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Decreased GABA-A Receptor Binding in Association With β-Lactam Antibiotic Use

Flaus, Anthime MD, MSc*,†; Riaño Barros, Daniela Alexandra MRCPsych, PhD‡,§; Hinz, Rainer PhD; Myers, James F. PhD; Lingford-Hughes, Anne PhD; Koepp, Matthias J. MD, PhD**,††; Hammers, Alexander HDR, PhD, MD†,‡,§,‡‡; McGinnity, Colm Joseph MBChB, PhD†,‡,§

Clinical Nuclear Medicine: December 2019 - Volume 44 - Issue 12 - p 981–982
doi: 10.1097/RLU.0000000000002811
Interesting Images

β-Lactam antibiotics are proconvulsive. In laboratory animals, this effect seems to be predominantly mediated through inhibition of GABA-A receptors, but it has not been demonstrated in humans in vivo. We report images of a [11C]Ro15-4513 PET from a 40-year-old man who had completed a 1-week course of flucloxacillin before it. Relative to healthy controls, the participant had significantly lower mean gray matter binding. These novel data suggest that, in humans, the proconvulsive effect of β-lactam antibiotics is mediated via either competition for the same benzodiazepine-binding site as [11C]Ro15-4513 or downregulation of GABA-A receptor expression.

From the *Department of Nuclear Medicine, University Hospital, Saint-Etienne, France

School of Biomedical Engineering & Imaging Sciences, King's College London, and Guy's and St Thomas' PET Centre, St Thomas' Hospital

Centre for Neuroscience, Department of Medicine, Imperial College London

§MRC Clinical Sciences Centre Hammersmith Hospital, London

Wolfson Molecular Imaging Centre, University of Manchester, Manchester

Neuropsychopharmacology Unit, Department of Medicine, Imperial College London

**Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London

††Epilepsy Society, Chalfont St Peter, United Kingdom

‡‡Neurodis Foundation, CERMEP, Imagerie du Vivant, Lyon, France.

Received for publication June 7, 2019; revision accepted July 28, 2019.

Conflicts of interest and sources of funding: This work was supported by Medical Research Council (UK) grand MR/N013042/1. None declared to all authors.

Informed consent was obtained from all individual participants included in the study.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Correspondence to: Anthime Flaus, Service de Médecine Nucléaire, Hopital Nord, CHU de St Etienne, 42055 Saint-Etienne Cedex 2, France. E-mail: anthime.flaus@gmail.com.

Online date: October 31, 2019

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