Department of Anesthesiology, Columbia University, New York, New York 10032, USA.
Anesthesiology. 2013 Apr;118(4):825-33. doi: 10.1097/ALN.0b013e318287b850.
The finding that exposure to general anesthetics (GAs) in childhood may increase rates of learning disabilities has raised a concern that anesthetics may interfere with brain development. The generation of neuronal circuits, a complex process in which axons follow guidance cues to dendritic targets, is an unexplored potential target for this type of toxicity.
GA exposures were conducted in developing neocortical neurons in culture and in early postnatal neocortical slices overlaid with fluorescently labeled neurons. Axon targeting, growth cone collapse, and axon branching were measured using quantitative fluorescence microscopy.
Isoflurane exposure causes errors in Semaphorin-3A-dependent axon targeting (n = 77 axons) and a disruption of the response of axonal growth cones to Semaphorin-3A (n = 2,358 growth cones). This effect occurs at clinically relevant anesthetic doses of numerous GAs with allosteric activity at γ-aminobutyric acid type A receptors, and it was reproduced with a selective agonist. Isoflurane also inhibits growth cone collapse induced by Netrin-1, but does not interfere branch induction by Netrin-1. Insensitivity to guidance cues caused by isoflurane is seen acutely in growth cones in dissociated culture, and errors in axon targeting in brain slice culture occur at the earliest point at which correct targeting is observed in controls.
These results demonstrate a generalized inhibitory effect of GAs on repulsive growth cone guidance in the developing neocortex that may occur via a γ-aminobutyric acid type A receptor mechanism. The finding that GAs interfere with axon guidance, and thus potentially with circuit formation, represents a novel form of anesthesia neurotoxicity in brain development.
儿童时期接触全身麻醉剂(GAs)可能会增加学习障碍的发生率,这一发现引起了人们的担忧,即麻醉剂可能会干扰大脑发育。神经元回路的生成是一个复杂的过程,其中轴突沿着导向线索到达树突靶标,这是这种毒性的一个未被探索的潜在靶点。
在培养中的发育性新皮层神经元和覆盖有荧光标记神经元的早期新生新皮层切片中进行 GA 暴露。使用定量荧光显微镜测量轴突靶向、生长锥塌陷和轴突分支。
异氟烷暴露导致 Semaphorin-3A 依赖性轴突靶向错误(n = 77 个轴突)和对 Semaphorin-3A 的轴突生长锥反应中断(n = 2,358 个生长锥)。这种效应发生在具有 GABA 受体变构活性的许多 GA 的临床相关麻醉剂量下,并且可以用选择性激动剂复制。异氟烷还抑制 Netrin-1 诱导的生长锥塌陷,但不干扰 Netrin-1 诱导的分支诱导。异氟烷引起的对导向线索的不敏感性在分离培养中的生长锥中急性出现,并且在对照中观察到正确靶向的最早时间点,脑片培养中的轴突靶向错误发生。
这些结果表明,GA 对发育中的新皮层中排斥性生长锥导向具有普遍的抑制作用,这种作用可能通过 GABA 受体机制发生。GA 干扰轴突导向,从而潜在地干扰回路形成,代表了脑发育中麻醉神经毒性的一种新形式。