Chai Dongdong, Jiang Hong, Liu Hua
Department of Anesthesiology and Critical Care Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cell Neurosci. 2024 Oct 8;18:1481630. doi: 10.3389/fncel.2024.1481630. eCollection 2024.
The impact of maternal surgery combined with general anesthesia on neuroinflammation and the development of learning and memory impairment in offspring remains unclear. This study utilized a pathogen-free laparotomy model to investigate these changes during the second trimester, as well as their response to anti-inflammatory therapy.
C57BL/6 pregnant mice at the 14.5-day embryo stage (E 14.5) were either exposed to sevoflurane anesthesia alone or underwent laparotomy procedure. The neuroinflammatory response was evaluated at 7, 14, 21, and 28 days postnatal (P7, P14, P21, P28). Tau phosphorylation and cognitive ability were assessed at P28 and P30, respectively. The impact of perioperative administration of ibuprofen (60 mg/kg) on these aforementioned changes was subsequently evaluated.
In the laparotomy group, levels of inflammatory factors (IL-4, IL-8, IL-17A, TGF-β, M-CSF, CCL2) in the brains of offspring mice, including the cerebral cortex and hippocampus, remained consistently elevated from P7 to P28. At P14, while the majority of inflammatory cytokine has no statistical difference, there was still a significant reactivation of inflammatory cytokines observed in the frontal cortex and hippocampus at P28. Furthermore, abnormal phosphorylation of tau and deficits in learning and memory were observed at P28 and P30. Administration of perioperative ibuprofen led to improvements in cognitive performance, reduction of systemic inflammation, and inhibiting abnormal phosphorylation of tau in the frontal cortex and hippocampus.
Our findings indicate that cognitive dysfunction is correlated with elevated levels of inflammatory cytokines and tau phosphorylation. Cognitive impairment and tau phosphorylation after laparotomy can persist at least until P28. Anti-inflammatory medications have been shown to enhance cognitive function by rapidly reducing inflammation in the brain, while also impacting neurological changes. This discovery may have implications for the development of treatment strategies aimed at managing cognitive impairment in post-operative patients.
母体手术联合全身麻醉对子代神经炎症及学习记忆障碍发展的影响尚不清楚。本研究采用无菌剖腹手术模型,以探究孕中期的这些变化及其对抗炎治疗的反应。
将处于胚胎14.5天阶段(E 14.5)的C57BL/6孕鼠单独暴露于七氟醚麻醉或进行剖腹手术。在出生后7、14、21和28天(P7、P14、P21、P28)评估神经炎症反应。分别在P28和P30评估 Tau 蛋白磷酸化和认知能力。随后评估围手术期给予布洛芬(60mg/kg)对上述变化的影响。
在剖腹手术组中,子代小鼠大脑(包括大脑皮层和海马体)中的炎症因子(IL-4、IL-8、IL-17A、TGF-β、M-CSF、CCL2)水平从P7到P28持续升高。在P14时,虽然大多数炎性细胞因子无统计学差异,但在P28时额叶皮层和海马体中仍观察到炎性细胞因子的显著重新激活。此外,在P28和P30观察到 Tau 蛋白异常磷酸化以及学习和记忆缺陷。围手术期给予布洛芬可改善认知表现,减轻全身炎症,并抑制额叶皮层和海马体中 Tau 蛋白的异常磷酸化。
我们的研究结果表明,认知功能障碍与炎性细胞因子水平升高和 Tau 蛋白磷酸化相关。剖腹手术后的认知障碍和 Tau 蛋白磷酸化至少可持续到P28。抗炎药物已被证明可通过迅速减轻大脑炎症来增强认知功能,同时还会影响神经学变化。这一发现可能对旨在管理术后患者认知障碍的治疗策略的开发具有启示意义。