The simultaneous cytological and metabolic investigation of various extravascular body fluids (EBFs) provides clinically relevant information about the type and intensity of the immune response in particular organ systems. The oxidative burst of professional phagocytes with the concomitant production of reactive oxygen species consumes a large amount of oxygen and is the cause of switch to the development of anaerobic metabolism. We assessed the relationships between percentages of neutrophils, aerobic and anaerobic metabolism, and tissue damage via the determination of aspartate aminotransferase catalytic activities (AST) in cerebrospinal fluid (CSF), pleural effusions (PE), abdominal effusions (AE), and synovial fluids (SF). EBFs with 0.0-20.0% neutrophils: 83.0% aerobic and 1.3% strongly anaerobic cases with median of AST = 13.8 IU/L in CSF; 68.0% aerobic and 9.0% strongly anaerobic cases with median of AST = 20.4 IU/L in PE; 77.5% aerobic and 10.5% strongly anaerobic cases with median of AST = 18.0 IU/L in AE; 64.1% aerobic and 7.7% strongly anaerobic cases with median of AST = 13.8 IU/L in SF. EBFs with 80.0-100.0% neutrophils: 4.2% aerobic and 73.7% strongly anaerobic cases with median of AST = 19.2 IU/L in CSF; 7.4% aerobic and 77.3% strongly anaerobic cases with median of AST = 145.2 IU/L in PE; 11.8% aerobic and 73.7% strongly anaerobic cases with median of AST = 61.8 IU/L in AE; 25.5% aerobic and 38.2% strongly anaerobic cases with median of AST = 37.2 IU/L in SF. The significant presence of neutrophils, concomitant strong anaerobic metabolism, and elevated AST in various EBFs are reliable signs of damaging purulent inflammation.

Department of Biomedicine and Laboratory Diagnostics Faculty of Health Studies Jan Evangelista Purkinje University and Masaryk Hospital 401 13 Usti nad Labem Czech Republic

Department of Clinical Immunology and Allergology Faculty of Medicine and University Hospital Charles University Prague 500 03 Hradec Kralove Czech Republic

Department of Histology and Embryology 2nd Faculty of Medicine Charles University 150 06 Prague Czech Republic

Department of Neurosurgery Faculty of Health Studies Jan Evangelista Purkinje University and Masaryk Hospital 401 13 Usti nad Labem Czech Republic

Department of Neurosurgery Faculty of Medicine and University Hospital Charles University Prague 301 00 Pilsen Czech Republic

Department of Orthopaedics Faculty of Health Studies Jan Evangelista Purkinje University and Masaryk Hospital 401 13 Usti nad Labem Czech Republic

Department of Orthopaedics Regional Hospital 360 01 Karlovy Vary Czech Republic

Department of Thoracic Surgery Masaryk Hospital 401 13 Usti nad Labem Czech Republic

Laboratory for Cerebrospinal Fluid Neuroimmunology Pathology and Special Diagnostics Topelex 190 00 Prague Czech Republic

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