Xu Zhipeng, Dong Yuanlin, Wang Hui, Culley Deborah J, Marcantonio Edward R, Crosby Gregory, Tanzi Rudolph E, Zhang Yiying, Xie Zhongcong
Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts.
Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts; Department of Anesthesia, Beijing Chaoyang Hospital, Capital Medical University, Beijing, P. R. China.
PLoS One. 2014 May 5;9(5):e96752. doi: 10.1371/journal.pone.0096752. eCollection 2014.
Post-operative cognitive dysfunction is associated with morbidity and mortality. However, its neuropathogenesis remains largely to be determined. Neuroinflammation and accumulation of β-amyloid (Aβ) have been reported to contribute to cognitive dysfunction in humans and cognitive impairment in animals. Our recent studies have established a pre-clinical model in mice, and have found that the peripheral surgical wounding without the influence of general anesthesia induces an age-dependent Aβ accumulation and cognitive impairment in mice. We therefore set out to assess the effects of peripheral surgical wounding, in the absence of general anesthesia, on neuroinflammation in mice with different ages. Abdominal surgery under local anesthesia was established in 9 and 18 month-old mice. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), Iba1 positive cells (the marker of microglia activation), CD33, and cognitive function in mice were determined. The peripheral surgical wounding increased the levels of TNF-α, IL-6, and Iba1 positive cells in the hippocampus of both 9 and 18 month-old mice, and age potentiated these effects. The peripheral surgical wounding increased the levels of CD33 in the hippocampus of 18, but not 9, month-old mice. Finally, anti-inflammatory drug ibuprofen ameliorated the peripheral surgical wounding-induced cognitive impairment in 18 month-old mice. These data suggested that the peripheral surgical wounding could induce an age-dependent neuroinflammation and elevation of CD33 levels in the hippocampus of mice, which could lead to cognitive impairment in aged mice. Pending further studies, anti-inflammatory therapies may reduce the risk of postoperative cognitive dysfunction in elderly patients.
术后认知功能障碍与发病率和死亡率相关。然而,其神经发病机制在很大程度上仍有待确定。据报道,神经炎症和β-淀粉样蛋白(Aβ)的积累会导致人类认知功能障碍和动物认知损害。我们最近的研究在小鼠中建立了一个临床前模型,并发现无全身麻醉影响的外周手术创伤会诱导小鼠出现年龄依赖性的Aβ积累和认知损害。因此,我们着手评估在无全身麻醉的情况下,外周手术创伤对不同年龄小鼠神经炎症的影响。对9个月和18个月大的小鼠进行局部麻醉下的腹部手术。测定小鼠体内肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、Iba1阳性细胞(小胶质细胞激活的标志物)、CD33的水平以及认知功能。外周手术创伤增加了9个月和18个月大的小鼠海马体中TNF-α、IL-6和Iba1阳性细胞的水平,且年龄会增强这些影响。外周手术创伤增加了18个月大但未增加9个月大小鼠海马体中CD33的水平。最后,抗炎药物布洛芬改善了18个月大小鼠外周手术创伤诱导的认知损害。这些数据表明,外周手术创伤可诱导小鼠海马体出现年龄依赖性神经炎症和CD33水平升高,这可能导致老年小鼠认知损害。在进一步研究之前,抗炎治疗可能会降低老年患者术后认知功能障碍的风险。