Mannitol-facilitated entry of vancomycin into the central nervous system inhibits neuroinflammation in a rat model of MRSA intracranial infection by modulating brain endothelial cells

Yin Wen, Zhiwei Su, Huishan Zhu, Mengting Liu, Zhuo Li, Shiying Zhang, Shuangming Cai, Jiaqi Tang, Hongguang Ding, Hongke Zeng

Figure 2. Simultaneous therapy of mannitol and vancomycin attenuated inflammation and improved therapeutic effect in rats with MRSA-induced intracranial infection. A: the modified Garcia JH scores were lower in the MRSA group than in the sham group (P<0.0001); B: the levels of PCT decreased in the MRSA+Van+Man group compared to those in the MRSA group, the MRSA+Man group, the MRSA+Van group and the MRSA+Van+Man (10 h) group significantly (P<0.05); C: the levels of CRP decreased in the MRSA+Van+Man group compared to those in the MRSA group, the MRSA+Man group, the MRSA+Van group and the MRSA+Van+Man (10 h) group significantly (P<0.05); D: the HE staining displayed the inflammatory cell infiltration in the brain tissues of each group; E: the MRSA+Van+Man group had better neurological function compared with the MRSA group, the MRSA+Man group, the MRSA+Van group and the MRSA+Van+Man (10 h) group on days 3 and 7; F: the MRSA+Van+Man group had a better 7-day survival rate than the MRSA group, the MRSA+Man group, the MRSA+Van group, and the MRSA+Van+Man (10 h) group. *P<0.05, **P<0.01, ***P<0.001, ****P<0.0001. MRSA: Methicillin-resistant Staphylococcus aureus; sham, sham operation; Van: vancomycin; Man: mannitol; PCT: procalcitonin; CRP: C-reactive protein.