Beneficial Effect of Glucocorticoids on the Course of Haematogenously Acquired Staphylococcus aureus Nephritis

Abstract

Verba V, Sakiniene E, Tarkowski A. Beneficial Effect of Glucocorticoids on the Course of Haematogenously Acquired Staphylococcus aureus Nephritis. Scand J Immunol 1997;45:282-286 The effect of combined antibiotic and corticosteroid treatment on the course of haematogenously acquired Staphylococcus aureus nephritis was studied. Mice were given a single injection of S. aureus producing toxic shock syndrome toxin-1 in a dose capable of inducing a high frequency of inflammatory kidney lesions and divided into three groups according to a treatment regimen. In all untreated animals inflammatory infiltrates were seen in kidney cortex and medulla with high frequencies of glomerular (90%) and tubular damage (50%) as well as fibrotic changes (50%). The treatment with antibiotics alone reduced significantly only the occurrence of focal inflammatory infiltrates. In contrast, the mice treated with a combination of antibiotics and corticosteroids displayed in 64% of cases normal histological kidney appearance and a significant decrease in occurrence of glomerular (P<0.01) and tubular (P<0.05) lesions. Immunohistochemically, the combined treatment resulted in a more pronounced decrease in numbers of CD4, IL-2R (four to fivefold) and CD8 positive cells in kidney inflammatory lesions compared to antibiotics only treated group. Thus, glucocorticoids in association with antibiotics are shown to improve the outcome of septic murine nephritis, possibly due to suppression of kidney infiltrating T cells.

Study of histopathological changes by Staphylococcus aureus in kidney and ability to produce B-Lactamase

“…The results of this study showed an infiltration of inflammatory cells in interstitial tissue, cortex and medulla of the kidney (picture 1) and around the blood vesseles (picture 2), this agreed with (15,16,17,18).…”

Dexamethasone promotes phagocytosis and bacterial killing by human monocytes/macrophages in vitro

“…is often reduced or abrogated when patients show bacterial infections [33]. However, others describe that glucocorticoids can have beneficial effects in association with antibiotics [34]. We showed that not only phagocytosis of S. aureus bacteria was increased after treatment of human monocytes with DEX, but also the killing of S. aureus bacteria was at least twice as effective.…”

Dexamethasone as Adjuvant Therapy to Moxifloxacin Attenuates Valve Destruction in Experimental Aortic Valve Endocarditis Due to Staphylococcus aureus

“…In experimental models, dexamethasone has been successfully combined with antibiotics to treat staphylococcal endophthalmitis (27), septic arthritis (25), and septic nephritis (31), as well as pneumococcal (24) and Haemophilus influenzae type b (28) meningitis. There are also clinical trials and reports supporting the administration of steroids, especially dexamethasone, due to its strong anti-inflammatory properties, in combination with antibiotics for infections such as meningitis (19) and nephritis (15).…”