Minocycline prevents osmotic demyelination syndrome by inhibiting the activation of microglia

J Am Soc Nephrol. 2010 Dec;21(12):2090-8. doi: 10.1681/ASN.2010040438. Epub 2010 Oct 28.

Abstract

Rapid correction of chronic hyponatremia can lead to osmotic demyelination syndrome (ODS), a severe demyelination disease. The microglia that accumulate in the demyelinative lesions may play a detrimental role in the pathogenesis of ODS by producing proinflammatory cytokines, suggesting that they may be a target for therapeutic intervention. Here, we investigated whether minocycline, a selective and potent inhibitor of microglial activation, could protect against ODS in rats. We induced hyponatremia by liquid diet feeding and dDAVP infusion. Rapid correction of the hyponatremia 7 days later resulted in neurologic impairment with severe demyelinative lesions. Activated microglia accumulated at the site of demyelination. Treatment with minocycline within 24 hours of rapid correction, however, was protective: rats exhibited minimal neurologic impairment, and survival improved. Histologic analysis showed that minocycline inhibited demyelination and suppressed the accumulation of microglia at the site of demyelination. Real-time RT-PCR and immunohistochemical analyses showed that minocycline inhibited the activity of microglia and the expression of inflammatory cytokines (e.g. IL-1β, inducible nitric-oxide synthase, and TNF-α), monocyte chemoattractant protein-1, and matrix metalloproteinase-12 in microglia. These results demonstrate that minocycline can protect against ODS by inhibiting the activation and accumulation of microglia at the site of demyelinative lesions, suggesting its possible use in clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Animals
  • Cells, Cultured
  • Cytokines / metabolism*
  • Demyelinating Diseases / prevention & control*
  • Disease Models, Animal
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Hyponatremia / drug therapy*
  • Hyponatremia / pathology
  • Immunohistochemistry
  • Male
  • Matrix Metalloproteinases / drug effects
  • Matrix Metalloproteinases / metabolism
  • Microglia / drug effects*
  • Minocycline / pharmacology*
  • RNA, Messenger / analysis
  • RNA, Messenger / drug effects
  • Rats
  • Rats, Sprague-Dawley
  • Reverse Transcriptase Polymerase Chain Reaction

Substances

  • Cytokines
  • RNA, Messenger
  • Matrix Metalloproteinases
  • Minocycline