Astapenko David, Vajrychova Marie, Fabrik Ivo, Kupcik Rudolf, Pimkova Kristyna, Tambor Vojtech, Radochova Vera, Cerny Vladimir
Department of Anesthesiology and Intensive Care, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.
Faculty of Health Sciences, Technical University in Liberec, Liberec, Czech Republic.
Heliyon. 2024 Mar 5;10(6):e27638. doi: 10.1016/j.heliyon.2024.e27638. eCollection 2024 Mar 30.
Anesthesia is regarded as an important milestone in medicine. However, the negative effect on memory and learning has been observed. In addition, the impact of anesthetics on postoperative cognitive functions is still discussed. In this work, experiment simulating a general anesthesia and ICU sedation was designed to assess the impact of two intravenous (midazolam, dexmedetomidine) and two inhalational (isoflurane, desflurane) agents on neuronal centers for cognition (neocortex), learning, and memory (hippocampus). More than 3600 proteins were quantified across both neocortex and hippocampus. Proteomic study revealed relatively mild effects of anesthetics, nevertheless, protein dysregulation uncovered possible different effect of isoflurane (and midazolam) compared to desflurane (and dexmedetomidine) to neocortical and hippocampal proteins. Isoflurane induced the upregulation of hippocampal NMDAR and other proteins of postsynaptic density and downregulation of GABA signaling, whereas desflurane and dexmedetomidine rather targeted mitochondrial VDAC isoforms and protein regulating apoptotic activity.
麻醉被视为医学上的一个重要里程碑。然而,人们已经观察到其对记忆和学习的负面影响。此外,麻醉剂对术后认知功能的影响仍在讨论中。在这项研究中,设计了模拟全身麻醉和重症监护病房镇静的实验,以评估两种静脉注射药物(咪达唑仑、右美托咪定)和两种吸入药物(异氟烷、地氟烷)对认知神经中枢(新皮质)、学习和记忆(海马体)的影响。在新皮质和海马体中对3600多种蛋白质进行了定量分析。蛋白质组学研究表明麻醉剂的影响相对较小,然而,蛋白质失调揭示了异氟烷(和咪达唑仑)与地氟烷(和右美托咪定)相比,对新皮质和海马体蛋白质可能存在不同的影响。异氟烷诱导海马体NMDAR及其他突触后致密蛋白的上调以及GABA信号的下调,而地氟烷和右美托咪定则主要作用于线粒体VDAC亚型和调节凋亡活性的蛋白质。