Intranasal Dexamethasone Reduces Mortality and Brain Damage in a Mouse Experimental Ischemic Stroke Model

Neurotherapeutics. 2020 Oct;17(4):1907-1918. doi: 10.1007/s13311-020-00884-9.

Abstract

Neuroinflammation triggered by the expression of damaged-associated molecular patterns released from dying cells plays a critical role in the pathogenesis of ischemic stroke. However, the benefits from the control of neuroinflammation in the clinical outcome have not been established. In this study, the effectiveness of intranasal, a highly efficient route to reach the central nervous system, and intraperitoneal dexamethasone administration in the treatment of neuroinflammation was evaluated in a 60-min middle cerebral artery occlusion (MCAO) model in C57BL/6 male mice. We performed a side-by-side comparison using intranasal versus intraperitoneal dexamethasone, a timecourse including immediate (0 h) or 4 or 12 h poststroke intranasal administration, as well as 4 intranasal doses of dexamethasone beginning 12 h after the MCAO versus a single dose at 12 h to identify the most effective conditions to treat neuroinflammation in MCAO mice. The best results were obtained 12 h after MCAO and when mice received a single dose of dexamethasone (0.25 mg/kg) intranasally. This treatment significantly reduced mortality, neurological deficits, infarct volume size, blood-brain barrier permeability in the somatosensory cortex, inflammatory cell infiltration, and glial activation. Our results demonstrate that a single low dose of intranasal dexamethasone has neuroprotective therapeutic effects in the MCAO model, showing a better clinical outcome than the intraperitoneal administration. Based on these results, we propose a new therapeutic approach for the treatment of the damage process that accompanies ischemic stroke.

Keywords: Dexamethasone; MCAO; inflammation; intranasal administration; ischemic stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intranasal
  • Animals
  • Anti-Inflammatory Agents / administration & dosage*
  • Blood-Brain Barrier / drug effects
  • Blood-Brain Barrier / pathology
  • Brain / drug effects
  • Brain / pathology
  • Brain Injuries / drug therapy*
  • Brain Injuries / mortality
  • Brain Injuries / pathology
  • Brain Ischemia / drug therapy*
  • Brain Ischemia / mortality
  • Brain Ischemia / pathology
  • Dexamethasone / administration & dosage*
  • Infarction, Middle Cerebral Artery / drug therapy
  • Infarction, Middle Cerebral Artery / mortality
  • Infarction, Middle Cerebral Artery / pathology
  • Ischemic Stroke / drug therapy*
  • Ischemic Stroke / mortality
  • Ischemic Stroke / pathology
  • Male
  • Mice
  • Mice, Inbred C57BL

Substances

  • Anti-Inflammatory Agents
  • Dexamethasone