Tang Chun-Chun, Liu De-Xing, Zhu Zhao-Qiong
Department of Anesthesiology Affiliated Hospital of Zunyi Medical University Zunyi Guizhou China.
Ibrain. 2023 Nov 30;10(4):450-461. doi: 10.1002/ibra.12136. eCollection 2024 Winter.
Perioperative neurocognitive disorder (PND) is a common complication in the perioperative period, which not only prolongs the hospitalization of patients, increases the cost of treatment, but even increases the postoperative mortality of patients, bringing a heavy burden to families and society. Mechanism exploration involves anesthesia and surgery that lead to microglial activation, promote the synthesis and secretion of inflammatory factors, cause an inflammatory cascade, aggravate nerve cell damage, and lead to cognitive dysfunction. It is believed that microglia-mediated neuroinflammatory responses play a vital role in the formation of PND. Microglia surface receptors are essential mediators for microglia to receive external stimuli, regulate microglial functional status, and carry out intercellular signal transmission. Various microglial surface receptors trigger neuroinflammation, damage neurons, and participate in the development and progression of PND by activating microglia. In this study, the roles of immunoglobulin receptors, chemokine receptors, purinergic receptors, and pattern recognition receptors in microglia surface receptors in PND were reviewed, to provide a reference for the mechanism research, prevention, and treatment of PND.
围手术期神经认知障碍(PND)是围手术期常见的并发症,不仅延长患者住院时间、增加治疗费用,甚至增加患者术后死亡率,给家庭和社会带来沉重负担。机制探索涉及麻醉和手术导致小胶质细胞活化,促进炎症因子合成与分泌,引发炎症级联反应,加重神经细胞损伤,进而导致认知功能障碍。人们认为小胶质细胞介导的神经炎症反应在PND形成中起关键作用。小胶质细胞表面受体是小胶质细胞接收外部刺激、调节小胶质细胞功能状态及进行细胞间信号传递的重要介质。多种小胶质细胞表面受体通过激活小胶质细胞引发神经炎症、损伤神经元,并参与PND的发生发展。本研究综述了免疫球蛋白受体、趋化因子受体、嘌呤能受体及模式识别受体在PND小胶质细胞表面受体中的作用,为PND的机制研究、预防及治疗提供参考。