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Salavati S, Mogheiseh A, Nazifi S, Amiri A, Nikahval B. The effects of melatonin on the concentrations of inflammatory cytokines and proteins, serotonin, cortisol and melatonin in ovariohysterectomised female dogs. Vet Med Sci 2023; 9:1103-1113. [PMID: 36913177 DOI: 10.1002/vms3.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/28/2023] [Accepted: 02/19/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Ovariohysterectomy (OHE) induces inflammation and stress in female dogs. The anti-inflammatory effects of melatonin have been reported in several studies. OBJECTIVES The goal of this study was to assess the effects of melatonin on the concentrations of melatonin, cortisol, serotonin, α-1-acid glycoprotein (AGP), serum amyloid A (SAA), c-reactive protein (CRP), interleukin-10 (IL-10), interleukin-8 (IL-8), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) before and after OHE. METHODS The total number of animals was 25 and aligned in 5 groups. Fifteen dogs were divided into three groups (n = 5): melatonin, melatonin+anaesthesia and melatonin+OHE and received melatonin (0.3 mg/kg, p.o.) on days -1, 0, 1, 2 and 3. Ten dogs were assigned to the control and OHE groups (n = 5) without melatonin treatment. OHE and anaesthesia were performed on day 0. Blood samples were obtained via jugular vein on days -1, 1, 3 and 5. RESULTS Melatonin and serotonin concentrations significantly increased in the melatonin, melatonin+OHE and melatonin+anaesthesia groups compared with the control group, while cortisol concentration decreased in the melatonin+OHE group compared with the OHE group. The concentrations of acute-phase proteins (APPs) and inflammatory cytokines significantly increased after OHE. The CRP, SAA and IL-10 concentrations decreased significantly in the melatonin+OHE group compared with the OHE group. The concentrations of cortisol, APPs and proinflammatory cytokines increased significantly in the melatonin+anaesthesia group compared with the melatonin group. CONCLUSIONS The oral administration of melatonin before and after OHE help controlling the high levels of inflammatory APPs, cytokines and cortisol induced by OHE in female dogs.
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Affiliation(s)
- Sina Salavati
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Fars, Iran
| | - Asghar Mogheiseh
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Fars, Iran
| | - Saeed Nazifi
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Fars, Iran
| | - Atefeh Amiri
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Fars, Iran
| | - Behrooz Nikahval
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Fars, Iran
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Luckett A, Yousef M, Tifft C, Jenkins K, Smith A, Munoz A, Quimby R, Porter FD, Dang Do AN. Anesthesia outcomes in lysosomal disorders: CLN3 and GM1 gangliosidosis. Am J Med Genet A 2023; 191:711-717. [PMID: 36461157 PMCID: PMC9928896 DOI: 10.1002/ajmg.a.63064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/05/2022] [Accepted: 11/20/2022] [Indexed: 12/04/2022]
Abstract
Natural history studies of pediatric rare neurometabolic diseases are important to understand disease pathophysiology and to inform clinical trial outcome measures. Some data collections require sedation given participants' age and neurocognitive impairment. To evaluate the safety of sedation for research procedures, we reviewed medical records between April 2017 and October 2019 from a natural history study for CLN3 (NCT03307304) and one for GM1 gangliosidosis (NCT00029965). Twenty-two CLN3 individuals underwent 28 anesthetic events (age median 11.0, IQR 8.4-15.3 years). Fifteen GM1 individuals had 19 anesthetic events (9.8, 7.1-14.7). All participants had the American Society of Anesthesiology classification of II (8/47) or III (39/47). Mean sedation durations were 186 (SD = 54; CLN3) and 291 (SD = 33; GM1) min. Individuals with GM1 (6/19, 31%) were more frequently prospectively intubated for sedation (CLN3 3/28, 11%). Minor adverse events associated with sedation occurred in 8/28 (28%, CLN3) and 6/19 (32%, GM1) individuals, frequencies within previously reported ranges. No major adverse clinical outcomes occurred in 47 anesthetic events in pediatric participants with either CLN3 or GM1 gangliosidosis undergoing research procedures. Sedation of pediatric individuals with rare neurometabolic diseases for research procedures is safe and allows for the collection of data integral to furthering their understanding and treatment.
