ALB and meningitis: It is well established that inflammatory cytokines can contribute to BBB dysfunction in human disease (Coisne and Engelhardt, 2011; Elwood et al., 2017), including studies of the BCSFB using albumin ratios in meningitis showing relationship to TNF- α (Sharief et al., 1992), and cardiac surgery showing relationship to IL-6 and IL-8 (Reinsfelt et al., 2012).