Doxycycline reduces mortality and injury to the brain and cochlea in experimental pneumococcal meningitis
Abstract
Bacterial meningitis is characterized by an inflammatory reaction to the invading pathogens that can ultimately lead to sensorineural hearing loss, permanent brain injury, or death. The matrix metalloproteinases (MMPs) and tumor necrosis factor alpha-converting enzyme (TACE) are key mediators that promote inflammation, blood-brain barrier disruption, and brain injury in bacterial meningitis. Doxycycline is a clinically used antibiotic with anti-inflammatory effects that lead to reduced cytokine release and the inhibition of MMPs. Here, doxycycline inhibited TACE with a 50% inhibitory dose of 74 microM in vitro and reduced the amount of tumor necrosis factor alpha released into the cerebrospinal fluid by 90% in vivo. In an infant rat model of pneumococcal meningitis, a single dose of doxycycline (30 mg/kg) given as adjuvant therapy in addition to ceftriaxone 18 h after infection significantly reduced the mortality, the blood-brain barrier disruption, and the extent of cortical brain injury. Adjuvant doxycycline (30 mg/kg given subcutaneously once daily for 4 days) also attenuated hearing loss, as assessed by auditory brainstem response audiometry, and neuronal death in the cochlear spiral ganglion at 3 weeks after infection. Thus, doxycycline, probably as a result of its anti-inflammatory properties, had broad beneficial effects in the brain and the cochlea and improved survival in this model of pneumococcal meningitis in infant rats.
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A subsequent meta-analysis investigating corticosteroid use showed no difference in mortality but some improvement in hearing loss.
“A subsequent meta-analysis investigating corticosteroid use showed no difference in mortality but some improvement in hearing loss.52”
From Community-acquired acute bacterial meningitis in adults: a clinical update (2019) · cites this paper as [52]
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- Authors
- Meli, D. N., Coimbra, R. S., Erhart, D. G., Loquet, G., Bellac, C. L., Täuber, M. G., Neumann, U., & Leib, S. L.
- Affiliations
- University of Bern (CH)
- Department of Medicine, Unit of Physiology, University of Fribourg, Fribourg, Switzerland
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, P.O. Box 61, CH-3010 Bern, Switzerland
- Novartis (Switzerland) (CH)
- Corresponding author
- Leib, Stephen L.
- Venue
- Infection and Immunity
- Publisher
- American Society for Microbiology
- Published
- 2006-07
- Volume
- 74
- Issue
- 7
- Pages
- 3890-3896
- ISSN
- 0019-9567 (ISSN-L)
- 1098-5522
- OpenAlex
- W2055918489
- Cited by
- 94
- References
- 50
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 7 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 6 · 2019: 7 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 7 · 2014: 6 · 2013: 1 · 2012: 4
- FWCI
- 6.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Infection and Immunity (publishedVersion)
- PubMed (publishedVersion)
- reroDoc Digital Library (submittedVersion)
- BORIS (University Library Bern) (submittedVersion)
- Funders
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- National Institutes of Health
- National Institute of Neurological Disorders and Stroke (P50NS035902)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- doxycycline, pneumococcal meningitis, Streptococcus pneumoniae, bacterial meningitis, matrix metalloproteinases, transarterial chemoembolization, TNF-α, anti-inflammatory activity, blood-brain barrier disruption, brain injury, sensorineural hearing loss, neuronal cell death, ceftriaxone, adjuvant antibiotic therapy, mortality, infant rat model
- MeSH terms
- Animals, Anti-Inflammatory Agents, Non-Steroidal, Anti-Bacterial Agents, Brain, Ceftriaxone, Cochlea, Doxycycline, Female, Injections, Subcutaneous, Meningitis, Pneumococcal, Tumor Necrosis Factor-alpha, Rats, Wistar, Rats
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