Güleryüz Bayram, Karacaer Feride, Biricik Ebru, Tunay Demet, Ilginel Murat, Can Müge, Kara Samet, Akillioğlu Kübra, Polat Sait
From the Department of Anesthesiology and Reanimation, Yüreğir State Hospital, Adana, Turkey.
Department of Anesthesiology and Reanimation, Medicine Faculty, Çukurova University, Adana, Turkey.
Anesth Analg. 2025 Jun 23. doi: 10.1213/ANE.0000000000007570.
Numerous studies have demonstrated that sevoflurane might have neurotoxic effects on the developing brain. However, the underlying mechanisms and potential treatment are largely unknown. Vitamin D has immunomodulatory, anti-inflammatory, and neuroprotective effects. We aimed to investigate whether vitamin D could attenuate sevoflurane-induced neurotoxicity in the offspring of mice.
Twenty 8-week-old pregnant Swiss albino mice were randomly divided into 4 groups with 5 mice each: Control, vitamin D (Vit-D), sevoflurane (Sevo), and sevoflurane-vitamin D (Sevo-Vit-D). Throughout the pregnancy, Vit-D and Sevo-Vit-D groups were intraperitoneally administered vitamin D, while Sevo and Control groups received 1 ml of saline. On the 14th day of pregnancy, Sevo and Sevo-Vit-D were exposed to 3% sevoflurane with 100% O2 for 2 hours. Control and Vit-D were exposed to 100% O2 for 2 hours. Newborn mice from the groups were included in the study. Tissue sections of the prefrontal cortex and hippocampus were examined by immunohistochemical methods and electron microscopy (EM) on postnatal day 7 and postnatal day 45 (PN7 and PN45). The immunohistochemical methods assessed the expression levels of inflammatory cytokines, apoptotic factors, neuroprotective proteins. Open field and elevated plus maze tests were performed to assess behavioral changes at PN45.
Vitamin D significantly attenuated the mean (95% confidence interval [CI]) sevoflurane-induced increase in the expression levels of inflammatory cytokines and apoptotic factors, such as interleukin-6 (IL-6; Sevo versus Sevo-Vit-D: 0.68 (0.66-0.7) versus 0.34 (0.32-0.35); P < .001), tumor necrosis factor alpha (TNF-α; Sevo vs Sevo-Vit-D: 0.89 (0.88-0.9) versus 0.53 (0.51-0.55); P < .001), Bax (Sevo vs Sevo-Vit-D: 0.61 (0.6-0.63) versus 0.34 (0.32-0.36); P < .001) and c-Fos (Sevo vs Sevo-Vit-D: 0.64 (0.62-0.66) vs 0.42 (0.4-0.43); P < .001) in the hippocampus at PN7. Furthermore, vitamin D improved the mean (95% CI) expression levels of antiapoptotic and neuroprotective proteins, such as Bcl-2 (Sevo vs Sevo-Vit-D: 0.46 (0.45-0.47) versus 0.56 (0.54-0.58); P < .001), BDNF (Sevo vs Sevo-Vit-D: 0.37 (0.34-0.39) vs 0.64 (0.63-0.65); P < .001), Olig2 (Sevo vs Sevo-Vit-D: 0.38 (0.36-0.39) vs 0.56 (0.54-0.58); P < .001) in the hippocampus at PN7. These changes also occurred in the prefrontal cortex at PN7 and PN45. EM images supported these data. No significant difference was found in behavioral tests between the groups.
Our findings suggested that maternal sevoflurane exposure could cause neurotoxicity in the offspring mice. Vitamin D can protect against the negative effects of sevoflurane.
大量研究表明,七氟醚可能对发育中的大脑具有神经毒性作用。然而,其潜在机制和潜在治疗方法在很大程度上尚不清楚。维生素D具有免疫调节、抗炎和神经保护作用。我们旨在研究维生素D是否能减轻七氟醚对小鼠后代的神经毒性。
将20只8周龄的瑞士白化病怀孕小鼠随机分为4组,每组5只:对照组、维生素D(Vit-D)组、七氟醚(Sevo)组和七氟醚-维生素D(Sevo-Vit-D)组。在整个孕期,Vit-D组和Sevo-Vit-D组腹腔注射维生素D,而Sevo组和对照组注射1 ml生理盐水。在怀孕第14天,Sevo组和Sevo-Vit-D组暴露于含100%氧气的3%七氟醚中2小时。对照组和Vit-D组暴露于100%氧气中2小时。将这些组的新生小鼠纳入研究。在出生后第7天和第45天(PN7和PN45),通过免疫组织化学方法和电子显微镜(EM)检查前额叶皮质和海马体的组织切片。免疫组织化学方法评估炎性细胞因子、凋亡因子、神经保护蛋白的表达水平。在PN45进行旷场试验和高架十字迷宫试验以评估行为变化。
维生素D显著减轻了七氟醚诱导的炎性细胞因子和凋亡因子表达水平的平均(95%置信区间[CI])升高,如在PN7时海马体中的白细胞介素-6(IL-6;Sevo组与Sevo-Vit-D组:0.68(0.66 - 0.7)对0.34(0.32 - 0.35);P <.001)、肿瘤坏死因子α(TNF-α;Sevo组与Sevo-Vit-D组:0.89(0.88 - 0.9)对0.53(0.51 - 0.55);P <.001)、Bax(Sevo组与Sevo-Vit-D组:0.61(0.6 - 0.63)对0.34(0.32 - 0.36);P <.001)和c-Fos(Sevo组与Sevo-Vit-D组:0.64(0.62 - 0.66)对0.42(0.4 - 0.43);P <.001)。此外,维生素D改善了抗凋亡和神经保护蛋白的平均(95% CI)表达水平,如在PN7时海马体中的Bcl-2(Sevo组与Sevo-Vit-D组:0.46(0.45 - 0.47)对0.56(0.54 - 0.58);P <.001)、脑源性神经营养因子(BDNF;Sevo组与Sevo-Vit-D组:0.37(0.34 - 0.39)对0.64(0.63 - 0.65);P <.001)、少突胶质细胞转录因子2(Olig2;Sevo组与Sevo-Vit-D组:0.38(0.36 - 0.39)对0.56(0.54 - 0.58);P <.001)。这些变化在PN7和PN45时的前额叶皮质中也有发生。EM图像支持了这些数据。各组之间在行为测试中未发现显著差异。
我们的研究结果表明,母体暴露于七氟醚可导致后代小鼠神经毒性。维生素D可预防七氟醚的负面影响。