Department of Periodontics and Implant Dentistry, New York University College of Dentistry, New York University Medical Center, New York, USA.
Eur J Anaesthesiol. 2012 Jul;29(7):332-7. doi: 10.1097/EJA.0b013e3283534f56.
Surgery-induced neuroinflammation has been implicated in the development of postoperative cognitive dysfunction (POCD).
To test the hypothesis that meloxicam, a selective cyclooxygenase (COX)-2 inhibitor, preserves postoperative cognitive function and inhibits surgery-induced neuroinflammation in a mouse model.
A mouse model of splenectomy-induced inflammation.
Sixty Swiss Webster male mice (6-8 week old) were randomised into six groups that underwent splenectomy. Animals in groups 1-4 were tested once on day 1, 5, 9 or 14 to determine the time course of delayed transient cognitive dysfunction associated with splenectomy. Animals in groups 5 and 6 were tested once on day 5 or 9 to determine the ability of the NSAID meloxicam to attenuate cognitive dysfunction.
Animals in groups 1-4 received one dose 500 μl intraperitoneal physiological saline 24 h after splenectomy. Animals in groups 5 and 6 received one dose of intraperitoneal meloxicam (60 mg kg in 500 μl saline) 24 h after splenectomy.
Short-term working memory as determined by Object Recognition Test (ORT) index on days 1, 5, 9 and 14 was the first main outcome. Tomato lectin staining histochemistry of glial cells was assessed on days 1, 5, 9 and 14 as a second main outcome.
Compared with day 1 (group 1), the mean ORT indices at day 5 (group 2) and day 9 (group 3) were decreased by 27.5% [95% confidence interval (CI): 0.9 to 54.1%, P = 0.04] and 23.8% (95% CI, 4.3 to 51.9%, P = 0.09), respectively. At day 5 (group 5) and day 9 (group 6), the ORT indices in the meloxicam groups were reduced by 6.6% (95% CI: -11.4 to 24.5%) and 4.3% (95% CI: -25.3 to 34.0). Thus, the administration of meloxicam attenuated the decrease in ORT indices (P = 0.031). Histochemical staining with tomato lectin showed features of microglia activation at day 5 and 9, which was reduced by the administration of meloxicam.
These findings suggest that COX-2-dependent mechanisms may play a role in the development of POCD. This effect may be dependent on the modulation of glial cell activation.
手术引起的神经炎症与术后认知功能障碍(POCD)的发生有关。
通过在小鼠模型中检测 COX-2 选择性抑制剂美洛昔康是否可以保持术后认知功能并抑制手术引起的神经炎症,验证假说。
一种脾切除术诱导炎症的小鼠模型。
60 只瑞士 Webster 雄性小鼠(6-8 周龄)被随机分为 6 组进行脾切除术。第 1-4 组动物在第 1、5、9 或 14 天接受一次测试,以确定与脾切除术相关的延迟短暂性认知功能障碍的时间过程。第 5 组和第 6 组动物在第 5 天或第 9 天接受一次测试,以确定 NSAID 美洛昔康是否能够减轻认知功能障碍。
第 1-4 组动物在脾切除术后 24 小时内接受一次腹腔内注射生理盐水 500μl。第 5 组和第 6 组动物在脾切除术后 24 小时内接受一次腹腔内注射美洛昔康(60mg/kg,溶于 500μl 生理盐水中)。
短期工作记忆通过第 1、5、9 和 14 天的物体识别测试(ORT)指数来确定,这是第一个主要观察指标。第 1、5、9 和 14 天的小胶质细胞的番茄凝集素染色组织化学作为第二个主要观察指标。
与第 1 天(第 1 组)相比,第 5 天(第 2 组)和第 9 天(第 3 组)的平均 ORT 指数分别下降了 27.5%(95%置信区间:0.9 至 54.1%,P=0.04)和 23.8%(95%置信区间:4.3 至 51.9%,P=0.09)。在第 5 天(第 5 组)和第 9 天(第 6 组),美洛昔康组的 ORT 指数分别下降了 6.6%(95%置信区间:-11.4 至 24.5%)和 4.3%(95%置信区间:-25.3 至 34.0%)。因此,美洛昔康的给药减轻了 ORT 指数的下降(P=0.031)。用番茄凝集素进行的组织化学染色显示了第 5 天和第 9 天小胶质细胞激活的特征,而美洛昔康的给药减少了这种特征。
这些发现表明 COX-2 依赖性机制可能在 POCD 的发生中起作用。这种作用可能取决于对神经胶质细胞激活的调节。