Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
Institute of Anesthesia and Intensive Care, Padua University Hospital, Padua 35128. Italy.
Exp Biol Med (Maywood). 2023 Apr;248(7):641-655. doi: 10.1177/15353702231170003. Epub 2023 Jun 13.
General anesthetics are potent neurotoxins when given during early development, causing apoptotic deletion of substantial number of neurons and persistent neurocognitive and behavioral deficits in animals and humans. The period of intense synaptogenesis coincides with the peak of susceptibility to deleterious effects of anesthetics, a phenomenon particularly pronounced in vulnerable brain regions such as subiculum. With steadily accumulating evidence confirming that clinical doses and durations of anesthetics may permanently alter the physiological trajectory of brain development, we set out to investigate the long-term consequences on dendritic morphology of subicular pyramidal neurons and expression on genes regulating the complex neural processes such as neuronal connectivity, learning, and memory. Using a well-established model of anesthetic neurotoxicity in rats and mice neonatally exposed to sevoflurane, a volatile general anesthetic commonly used in pediatric anesthesia, we report that a single 6 h of continuous anesthesia administered at postnatal day (PND) 7 resulted in lasting dysregulation in subicular mRNA levels of cAMP responsive element modulator (, cAMP responsive element-binding protein 1 (, and Protein phosphatase 3 catalytic subunit alpha, a subunit of calcineurin ( (calcineurin) when examined during juvenile period at PND28. Given the critical role of these genes in synaptic development and neuronal plasticity, we deployed a set of histological measurements to investigate the implications of anesthesia-induced dysregulation of gene expression on morphology and complexity of surviving subicular pyramidal neurons. Our results indicate that neonatal exposure to sevoflurane induced lasting rearrangement of subicular dendrites, resulting in higher orders of complexity and increased branching with no significant effects on the soma of pyramidal neurons. Correspondingly, changes in dendritic complexity were paralleled by the increased spine density on apical dendrites, further highlighting the scope of anesthesia-induced dysregulation of synaptic development. We conclude that neonatal sevoflurane induced persistent genetic and morphological dysregulation in juvenile rodents, which could indicate heightened susceptibility toward cognitive and behavioral disorders we are beginning to recognize as sequelae of early-in-life anesthesia.
全身麻醉药物在发育早期使用时是有效的神经毒素,会导致动物和人类大量神经元凋亡和持续的神经认知及行为缺陷。强烈的突触发生期与麻醉药物有害影响的易感性高峰一致,这种现象在海马下区等脆弱的脑区尤为明显。越来越多的证据证实,临床剂量和麻醉持续时间可能会永久改变大脑发育的生理轨迹,因此我们着手研究其对海马下区锥体神经元树突形态和调节神经元连接、学习和记忆等复杂神经过程的基因表达的长期影响。我们使用了一种已建立的麻醉神经毒性大鼠和小鼠模型,这些动物在新生期(PND)7 天时暴露于七氟醚(一种常用于小儿麻醉的挥发性全身麻醉剂),结果表明,在 PND28 的青少年期检查时,PND7 时给予的单次 6 小时连续麻醉会导致海马下区 cAMP 反应元件调节因子(,cAMP 反应元件结合蛋白 1(,和蛋白磷酸酶 3 催化亚基α(钙调神经磷酸酶的一个亚基)的 mRNA 水平持续失调(。鉴于这些基因在突触发育和神经元可塑性中的关键作用,我们采用了一系列组织学测量方法来研究麻醉诱导的基因表达失调对存活的海马下区锥体神经元形态和复杂性的影响。结果表明,新生期暴露于七氟醚会导致海马下区树突的持久重排,导致更高阶的复杂性和分支增加,而对锥体神经元的胞体没有显著影响。相应地,树突复杂性的变化伴随着树突棘密度的增加,进一步强调了麻醉诱导的突触发育失调的范围。我们的结论是,新生期七氟醚诱导了幼年啮齿动物的持续遗传和形态失调,这可能表明它们对认知和行为障碍的敏感性增加,而这些障碍我们才刚刚开始认识到是早期麻醉的后遗症。