Due to their anti-inflammatory action, corticosteroids are the reference treatment for brain injuries and many inflammatory diseases. However, the benefits of acute corticotherapy are now being questioned, particularly in the case of acute peripheral vestibulopathies (APV), characterized by a vestibular syndrome composed of sustained spinning vertigo, spontaneous ocular nystagmus and oscillopsia, perceptual-cognitive, posturo-locomotor, and vegetative disorders. We assessed the effectiveness of acute corticotherapy, and the functional role of acute inflammation observed after sudden unilateral vestibular loss. We used the rodent model of unilateral vestibular neurectomy, mimicking the syndrome observed in patients with APV. We treated the animals during the acute phase of the vestibular syndrome, either with placebo or methylprednisolone, an anti-inflammatory corticosteroid. At the cellular level, impacts of methylprednisolone on endogenous plasticity mechanisms were assessed through analysis of cell proliferation and survival, glial reactions, neuron’s membrane excitability, and stress marker. At the behavioral level, vestibular and posturo-locomotor functions’ recovery were assessed with appropriate qualitative and quantitative evaluations. We observed that acute treatment with methylprednisolone significantly decreases glial reactions, cell proliferation and survival. In addition, stress and excitability markers were significantly impacted by the treatment. Besides, vestibular syndrome’s intensity was enhanced, and vestibular compensation delayed under acute methylprednisolone treatment. We show here, for the first time, that acute anti-inflammatory treatment alters the expression of the adaptive plasticity mechanisms in the deafferented vestibular nuclei and generates enhanced and prolonged vestibular and postural deficits. These results strongly suggest a beneficial role for acute endogenous neuroinflammation in vestibular compensation. They open the way to a change in dogma for the treatment and therapeutic management of vestibular patients.

中文翻译：

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打破教条：急性抗炎治疗改变了急性外周前庭病啮齿动物模型的损伤后功能恢复和内源性适应性可塑性机制

由于其抗炎作用，皮质类固醇是脑损伤和许多炎症性疾病的参考治疗方法。然而，急性皮质疗法的益处现在受到质疑，特别是在急性外周前庭病（APV）的情况下，其特征是前庭综合征，包括持续旋转性眩晕、自发性眼震和颤动、知觉认知、姿势运动和植物失调。我们评估了急性皮质疗法的有效性，以及突发单侧前庭丧失后观察到的急性炎症的功能作用。我们使用单侧前庭神经切除术的啮齿动物模型，模仿 APV 患者中观察到的综合征。我们在前庭综合征的急性期使用安慰剂或甲泼尼龙（一种抗炎皮质类固醇）治疗动物。在细胞水平上，通过分析细胞增殖和存活、神经胶质反应、神经元膜兴奋性和应激标记来评估甲基强的松龙对内源性可塑性机制的影响。在行为水平上，通过适当的定性和定量评估来评估前庭和姿势运动功能的恢复。我们观察到，甲基强的松龙急性治疗可显着降低神经胶质反应、细胞增殖和存活。此外，压力和兴奋性标记物受到治疗的显着影响。此外，急性甲基强的松龙治疗后前庭综合征的强度增强，前庭代偿延迟。我们在这里首次表明，急性抗炎治疗改变了传入神经阻滞的前庭核中适应性可塑性机制的表达，并产生增强和延长的前庭和姿势缺陷。这些结果强烈表明急性内源性神经炎症在前庭代偿中发挥有益作用。它们为改变前庭患者的治疗和治疗管理的教条开辟了道路。