Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
National Yang-Ming University, Taipei, Taiwan.
Parasitology. 2021 Feb;148(2):187-197. doi: 10.1017/S0031182020001870. Epub 2020 Oct 2.
Steroids have been shown to be beneficial in patients and mice with eosinophilic meningitis caused by Angiostrongylus cantonensis infection; however, the mechanism for this beneficial effect is unknown. We speculated that the effect of steroids in eosinophilic meningitis caused by A. cantonensis infection may be mediated by the downregulation of matrix metallopeptidase-9 (MMP-9) and oxidative stress pathways via glucocorticoid receptors (GRs). We found blood-brain barrier (BBB) dysfunction in mice with eosinophilic meningitis 2-3 weeks after infection as evidenced by increased extravasation of Evans blue and cerebrospinal fluid (CSF) albumin levels. The administration of dexamethasone significantly decreased the amount of Evans blue and CSF albumin. The effect of dexamethasone was mediated by GRs and heat shock protein 70, resulting in subsequent decreases in the expressions of nuclear factor kappa B (NF-κB), c-Jun N-terminal kinase (JNK), and extracellular signal-regulated kinase (ERK) in the CSF and brain parenchymal after 2 weeks of steroid administration. Steroid treatment also decreased CSF/brain homogenate MMP-9 concentrations, but had no effect on CSF MMP-2 levels, indicating that MMP-9 rather than MMP-2 played a major role in BBB dysfunction in mice with eosinophilic meningitis. The concentration of 8-hydroxy-2'-deoxyguanosine (8-OHdG) gradually increased after 1-3 weeks of infection, and the administration of dexamethasone significantly downregulated the concentration of oxidized derivative 8-OHdG in CSF. In conclusion, increased 8-OHdG and MMP-9 concentrations were found in mice with eosinophilic meningitis caused by A. cantonensis infection. The effect of dexamethasone was mediated by GRs and significantly decreased not only the levels of 8-OHdG and MMP-9 but also NF-κB, JNK and ERK.
在血管内圆线虫感染引起的嗜酸性粒细胞性脑膜炎患者和小鼠中,类固醇已被证明是有益的;然而,这种有益效果的机制尚不清楚。我们推测,类固醇在血管内圆线虫感染引起的嗜酸性粒细胞性脑膜炎中的作用可能是通过糖皮质激素受体 (GRs) 下调基质金属蛋白酶-9 (MMP-9) 和氧化应激途径来介导的。我们发现,感染后 2-3 周,嗜酸性粒细胞性脑膜炎小鼠的血脑屏障 (BBB) 功能障碍,表现为伊文思蓝和脑脊液 (CSF) 白蛋白渗出增加。地塞米松的给药显著降低了伊文思蓝和 CSF 白蛋白的量。地塞米松的作用是通过 GRs 和热休克蛋白 70 介导的,导致类固醇给药 2 周后 CSF 和脑实质中核因子 kappa B (NF-κB)、c-Jun N 末端激酶 (JNK) 和细胞外信号调节激酶 (ERK) 的表达减少。类固醇治疗还降低了 CSF/脑匀浆中 MMP-9 的浓度,但对 CSF MMP-2 水平没有影响,表明 MMP-9 而不是 MMP-2 在嗜酸性粒细胞性脑膜炎小鼠的 BBB 功能障碍中起主要作用。8-羟基-2'-脱氧鸟苷 (8-OHdG) 的浓度在感染后 1-3 周逐渐增加,地塞米松的给药显著下调了 CSF 中氧化衍生物 8-OHdG 的浓度。总之,在血管内圆线虫感染引起的嗜酸性粒细胞性脑膜炎小鼠中发现 8-OHdG 和 MMP-9 浓度增加。地塞米松的作用是通过 GRs 介导的,不仅显著降低了 8-OHdG 和 MMP-9 的水平,而且还降低了 NF-κB、JNK 和 ERK 的水平。