Abstract
Intraventricular or intrathecal administration of polymyxins are increasingly used to treat multidrug-resistant (MDR) Gram-negative bacteria caused infections in the central nervous system (CNS). However, our limited knowledge of the mechanisms underpinning polymyxin-induced neurotoxicity significantly hinders the development of safe and efficacious polymyxin dosing regimens. To this end, we conducted transcriptomic analyses of the rat brain and spinal cord 1 h following intracerebroventricular administration of polymyxin B into rat lateral ventricle at a clinically relevant dose (0.5 mg/kg). Following the treatment, 66 differentially expressed genes (DEGs) were identified in the brain transcriptome while none for the spinal cord (FDR ≤ 0.05, fold-change ≥ 1.5). DEGs were enriched in signaling pathways associated with hormones and neurotransmitters, including dopamine and (nor)epinephrine. Notably, the expression levels of Slc6a3 and Gabra6 were decreased by 20-fold and 4.3-fold, respectively, likely resulting in major perturbations of dopamine and γ-aminobutyric acid signaling in the brain. Mass spectrometry imaging of brain sections revealed a distinct pattern of polymyxin B distribution with the majority accumulating in the injection-side lateral ventricle and subsequently into third and fourth ventricles. Polymyxin B was not detectable in the left lateral ventricle or brain tissue. Electrophysiological measurements on primary cultured rat neurons revealed a large inward current and significant membrane leakage following polymyxin B treatment. Our work demonstrates, for the first time, the key CNS signaling pathways associated with polymyxin neurotoxicity. This mechanistic insight combined with pharmacokinetic/pharmacodynamic dosing strategies will help guide the design of safe and effective intraventricular/intrathecal polymyxin treatment regimens for CNS infections caused by MDR Gram-negative pathogens.
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Data Availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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This research was supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH, R01 AI132154 to GR and TV). G.G.R., T.V., and J.L. are supported by the National Institute of Allergy and Infectious Diseases, award number R01AI146241. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIAID or NIH.
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T.V., J.L., and G.G.R conceived and supervised the project and were involved in manuscript editing. J.Lu conducted the experiment and wrote the manuscript. Y.Z analyzed the RNA-seq data. S.O and L.C conducted the surgery on the animals. H.P and M.T conducted and analyzed the electrophysiology measurements. D.R. conducted the MALDI-MS imaging experiment. P.B, M.H, R.S., and R.A were involved in project discussions and manuscript editing. All authors reviewed and agreed to the final manuscript.
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Lu, J., Zhu, Y., Parkington, H.C. et al. Transcriptomic Mapping of Neurotoxicity Pathways in the Rat Brain in Response to Intraventricular Polymyxin B. Mol Neurobiol 60, 1317–1330 (2023). https://doi.org/10.1007/s12035-022-03140-7
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DOI: https://doi.org/10.1007/s12035-022-03140-7