and extraction. The whole blood manipulation avoids this risk, unlike dealing with extracted white blood cells. In addition, whole-blood RNA can be stabilized immediately by using RNA blood sampling

and reproduction in any medium, provided the original work is properly cited.

**Whole Blood RNA Analysis, Aging and Disease** 

Microarray techniques allow to detect genome-wide perturbations during various treatments and to measure various responses by multitude of gene probes. Toxicogenomics, in which microarray techniques are specifically used in toxicology test, has been widely recognized as one of standard safety procedures for chemicals [1-3]. Gene expression microarrays have been used particularly for screening of genes involved in specific biological processes of interest, such as diseases or responses to environmental stimuli. Such experiments adopt the "healthy state" as a control, and identify highly expressed or suppressed genes. However, few studies deal with the features of gene expression and its variation at the "healthy state" to be influenced by species, age, sex, and individual variability. In measuring the state of disease and drug response, minimally invasive blood sampling, which allows for direct measurement of immune-responsive blood cells, excels other invasive biopsy techniques upon disease diagnostics and assessment of drug response, as well as health monitoring. Blood RNA contains an enormous amount of information on expression of messenger RNA and non coding functional RNA which remains without being translated into protein. Thus, blood RNA offers an opportunity to detect subtle change in physiological state. In this chapter, we discuss the potential of the RNA diagnosis using whole blood, showing a series of whole blood microarray experiments to evaluate variations of correlation among individuals and ages [4], dietary-induced hyperlipidemia,

and other stresses using specific pathogen-free (SPF) miniature pigs.

**2. The use of whole blood RNA analysis** 

Junko Takahashi, Akiko Takatsu, Masaki Misawa and Hitoshi Iwahashi

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/48226

**1. Introduction** 
