Metformin is a biguanide drug which is used to treat diabetes mellitus type 2. Recently, Metformin has shown an ability to suppress neuroinflammation and induce neuro-regeneration. It has been evaluated as a neuroprotective agent in the prodromal Parkinson’s disease (1).
Muri et al. have studied a potential of this medication to decrease the risk of neurological sequelae in pneumococcal meningitis, such as cognitive impairment and hearing loss. These sequelae are due to hyperinflammatory reaction in response to bacterial brain invasion. This study evaluated the effect of metformin adjunctive to antibiotics on neuroinflammation, brain and inner ear damage, and neurofunctional outcome in experimental paediatric pneumococcal meningitis (2).
Eleven-day-old Wistar rats were infected intracisternally with Streptococcus pneumoniae and they were randomized for treatment with metformin plus ceftriaxone or ceftriaxone monotherapy. Cortical damage and hippocampal apoptosis were evaluated histomorphometrically 42 hours after infection. Cerebrospinal fluid cytokine levels were analyzed as well. Metformin treatment significantly reduced levels of inflammatory cytokines and nitric oxide production in cerebrospinal fluid and in astroglial cell cultures in vitro. Compared to ceftriaxone monotherapy, adjunctive metformin significantly reduced cortical necrosis. Adjuvant metformin significantly improved pure tone hearing thresholds at all assessed frequencies compared to ceftriaxone monotherapy and protected from spiral ganglion neuron loss in the inner ear, induced by the pneumococcal meningitis.
According to this experimental study, Metformin, combined with antibiotic treatment may be a promising therapeutic option to prevent neurologic sequelae after pneumococcal meningitis.
Key Points:
- Metformin has shown an ability to suppress neuroinflammation and induce neuroregeneration.
- Metformin, in combination with antibiotic treatment, has a potential to prevent neurologic sequelae after pneumococcal meningitis.
- Metformin is being evaluated as a neuroprotective agent in other neurological diseases as well, such as Parkinson’s disease.
References:
- Muri L, Le ND, Zemp J, Grandgirard D, Leib SL. Metformin mediates neuroprotection and attenuates hearing loss in experimental pneumococcal meningitis. J Neuroinflammation. 2019 Jul 27;16(1):156. doi: 10.1186/s12974-019-1549-6. PMID: 31351490; PMCID: PMC6660697.
- Sportelli C, Urso D, Jenner P, Chaudhuri KR. Metformin as a Potential Neuroprotective Agent in Prodromal Parkinson's Disease-Viewpoint. Front Neurol. 2020 Jun 12;11:556. doi: 10.3389/fneur.2020.00556. PMID: 32595595; PMCID: PMC7304367.
Publish on behalf of the Scientific Panel on Infectious diseases