Department of Anesthesia and Trauma Research, Department of Anesthesiology, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou, China.
Department of Anesthesiology, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
J Neuroinflammation. 2023 Jul 11;20(1):162. doi: 10.1186/s12974-023-02845-3.
Perioperative neurocognitive disorders (PND), such as delirium and cognitive impairment, are commonly encountered complications in aged patients. The inhibitory neurotransmitter γ-aminobutyric acid (GABA) is aberrantly synthesized from reactive astrocytes following inflammatory stimulation and is implicated in the pathophysiology of neurodegenerative diseases. Additionally, the activation of NOD-like receptor protein 3 (NLRP3) inflammasome is involved in PND. Herein, we aimed to investigate whether the NLRP3-GABA signaling pathway contributes to the pathogenesis of aging mice's PND.
24-month-old C57BL/6 and astrocyte-specific NLRP3 knockout male mice were used to establish a PND model via tibial fracture surgery. The monoamine oxidase-B (MAOB) inhibitor selegiline (1 mg/kg) was intraperitoneally administered once a day for 7 days after the surgery. PND, including impulsive-like behaviors and cognitive impairment, was evaluated by open field test, elevated plus maze, and fear conditioning. Thereafter, pathological changes of neurodegeneration were explored by western blot and immunofluorescence assays.
Selegiline administration significantly ameliorated TF-induced impulsive-like behaviors and reduced excessive GABA production in reactive hippocampal astrocytes. Moreover, astrocyte-specific NLRP3 knockout mice reversed TF-induced impulsive-like and cognitive impairment behaviors, decreased GABA levels in reactive astrocytes, ameliorated NLRP3-associated inflammatory responses during the early stage, and restored neuronal degeneration in the hippocampus.
Our findings suggest that anesthesia and surgical procedures trigger neuroinflammation and cognitive deficits, which may be due to NLRP3-GABA activation in the hippocampus of aged mice.
围手术期神经认知障碍(PND),如谵妄和认知障碍,是老年患者常见的并发症。抑制性神经递质γ-氨基丁酸(GABA)在炎症刺激下从反应性星形胶质细胞中异常合成,并与神经退行性疾病的病理生理学有关。此外,NOD 样受体蛋白 3(NLRP3)炎性小体的激活与 PND 有关。在此,我们旨在研究 NLRP3-GABA 信号通路是否有助于衰老小鼠 PND 的发病机制。
使用 24 个月大的 C57BL/6 和星形胶质细胞特异性 NLRP3 敲除雄性小鼠通过胫骨骨折手术建立 PND 模型。手术后每天腹腔内给予单胺氧化酶-B(MAOB)抑制剂司来吉兰(1mg/kg)一次,共 7 天。通过旷场试验、高架十字迷宫和恐惧条件反射评估冲动样行为和认知障碍。然后,通过 Western blot 和免疫荧光检测评估神经退行性病变的病理变化。
司来吉兰给药可显著改善 TF 诱导的冲动样行为,并减少反应性海马星形胶质细胞中 GABA 的过度产生。此外,星形胶质细胞特异性 NLRP3 敲除小鼠逆转了 TF 诱导的冲动样和认知障碍行为,降低了反应性星形胶质细胞中的 GABA 水平,改善了早期 NLRP3 相关炎症反应,并恢复了海马神经元变性。
我们的研究结果表明,麻醉和手术程序会引发神经炎症和认知缺陷,这可能是由于老年小鼠海马中 NLRP3-GABA 的激活。