Department of Anesthesiology, Peking University Third Hospital, Beijing, China.
Basic Clin Pharmacol Toxicol. 2013 Oct;113(4):215-20. doi: 10.1111/bcpt.12079. Epub 2013 Jul 9.
Melatonin is an endogenous hormone with neuroprotective effects. Melatonin levels in elderly patients are reduced after surgeries that require anaesthesia. Whether reduced melatonin levels are important for postoperative cognitive dysfunction (POCD) remains unclear. Here, we investigated the effects of melatonin on cognitive dysfunctions induced by isoflurane and mechanisms underlying these effects. Seventy-two 20-month-old Sprague-Dawley rats were randomly divided into six groups (n = 12). These groups included M1 and M10 groups that received intraperitoneal melatonin at 1 mg/kg or 10 mg/kg, respectively, and an ISO group that received 4 hr of inhaled 2% isoflurane. They also included M1+ISO and M10+ISO groups that received 1 mg/kg or 10 mg/kg of melatonin plus 4 hr of inhaled 2% isoflurane, respectively, and a control group that received an equal volume of saline. Injections were administered daily for 14 consecutive days. Memory was assessed in the Morris water maze. Plasma and hippocampi were harvested to determine melatonin concentrations and MT1/MT2 receptor expression. Rats treated only with isoflurane showed significantly longer latencies in Morris water maze test trials compared with the control group, with shorter time in the probe trial (p < 0.05). Although plasma melatonin levels and MT2 expression in the hippocampus were significantly decreased, MT1 expression was higher in the isoflurane group than in the control group (p < 0.001). However, these parameters did not significantly vary in animals administered melatonin compared with controls. Isoflurane may induce cognitive dysfunction by influencing melatonin and MT1/MT2 levels. Melatonin can improve cognitive dysfunction by normalizing plasma melatonin and its receptor levels.
褪黑素是一种具有神经保护作用的内源性激素。接受需要麻醉的手术的老年患者褪黑素水平降低。褪黑素水平降低是否对术后认知功能障碍(POCD)很重要仍不清楚。在这里,我们研究了褪黑素对异氟烷诱导的认知功能障碍的影响及其作用机制。将 72 只 20 月龄的 Sprague-Dawley 大鼠随机分为六组(n=12)。这些组包括分别接受腹腔内 1mg/kg 或 10mg/kg 褪黑素的 M1 和 M10 组,以及接受 4 小时吸入 2%异氟烷的 ISO 组。它们还包括分别接受 1mg/kg 或 10mg/kg 褪黑素加 4 小时吸入 2%异氟烷的 M1+ISO 和 M10+ISO 组,以及接受等量生理盐水的对照组。注射每天连续 14 天。使用 Morris 水迷宫评估记忆。采集血浆和海马以确定褪黑素浓度和 MT1/MT2 受体表达。仅接受异氟烷治疗的大鼠在 Morris 水迷宫测试试验中的潜伏期明显长于对照组,在探针试验中的时间更短(p<0.05)。尽管海马中的血浆褪黑素水平和 MT2 表达明显降低,但异氟烷组的 MT1 表达高于对照组(p<0.001)。然而,与对照组相比,给予褪黑素的动物这些参数没有显着变化。异氟烷可能通过影响褪黑素和 MT1/MT2 水平引起认知功能障碍。褪黑素可以通过使血浆褪黑素及其受体水平正常化来改善认知功能障碍。