Zuo Yong, Chang Yanzhong, Thirupathi Anand, Zhou Changhao, Shi Zhenhua
Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, China.
Faculty of Sports Science, Ningbo University, Ningbo, China.
Int J Dev Neurosci. 2021 Feb;81(1):1-9. doi: 10.1002/jdn.10080. Epub 2020 Dec 14.
For decades, the neurotoxicity caused by anesthetics in mammalian brain development has gained increasing attention. Exposure to anesthetics leads to neurotoxicity and apoptosis of nerve cells, which in turn induces cognitive dysfunction. Although most of the data came from animal studies, general anesthetics have been shown to have adverse effects on cognitive function in infants and young children in recent years. This concern has led to a number of retrospective studies that observed an association between general anesthesia in pregnant women and neurobehavioral problems in fetuses or offspring. Every year, many pregnant women undergo non-obstetric anesthesia due to various reasons such as traffic accidents, fetal interventions, acute appendicitis, symptomatic cholelithiasis, and trauma. A matter of concern for these pregnant women is whether anesthesia has a detrimental effect on fetal brain development in the womb and whether the fetus has cognitive impairment after birth. In humans, the association of anesthetic exposure in infants with the long-term impairment of neurologic functions has been reported in several retrospective clinical studies. Recently, we have found that sevoflurane anesthesia during pregnancy in mice-induced cognitive impairment in the offspring by causing iron deficiency and inhibiting myelinogenesis. Sevoflurane is a commonly used general anesthetic in the hospitals, which can induce neurotoxicity and cause cognitive impairment in fetuses, infants, children, and adults. However, the exact mechanism of sevoflurane-induced damage to the central nervous system (CNS) is not fully understood. Based on our recent results, this paper reviewed the effects of sevoflurane on cognitive impairment and pathological changes such as neurogenesis, neuronal apoptosis, and iron metabolism dysfunction in the offspring.
几十年来,麻醉剂对哺乳动物大脑发育造成的神经毒性日益受到关注。接触麻醉剂会导致神经毒性和神经细胞凋亡,进而引发认知功能障碍。尽管大部分数据来自动物研究,但近年来已表明全身麻醉剂对婴幼儿的认知功能有不良影响。这种担忧引发了一些回顾性研究,这些研究观察到孕妇接受全身麻醉与胎儿或后代的神经行为问题之间存在关联。每年,许多孕妇因交通事故、胎儿干预、急性阑尾炎、有症状的胆结石和外伤等各种原因接受非产科麻醉。这些孕妇关心的一个问题是麻醉是否会对子宫内胎儿的大脑发育产生不利影响,以及胎儿出生后是否存在认知障碍。在人类中,几项回顾性临床研究报告了婴儿接触麻醉剂与神经功能长期受损之间的关联。最近,我们发现小鼠孕期七氟醚麻醉通过导致缺铁和抑制髓鞘形成,致使后代出现认知障碍。七氟醚是医院常用的全身麻醉剂,可诱发神经毒性并导致胎儿、婴儿、儿童和成人出现认知障碍。然而,七氟醚诱导中枢神经系统(CNS)损伤的确切机制尚未完全明确。基于我们最近的研究结果,本文综述了七氟醚对后代认知障碍以及神经发生、神经元凋亡和铁代谢功能障碍等病理变化的影响。
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