Zuo Youbo, Hu Xingping, Yang Qiuyan, Zhao Lei, Chen Xueli, Lin Jiangtao, Yang Tiande
Department of Anesthesiology, Xinqiao Hospital, Army Medical University, Chongqing 400037, China; Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Behav Brain Res. 2019 Nov 5;373:112107. doi: 10.1016/j.bbr.2019.112107. Epub 2019 Jul 21.
With the acceleration of an aging population, postoperative cognitive dysfunction (POCD) has become a large problem. Preoperative carbohydrate (CHO) loading has been reported to attenuate surgery stress response and insulin resistance. The present study aimed to investigate whether preoperative vitamin-rich CHO loading has an effect on POCD, endoplasmic reticulum (ER) stress, and apoptosis. Eighty male Sprague-Dawley rats (20-month old) were randomly assigned to four groups (20 per group): control group (no anesthesia and surgery), fasting group (fasting 14 h before surgery), water group (oral water 3 h before surgery), and CHO group (oral vitamin-rich CHO 3 h before surgery). The POCD rat model was established by splenectomy under intraperitoneal injection of pentobarbital sodium. Cognitive function was assessed using the Morris water maze (MWM) after surgery. The levels of endoplasmic reticulum (ER) stress markers and apoptosis related proteins in the hippocampus were examined by western blot analysis. The vitamin-rich CHO treated animals performed better in the MWM tests than the animals in the fasting and water groups. Furthermore, preoperative CHO loading reduced ER stress and neuronal apoptosis in the hippocampus of aged rats, as indicated by the protein biomarkers of GRP78, eIF2a, Beclin1, Bax, and Bcl-2. In conclusion, preoperative vitamin-rich CHO loading could improve POCD by attenuating ER stress and neural apoptosis, providing a basis as a potential treatment against POCD.
随着人口老龄化加速，术后认知功能障碍（POCD）已成为一个重大问题。据报道，术前碳水化合物（CHO）负荷可减轻手术应激反应和胰岛素抵抗。本研究旨在探讨术前富含维生素的CHO负荷是否对POCD、内质网（ER）应激和细胞凋亡有影响。80只雄性Sprague-Dawley大鼠（20月龄）随机分为四组（每组20只）：对照组（无麻醉和手术）、禁食组（术前禁食14小时）、饮水组（术前3小时口服水）和CHO组（术前3小时口服富含维生素的CHO）。通过腹腔注射戊巴比妥钠后行脾切除术建立POCD大鼠模型。术后采用莫里斯水迷宫（MWM）评估认知功能。通过蛋白质印迹分析检测海马中内质网（ER）应激标志物和凋亡相关蛋白的水平。富含维生素的CHO处理的动物在MWM试验中的表现优于禁食组和饮水组的动物。此外，术前CHO负荷降低了老年大鼠海马中的ER应激和神经元凋亡，GRP78、eIF2a、Beclin1、Bax和Bcl-2的蛋白质生物标志物表明了这一点。总之，术前富含维生素的CHO负荷可通过减轻ER应激和神经细胞凋亡来改善POCD，为作为POCD的潜在治疗方法提供了依据。
