Wei Yi, Pan Sining, Zhou Zhan, Yang Ying, Liu Tianxiao, Chen Jing, Xie Yubo
Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
Sci Rep. 2025 Apr 21;15(1):13784. doi: 10.1038/s41598-025-95379-y.
Sepsis is a severe disorder that is always accompanied by brain injury and dysfunction. This study aimed to evaluate the effects of remimazolam, a new ultra-short-acting sedative, on LPS-induced neuronal injury, and the role of Nrf2 signaling pathway involved. LPS was administered to Sprague-Dawley rats in the presence or absence of remimazolam. Then the behavior analysis was performed by using the Morris Water Maze and Open Field Test. The levels of the Superoxide Dismutase (SOD) and Malondialdehyde (MDA), the neuronal apoptosis, and the expression of Nrf2, HO-1, and Bcl-2 were detected in the hippocampus. In vitro, primary hippocampal neurons were exposed to LPS with or without remimazolam administration. Then the cell viability, apoptosis, mitochondrial membrane potential (MMP), and intracellular ROS were measured to assess oxidative stress and neuron injury. The expression of Nrf2, and HO-1 was also determined by Western blotting. LPS triggered neuroapoptosis, evoked oxidative stress, and inhibited the expression of Nrf2, and HO-1 in rat hippocampus, which were attenuated by remimazolam treatment. Additionally, remimazolam alleviated LPS-induced cognitive dysfunction and anxiety‑like behaviors in rats. In vitro, remimazolam could ameliorate neuronal damage, decrease the production of ROS, and increase the MMP of neurons exposed to LPS, which was accompanied by an increase in the expression of Nrf2 and HO-1. However, ML385 (an Nrf2 inhibitor) reversed the beneficial effects of remimazolam on primary hippocampal neurons. These findings suggest that remimazolam exerted protective effects on LPS-induced hippocampal neuronal injury in vivo and in vitro, which was associated with activation of Nrf2 signaling. Further experiments are needed to fully explore the exact molecular mechanism of Nrf2 upstream and downstream of remimazolam and its effects on distinct brain regions, which will help to better understand the neural effects of remimazolam.
脓毒症是一种严重的病症,总是伴有脑损伤和功能障碍。本研究旨在评估新型超短效镇静剂瑞米唑仑对脂多糖(LPS)诱导的神经元损伤的影响,以及所涉及的Nrf2信号通路的作用。在有或没有瑞米唑仑的情况下,将LPS给予Sprague-Dawley大鼠。然后通过莫里斯水迷宫和旷场试验进行行为分析。检测海马中超氧化物歧化酶(SOD)和丙二醛(MDA)的水平、神经元凋亡以及Nrf2、血红素加氧酶-1(HO-1)和Bcl-2的表达。在体外,原代海马神经元在有或没有给予瑞米唑仑的情况下暴露于LPS。然后测量细胞活力、凋亡、线粒体膜电位(MMP)和细胞内活性氧(ROS),以评估氧化应激和神经元损伤。还通过蛋白质免疫印迹法测定Nrf2和HO-1的表达。LPS引发大鼠海马神经细胞凋亡,诱发氧化应激,并抑制Nrf2和HO-1的表达,而瑞米唑仑治疗可使其减轻。此外,瑞米唑仑减轻了LPS诱导的大鼠认知功能障碍和焦虑样行为。在体外,瑞米唑仑可改善神经元损伤,减少ROS的产生,并增加暴露于LPS的神经元的MMP,同时伴有Nrf2和HO-1表达的增加。然而,ML385(一种Nrf2抑制剂)逆转了瑞米唑仑对原代海马神经元的有益作用。这些发现表明,瑞米唑仑在体内和体外对LPS诱导的海马神经元损伤均具有保护作用,这与Nrf2信号的激活有关。需要进一步的实验来充分探索瑞米唑仑Nrf2上下游的确切分子机制及其对不同脑区的影响,这将有助于更好地理解瑞米唑仑的神经效应。
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