title: Inhibition of Hippocampal Regeneration by Adjuvant Dexamethasone in Experimental Infant Rat Pneumococcal Meningitis.
abstract: Pneumococcal meningitis (PM) causes neurological sequelae in up to half of surviving patients. Neuronal damage associated with poor outcome is largely mediated by the inflammatory host response. Dexamethasone (DXM) is used as an adjuvant therapy in adult PM, but its efficacy in the treatment of pneumococcal meningitis in children is controversially discussed. While DXM has previously been shown to enhance hippocampal apoptosis in experimental PM, its impact on hippocampal cell proliferation is not known. This study investigated the impact of DXM on hippocampal proliferation in infant rat PM. Eleven-day-old nursing Wistar rats (n = 90) were intracisternally infected with Streptococcus pneumoniae to induce experimental meningitis. Treatment with DXM or vehicle was started 18 h after infection, concomitantly with antibiotics (ceftriaxone 100 mg/kg of body weight twice a day [b.i.d.]). Clinical parameters were monitored, and the amount of cells with proliferating activity was assessed using in vivo incorporation of bromodeoxyuridine (BrdU) and an in vitro neurosphere culture system at 3 and 4 d postinfection. DXM significantly worsened weight loss and survival. Density of BrdU-positive cells, as an index of cells with proliferating activity, was significantly lower in DXM-treated animals compared to vehicle controls (P < 0.0001). In parallel, DXM reduced neurosphere formation as an index for stem/progenitor cell density compared to vehicle treatment (P = 0.01). Our findings provide clear evidence that DXM exerts an antiproliferative effect on the hippocampus in infant rat PM. We conclude that an impairment of regenerative hippocampal capacity should be taken into account when considering adjuvant DXM in the therapeutic regimen for PM in children.
authors.affiliation: Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
authors.forename: Lia
authors.initials: L
authors.lastname: Bally
authors.affiliation: Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
authors.forename: Denis
authors.initials: D
authors.lastname: Grandgirard
authors.affiliation: Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland stephen.leib@ifik.unibe.ch.
authors.forename: Stephen L
authors.identifier: http://orcid.org/0000-0002-1106-6123
authors.initials: SL
authors.lastname: Leib
mesh_terms: D000277:Adjuvants, Pharmaceutic / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects*; D002443:Ceftriaxone / Q000627:therapeutic use; D049109:Cell Proliferation / Q000187:drug effects; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use*; D006624:Hippocampus / Q000166:cytology / Q000187:drug effects* / Q000382:microbiology; D008586:Meningitis, Pneumococcal / Q000188:drug therapy*; D051381:Rats; D017208:Rats, Wistar; D012038:Regeneration / Q000187:drug effects*; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000472:pathogenicity
chemical_list: D000277:Adjuvants, Pharmaceutic; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D002443:Ceftriaxone; D003907:Dexamethasone
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