Department of Anesthesiology, Peking University Third Hospital (PUTH), Beijing 100191, China.
Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Neurosci Lett. 2022 Jul 27;784:136740. doi: 10.1016/j.neulet.2022.136740. Epub 2022 Jun 21.
Postoperative cognitive impairment is more likely to occur in elderly patients and in those with neurodegenerative diseases. The mechanisms underlying this impairment include neuroinflammation and oxidative stress. The increase in reactive oxygen species during oxidative stress causes cellular and molecular injury to neurons, including DNA damage, which aggravate brain dysfunction. Vitamin C has antioxidant effects and improves cognitive function in patients with Alzheimer's disease. However, it is unclear whether it can ameliorate surgery-induced cognitive impairment by inhibiting oxidative stress. In this study, 6-month-old mice overexpressing mutant amyloid precursor protein and presenilin-1 (APP/PS1) were subjected to laparotomy. The open field and fear conditioning tests were used to assess cognitive function. Mice that underwent surgery showed cognitive impairment without changes in spontaneous locomotor activity. Oxidative stress, DNA damage and inflammatory mediators were increased in the hippocampus after surgery. The expression levels of non-homologous end-joining DNA repair-associated proteins, including Ku heterodimer, DNA-dependent protein kinase catalytic subunit, X-ray repair cross complementing 4 (XRCC4) and XRCC4-like factor, were increased after surgery. Vitamin C pretreatment effectively attenuated cognitive dysfunction induced by surgery and reduced oxidative stress and DNA damage. Our findings suggest that DNA damage plays an important role in surgery-induced cognitive dysfunction, and that vitamin C pretreatment may have therapeutic potential as a preventative approach for the cognitive impairment.
术后认知功能障碍更容易发生在老年患者和神经退行性疾病患者中。这种损伤的机制包括神经炎症和氧化应激。氧化应激过程中活性氧的增加导致神经元的细胞和分子损伤,包括 DNA 损伤,从而加重脑功能障碍。维生素 C 具有抗氧化作用,可以改善阿尔茨海默病患者的认知功能。然而,目前尚不清楚它是否可以通过抑制氧化应激来改善手术引起的认知障碍。在这项研究中,过表达突变淀粉样前体蛋白和早老素-1(APP/PS1)的 6 个月大的小鼠接受了剖腹手术。使用旷场和恐惧条件反射测试来评估认知功能。手术小鼠表现出认知功能障碍,而自发运动活动没有变化。手术后,海马体中的氧化应激、DNA 损伤和炎症介质增加。手术后,非同源末端连接 DNA 修复相关蛋白的表达水平增加,包括 Ku 异二聚体、DNA 依赖性蛋白激酶催化亚基、X 射线修复交叉互补蛋白 4(XRCC4)和 XRCC4 样因子。维生素 C 预处理可有效减轻手术引起的认知功能障碍,并降低氧化应激和 DNA 损伤。我们的研究结果表明,DNA 损伤在手术引起的认知功能障碍中起重要作用,维生素 C 预处理可能具有作为预防认知障碍的治疗潜力。