Xue Xing, Lv Ying, Leng Yufang, Zhang Yan
The First Hospital of Lanzhou University, Department of Anaesthesiology, Lanzho, China.
Gansu Agricultural University, College of Resources and Environmental Sciences, Lanzhou, China.
Braz J Anesthesiol. 2020 Nov-Dec;70(6):627-634. doi: 10.1016/j.bjan.2020.04.020. Epub 2020 Nov 18.
The mechanisms by which local anesthetics cause neurotoxicity are very complicated. Apoptosis and autophagy are highly coordinated mechanisms that maintain cellular homeostasis against stress. Studies have shown that autophagy activation serves as a protective mechanism . However, whether it also plays the same role is unclear. The aim of this study was to explore the role of autophagy in local anesthetic-induced neurotoxicity and to elucidate the mechanism of neurotoxicity in an intrathecally injected rat model.
Eighteen healthy adult male Sprague-Dawley rats were randomly divided into three groups. Before receiving an intrathecal injection of 1% bupivacaine, each rat received an intraperitoneal injection of vehicle or rapamycin (1 mg.kg) once a day for 3 days. The pathological changes were examined by Haematoxylin and Eosin (HE) staining. Apoptosis was analysed by TdT-mediated dUTP Nick-End Labelling (TUNEL) staining. Caspase-3, Beclin1 and LC3 expression was examined by Immunohistochemical (IHC) staining. Beclin1 and LC3 expression and the LC3-II/LC3-I ratio were detected by western blot analysis.
After bupivacaine was injected intrathecally, pathological damage occurred in spinal cord neurons, and the levels of apoptosis and caspase-3 increased. Enhancement of autophagy with rapamycin markedly alleviated the pathological changes and decreased the levels of apoptosis and caspase-3 while increasing the expression of LC3 and Beclin1 and the ratio of LC3-II to LC3-I.
Enhancement of autophagy decreases caspase-3-dependent apoptosis and improves neuronal survival. Activation of autophagy may be a potential therapeutic strategy for local anaesthetic-induced neurotoxicity.
局部麻醉药引起神经毒性的机制非常复杂。凋亡和自噬是维持细胞内稳态以应对应激的高度协调机制。研究表明,自噬激活是一种保护机制。然而,其是否也发挥相同作用尚不清楚。本研究旨在探讨自噬在局部麻醉药诱导的神经毒性中的作用,并阐明鞘内注射大鼠模型中神经毒性的机制。
将18只健康成年雄性Sprague-Dawley大鼠随机分为三组。在鞘内注射1%布比卡因之前,每只大鼠每天腹腔注射溶媒或雷帕霉素(1mg/kg),共3天。通过苏木精和伊红(HE)染色检查病理变化。通过末端脱氧核苷酸转移酶介导的dUTP缺口末端标记(TUNEL)染色分析凋亡情况。通过免疫组织化学(IHC)染色检测半胱天冬酶-3、Beclin1和LC3的表达。通过蛋白质免疫印迹分析检测Beclin1和LC3的表达以及LC3-II/LC3-I比值。
鞘内注射布比卡因后,脊髓神经元出现病理损伤,凋亡水平和半胱天冬酶-3水平升高。雷帕霉素增强自噬明显减轻了病理变化,降低了凋亡水平和半胱天冬酶-3水平,同时增加了LC3和Beclin1的表达以及LC3-II与LC3-I的比值。
增强自噬可减少半胱天冬酶-3依赖性凋亡并改善神经元存活。自噬激活可能是局部麻醉药诱导的神经毒性的一种潜在治疗策略。