Ma Yuanzhong, Cheng Qinghao, Wang Ermin, Li Lei, Zhang Xubin
Department of Anesthesiology, Dezhou People's Hospital, Dezhou, Shandong 253045, P.R. China.
Department of Anesthesiology, China Meitan General Hospital, Beijing 100028, P.R. China.
Mol Med Rep. 2015 Aug;12(2):3095-100. doi: 10.3892/mmr.2015.3744. Epub 2015 May 7.
Postoperative cognitive dysfunction (POCD), commonly observed in elderly patients, is characterized by impaired concentration, memory and learning following surgery, and may persist for a long duration or progress into serious central nervous system diseases. It has been demonstrated neuroinflammation caused by surgery is involved in the development of POCD. However, the detailed molecular mechanism remains to be fully elucidated. The present study aimed to reveal the role of tumor necrosis factor (TNF)-α in the development of POCD in aged rats. Laparotomy was performed to mimic human abdominal surgery in the aged rats. Following surgery, the memory and learning functions were impaired, with significant upregulation of pro-inflammatory cytokines, including TNF-α, interleukin (IL)-1β, IL-4 and IL-6 in the hippocampal tissues. However, intracisternal administration of the TNF-α receptor antagonist, R-7050, during surgery attenuated these defects in cognitive function and inhibited the production of the pro-inflammatory cytokines in the hippocampal tissues. Furthermore, intracisternal administration of R-7050 inhibited the activation of the downstream nuclear factor-κB and mitogen-activated protein kinase signaling pathway in the hippocampal tissues. Therefore, the results of the present study suggested a key role of the TNF-α-mediated signaling pathway in the development of POCD.
术后认知功能障碍(POCD)常见于老年患者,其特征为术后注意力、记忆力和学习能力受损,可能会长期持续或进展为严重的中枢神经系统疾病。已有研究表明,手术引起的神经炎症与POCD的发生有关。然而,具体的分子机制仍有待充分阐明。本研究旨在揭示肿瘤坏死因子(TNF)-α在老年大鼠POCD发生中的作用。通过开腹手术模拟老年大鼠的人类腹部手术。术后,记忆力和学习功能受损,海马组织中包括TNF-α、白细胞介素(IL)-1β、IL-4和IL-6在内的促炎细胞因子显著上调。然而,手术期间脑池内注射TNF-α受体拮抗剂R-7050可减轻这些认知功能缺陷,并抑制海马组织中促炎细胞因子的产生。此外,脑池内注射R-7050可抑制海马组织中下游核因子-κB和丝裂原活化蛋白激酶信号通路的激活。因此,本研究结果表明TNF-α介导的信号通路在POCD的发生中起关键作用。