- Exposure of primary rat glial cells to heat inactivated Streptococcus pneumoniae , induced dose-dependent production of tumor necrosis factor α (TNFα), nitric oxide (NO) and prostaglandin E 2 (PGE 2 ). Concomitant addition of the bacterium and the synthetic glucocorticoid dexamethasone resulted in complete suppression of TNFα, NO and PGE 2 production. Pentoxifylline, a phosphodiesterase inhibitor completely blocked TNFα secretion, whereas NO and PGE 2 were not affected. Low-molecular-weight heparin enoxaparin caused 25–64% inhibition in TNFα production, up to 30% inhibition of NO secretion and a 10% reduction in PGE 2 . Thus, Streptococcus pneumoniae , the pathogen most commonly associated with meningitis in the Western world can be added to the list of agents causing direct stimulation of glial cells. Pentoxifylline and enoxaparin in addition to dexamethasone may limit the central nervous system local inflammatory responses and could improve the effort towards reducing the dismal outcome of patients with pneumococcal meningitis.