Lipidomic insights into infectious meningitis: Pathogen-specific alterations and therapeutic implications

Infectious meningitis represents a critical neurological condition resulting from the invasion of bacterial, viral, fungal, or parasitic pathogens into the central nervous system (CNS). Recent advances in mass spectrometry-based lipidomics have provided unprecedented insights into pathogen-induced alterations of the cerebrospinal fluid (CSF) and neural tissue lipidome. This review summarizes the structural and functional roles of lipids in neuroinflammation and describes pathogen-specific lipidomic alterations observed in tuberculous, viral, bacterial, fungal, and parasitic meningitis. Distinct lipid signatures - including phosphatidylcholines (PC), sphingomyelins (SM), ceramides (Cer), and lysophosphatidylcholines (LysoPC) - serve as potential biomarkers for disease differentiation, prognosis, and therapeutic monitoring. Understanding lipid-pathogen interactions not only deepens mechanistic insight into the pathophysiology of neuroinfection but also opens new perspectives for precision diagnostics and lipid-targeted interventions.