孕期七氟醚暴露相关的胎儿毒性基础

Fundamentals of fetal toxicity relevant to sevoflurane exposures during pregnancy.

作者信息

Chai Dongdong, Cheng Yanyong, Jiang Hong

机构信息

Department of Anesthesiology and Critical Care Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Anesthesiology and Critical Care Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Int J Dev Neurosci. 2019 Feb;72:31-35. doi: 10.1016/j.ijdevneu.2018.11.001. Epub 2018 Nov 15.

Abstract

Over the last three decades, advances in medical and surgical techniques have proven life saving and life-improving for young children. Consequently, early and repeated exposure to general anesthetics in childhood has increased. However, accumulating evidence suggests that general anesthetics may be neurotoxic in children. Of particular concern is the neurotoxicity fetuses may suffer from maternal exposure to sevoflurane during surgeries and fetal intervention procedures performed during the second trimester, as this can cause neurodevelopmental impairment in offspring. In this review we demonstrate that the pathology associated with fetal toxicity resulting from exposure to sevoflurane during pregnancy involves oxidative stress, neuroinflammation, neuroapoptosis, and alteration of synaptic properties. The mechanisms remain to be elucidated, but may include increased tau protein phosphorylation and abnormal methylation. These findings highlight the need for a global and comprehensive understanding of the potential neurotoxicity of anesthetic exposure in fetuses and its long-term effects.

摘要

在过去三十年中,医学和外科技术的进步已被证明对幼儿具有挽救生命和改善生活的作用。因此,儿童早期和反复接触全身麻醉剂的情况有所增加。然而,越来越多的证据表明,全身麻醉剂可能对儿童具有神经毒性。特别令人担忧的是,胎儿在孕期手术和孕中期进行的胎儿干预手术中可能因母亲接触七氟醚而遭受神经毒性,因为这会导致后代出现神经发育障碍。在本综述中,我们证明,孕期接触七氟醚导致胎儿毒性的病理过程涉及氧化应激、神经炎症、神经细胞凋亡以及突触特性改变。其机制尚待阐明,但可能包括tau蛋白磷酸化增加和甲基化异常。这些发现凸显了全面、综合地了解麻醉剂暴露对胎儿潜在神经毒性及其长期影响的必要性。

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