Meng Lingda, Gu Tianxiang, Yu Peng, Zhang Zhiwei, Wei Zhijing
Department of Cardiac Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.
Department of Trauma Center, The First Affiliated Hospital of China Medical University, Shenyang, China.
Front Cell Neurosci. 2024 Dec 17;18:1496520. doi: 10.3389/fncel.2024.1496520. eCollection 2024.
Cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) are indispensable core techniques in cardiac surgery. Numerous studies have shown that cardiopulmonary bypass and deep hypothermic circulatory arrest are associated with the occurrence of neuroinflammation, accompanied by the activation of microglia. Microglia, as macrophages in the central nervous system, play an irreplaceable role in neuroinflammation. Current research on neuroinflammation induced by microglia activation mainly focuses on neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, neuropathic pain, acquired brain injury, and others. However, there is relatively limited research on microglia and neuroinflammation under conditions of cardiopulmonary bypass and deep hypothermic circulatory arrest. The close relationship between cardiopulmonary bypass, deep hypothermic circulatory arrest, and cardiac surgery underscores the importance of identifying targets for intervening in neuroinflammation through microglia. This could greatly benefit cardiac surgery patients during cardiopulmonary bypass and the perioperative period, significantly improving patient prognosis. This review article provides the first comprehensive discussion on the signaling pathways associated with neuroinflammation triggered by microglia activation, the impact of cardiopulmonary bypass on microglia, as well as the current status and advancements in cardiopulmonary bypass animal models. It provides new insights and methods for the treatment of neuroinflammation related to cardiopulmonary bypass and deep hypothermic circulatory arrest, holding significant importance for clinical treatment by cardiac surgeons, management strategies by cardiopulmonary bypass physicians, and the development of neurologically related medications.
体外循环（CPB）和深低温停循环（DHCA）是心脏手术中不可或缺的核心技术。大量研究表明，体外循环和深低温停循环与神经炎症的发生有关，同时伴有小胶质细胞的激活。小胶质细胞作为中枢神经系统中的巨噬细胞，在神经炎症中发挥着不可替代的作用。目前关于小胶质细胞激活诱导神经炎症的研究主要集中在阿尔茨海默病、帕金森病、神经性疼痛、获得性脑损伤等神经退行性疾病。然而，关于体外循环和深低温停循环条件下小胶质细胞与神经炎症的研究相对较少。体外循环、深低温停循环与心脏手术之间的密切关系凸显了通过小胶质细胞确定干预神经炎症靶点的重要性。这可能会使心脏手术患者在体外循环期间及围手术期受益匪浅，显著改善患者预后。这篇综述文章首次全面讨论了与小胶质细胞激活引发的神经炎症相关的信号通路、体外循环对小胶质细胞的影响以及体外循环动物模型的现状和进展。它为治疗与体外循环和深低温停循环相关的神经炎症提供了新的见解和方法，对心脏外科医生的临床治疗、体外循环医生的管理策略以及神经相关药物的研发具有重要意义。
