IL6 and IL17 as inflammatory response in a case of Neurobrucellosis presenting as Leucoencephalopathy (P5.117)

Objective: To understand how Brucella genus can affect the central nervous system (CNS) by analysing immune system and if T or B cells are implicated. Background: It was demonstrated that Brucella infects microglia and astrocytes eliciting the production of a variety of pro-inflammatory cytokines and secretion of metalloproteinases which contribute to CNS damage. Studies highlighting the implication of T cells are few and experimental. Design/Methods: We describe the case of a young woman presenting Neurobrucellosis as a leucoencephalopathy (Figure) (positive Wright test agglutination: 1/80 in blood, 1/40 in CSF). To assess inflammatory response, PBMCs and cerebral spinal fluid (CSF) cells mRNA gene expression against a panel of cytokines were investigated by quantitative real-time PCR before and 3 months after antibiotic treatment. IL12/IFN-γ axis was investigated. Results: Analysis showed no defect in NADPH oxidase complex and no functional disorder of IL12/IFN-γ pathway. Comparison of cytokines expression by QRT PCR analysis revealed that inflammation in the CSF is due to IL-6 and IL17 that decreases after treatment; however in peripheral blood this inflammation involves IL-6, TNF-α, IL-1β and IL-17 Conclusions: Investigation of cytokines expression in PBMC and CSF revealed an IL6/IL17 inflammatory profile in this case report. These results could improve our understanding of inflammation in a leptomeningial and WM involvement related to Neurobrucellosis. This case could help us to give a better diagnosis when clinical, MRI data and hematological routine tests are non-specific and to improve therapeutic options. Disclosure: Dr. Kchaou has nothing to disclose. Dr. Belguith has nothing to disclose. Dr. Bahrini has nothing to disclose. Dr. jalleli has nothing to disclose. Dr. echebbi has nothing to disclose. Dr. Jamoussi has nothing to disclose. Dr. Ben Ali has nothing to disclose. Dr. Fredj has nothing to disclose. Dr. Barbouche has nothing to disclose.