During acute bacterial meningitis, recognition of the bacterial envelope by immune cells of the central nervous system (CNS) generates a robust response that is essential to clear bacteria. This response is further amplified during treatment when lytic antibiotics, required for cure, also generate a burst of highly inflammatory cell envelope debris. Different peptidoglycan (PG) subcomponents interact with neurons, glia, and the blood brain barrier resulting in the entire symptom complex of meningitis. Recently, this CNS-cell envelope signaling axis has been extended to non-inflammatory recognition of cell wall components circulating from endogenous bacteria to the brain resulting in both benefit and chronic damage. This review will describe the molecular details of a broad array of cell envelope-induced responses in the CNS and what current strategies can be implemented to improve clinical outcome.

在急性细菌性脑膜炎期间，中枢神经系统（CNS）免疫细胞对细菌包膜的识别会产生强烈的反应，这对于清除细菌至关重要。当治疗所需的溶解性抗生素也产生高发炎性细胞包膜碎片时，这种反应在治疗期间会进一步放大。不同的肽聚糖（PG）子组件与神经元，神经胶质和血脑屏障相互作用，导致脑膜炎的整个症状复杂。近来，该CNS-细胞包膜信号传导轴已经扩展到非炎性识别从内源性细菌循环到大脑的细胞壁成分，从而导致益处和慢性损害。