Glycerol does not reduce neuronal damage in experimental Streptococcus pneumoniae meningitis in rabbits

Schmidt, Holger; Stuertz, Kristin; Chen, Guihai; Ak, Stringaris; Brück, Wolfgang; Nau, R.

doi:10.1007/s10787-998-0003-7

Cited by 13 publications

(9 citation statements)

References 19 publications

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“…In the rabbit model of Str. pneumoniae meningitis, glycerol was unable to reduce neuronal injury in the hippocampal formation [132]. In ceftriaxone-treated Str.…”

Section: Glycerol and Other Intracranial Pressure-lowering Agentsmentioning

confidence: 98%

Bacterial meningitis: an update of new treatment options

Nau

Djukic

Spreer

et al. 2015

Expert Review of Anti-infective Therapy

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The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure <20 mmHg (in particular, external ventriculostomy, osmotherapy and temporary hyperventilation) were effective in a case-control study. Although many experimental approaches were protective in animal models, none of them has been proven effective in patients. Antibiotics, which are bactericidal but do not lyse bacteria, and inhibitors of matrix metalloproteinases or complement factor C5 appear the most promising therapeutic options. At present, vaccination is the most efficient method to reduce disease burden. Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections.

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“…In the rabbit model of Str. pneumoniae meningitis, glycerol was unable to reduce neuronal injury in the hippocampal formation [132]. In ceftriaxone-treated Str.…”

Section: Glycerol and Other Intracranial Pressure-lowering Agentsmentioning

confidence: 98%

Bacterial meningitis: an update of new treatment options

Nau

Djukic

Spreer

et al. 2015

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

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“…Moreover, in a rabbit model, pneumococcal meningitis treated with glycerol alone was associated with an increased level of hippocampal neuronal apoptosis (439). A study in which healthy mice were treated with high doses of glycerol (much higher than trial dosages) showed that treatment was associated with the occurrence of seizures (127), which were also seen more in the glycerol-treated patients in the Malawi trial (5).…”

Section: Adjunctive Glycerol Therapymentioning

confidence: 99%

Pathogenesis and Pathophysiology of Pneumococcal Meningitis

et al. 2011

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SUMMARY Pneumococcal meningitis continues to be associated with high rates of mortality and long-term neurological sequelae. The most common route of infection starts by nasopharyngeal colonization by Streptococcus pneumoniae , which must avoid mucosal entrapment and evade the host immune system after local activation. During invasive disease, pneumococcal epithelial adhesion is followed by bloodstream invasion and activation of the complement and coagulation systems. The release of inflammatory mediators facilitates pneumococcal crossing of the blood-brain barrier into the brain, where the bacteria multiply freely and trigger activation of circulating antigen-presenting cells and resident microglial cells. The resulting massive inflammation leads to further neutrophil recruitment and inflammation, resulting in the well-known features of bacterial meningitis, including cerebrospinal fluid pleocytosis, cochlear damage, cerebral edema, hydrocephalus, and cerebrovascular complications. Experimental animal models continue to further our understanding of the pathophysiology of pneumococcal meningitis and provide the platform for the development of new adjuvant treatments and antimicrobial therapy. This review discusses the most recent views on the pathophysiology of pneumococcal meningitis, as well as potential targets for (adjunctive) therapy.

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“…128 However, to date, there is insufficient clinical or experimental evidence to support glycerol therapy for BM. 141,142 …”

Section: Glycerol Therapymentioning

confidence: 99%