Sildenafil reduces neuroinflammation in cerebellum, restores GABAergic tone, and improves motor in‐coordination in rats with hepatic encephalopathy

Summary Aims Patients with liver disease may develop hepatic encephalopathy (HE), with cognitive impairment and motor in‐coordination. Rats with HE due to portacaval shunts (PCS) show motor in‐coordination. We hypothesized that in PCS rats: (i) Motor in‐coordination would be due to enhanced GABAergic tone in cerebellum; (ii) increased GABAergic tone would be due to neuroinflammation; (iii) increasing cGMP would reduce neuroinflammation and GABAergic tone and restore motor coordination. To assess these hypotheses, we assessed if (i) treatment with sildenafil reduces neuroinflammation; (ii) reduced neuroinflammation is associated with reduced GABAergic tone and restored motor coordination. Methods Rats were treated with sildenafil to increase cGMP. Microglia and astrocytes activation were analyzed by immunohistochemistry, extracellular GABA by microdialysis, and motor coordination in the beam walking. Results PCS rats show neuroinflammation in cerebellum, with microglia and astrocytes activation, increased IL‐1b and TNF‐a and reduced YM‐1 and IL‐4. Membrane expression of the GABA transporter GAT1 is reduced, while GAT3 is increased. Extracellular GABA and motor in‐coordination are increased. Sildenafil treatment eliminates neuroinflammation, microglia and astrocytes activation; changes in membrane expression of GABA transporters; and restores motor coordination. Conclusions This study supports an interplay between cGMP‐neuroinflammation and GABAergic neurotransmission in impairing motor coordination in PCS rats.