Straiko Megan M W, Young Chainllie, Cattano Davide, Creeley Catherine E, Wang Haihui, Smith Derek J, Johnson Stephen A, Li Erin S, Olney John W
Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri 63110, USA.
Anesthesiology. 2009 Apr;110(4):862-8. doi: 10.1097/ALN.0b013e31819b5eab.
Ethanol and anesthetic drugs trigger neuroapoptosis in the developing mouse brain. Recently, it was found that ethanol-induced neuroapoptosis is preceded by suppressed phosphorylation of extracellular signal-regulated protein kinase (ERK), and lithium counteracts both the phosphorylated ERK suppressant action and ethanol-induced neuroapoptosis. The current study was undertaken to address the following questions. (1) Do ketamine and propofol mimic ethanol in suppressing ERK phosphorylation? (2) If they do, does lithium prevent this suppressant action and also prevent these anesthetic drugs from triggering neuroapoptosis?
Postnatal day 5 mice were treated with propofol, ketamine, lithium, a combination of propofol or ketamine with lithium or saline, and their brains were prepared for Western blot analysis or histology. For Western blot, cytosolic lysates of caudate putamen were analyzed for expression of phosphorylated ERK and phosphorylated serine/threonine-specific protein kinase. For histology, brains were stained immunohistochemically with antibodies to activated caspase-3, and the density of activated caspase-3 positive cells was determined.
Ketamine and propofol suppressed phosphorylated ERK, and lithium counteracted both the phosphorylated ERK suppressant action and neuroapoptotic action of these anesthetic drugs.
If further testing finds lithium to be safe for use in pediatric/obstetric medicine, administration of a single dose of lithium before anesthesia induction may be a suitable means of mitigating the risk of anesthesia-induced developmental neuroapoptosis.
乙醇和麻醉药物会引发发育中小鼠大脑的神经细胞凋亡。最近发现,乙醇诱导的神经细胞凋亡之前会出现细胞外信号调节蛋白激酶(ERK)磷酸化受抑制的情况,而锂可抵消磷酸化ERK的抑制作用以及乙醇诱导的神经细胞凋亡。本研究旨在解决以下问题。(1)氯胺酮和丙泊酚是否会像乙醇一样抑制ERK磷酸化?(2)如果它们会,锂能否阻止这种抑制作用,并防止这些麻醉药物引发神经细胞凋亡?
对出生后第5天的小鼠使用丙泊酚、氯胺酮、锂、丙泊酚或氯胺酮与锂或生理盐水的组合进行处理,然后将其大脑用于蛋白质印迹分析或组织学检查。对于蛋白质印迹分析,分析尾状壳核的胞质裂解物中磷酸化ERK和磷酸化丝氨酸/苏氨酸特异性蛋白激酶的表达。对于组织学检查,用活化的半胱天冬酶-3抗体对大脑进行免疫组织化学染色,并测定活化的半胱天冬酶-3阳性细胞的密度。
氯胺酮和丙泊酚抑制了磷酸化ERK,锂抵消了这些麻醉药物的磷酸化ERK抑制作用和神经细胞凋亡作用。
如果进一步测试发现锂在儿科/产科医学中使用安全,那么在麻醉诱导前给予单剂量锂可能是减轻麻醉诱导的发育性神经细胞凋亡风险的合适方法。