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Affiliation(s)
- Amelia Luckett
- Department of Anesthesia and Surgical Services, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Muhammad Yousef
- Department of Anesthesia and Surgical Services, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Cynthia Tifft
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kisha Jenkins
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew Smith
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrea Munoz
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Rachel Quimby
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Forbes D Porter
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - An Ngoc Dang Do
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
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3
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Pikwer A, Yang B, Granström M, Mattsson N, Sadr-Azodi O. General anesthesia in early childhood and possible association with autism: a population-based matched cohort study. Minerva Anestesiol 2023; 89:22-31. [PMID: 36282219 DOI: 10.23736/s0375-9393.22.16543-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND In experimental animal studies, exposure to general anesthesia in early childhood may results in changes in infant brain morphology and behavior, potentially leading to the development of autistic behaviors in the long-term. However, in clinical studies the role of exposure to general anesthesia in early childhood and the risk of autism is unknown. METHODS This is a population-based cohort study including all children aged 0-5 years of age exposed to general anesthesia between 2001 and 2014 and a corresponding matched population without such an exposure. Propensity score calculation was based on 49 variables (including age of parents, malformations, APGAR Score, and family income, among others). Quasi-Poisson regression was used to estimate risk ratios (RRs) with 95% confidence intervals (CIs) for the association between exposure to general anesthesia and autism or autism spectrum disorder. RESULTS In total, 401,750 children exposed to general anesthesia were compared with 1,187,796 unexposed individuals. Autism or autism spectrum disorder were more common in the children exposed to general anesthesia as compared to unexposed children (1.65% and 0.98%, respectively, P<0.01). There was a statistically significant higher risk of autism or autism spectrum disorder in children exposed to general anesthesia as compared to unexposed children also after propensity score adjustment (RR 1.62, 95% CI: 1.57-1.67). CONCLUSIONS Exposure to general anesthesia in early childhood was associated with an increased risk of autism or autism spectrum disorder. Future studies are needed to asses if general anesthesia may cause autism or if the association is due to other factors.
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Affiliation(s)
- Andreas Pikwer
- Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden - .,Department of Anesthesia, Eskilstuna County Hospital, Eskilstuna, Sweden -
| | - Bei Yang
- Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
| | - Malin Granström
- Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.,Department of Anesthesia, Eskilstuna County Hospital, Eskilstuna, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Omid Sadr-Azodi
- Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.,Unit of Surgery, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.,Department of Surgery, Saint Goran Hospital, Stockholm, Sweden
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4
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Xiang X, Tang X, Yu Y, Xie S, Liu L, Chen M, Zhang R, Kang X, Zheng Y, Yang G, Gan S, Zhu S. Role of lipocalin-2 in surgery-induced cognitive decline in mice: a signal from neuron to microglia. J Neuroinflammation 2022; 19:92. [PMID: 35413913 PMCID: PMC9006597 DOI: 10.1186/s12974-022-02455-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perioperative neurocognitive disorders (PNDs) are common complications observed among surgical patients. Accumulating evidence suggests that neuroinflammation is one of the major contributors to the development of PNDs, but the underlying mechanisms remain unclear. METHODS qPCR and ELISA analysis were used for detecting LCN2 and cytokine levels. cx3cr1CreER/-:: R26iDTR/- crossed mouse line was used for microglia depletion; intracranial injection of recombinant LCN2 (rLCN2) and adeno-associated viruses (AAV)-mediated shRNA silencing approaches were used for gain and loss of function, respectively. Combing with in vitro microglia cell culture, we have studied the role of LCN2 in surgery-induced cognitive decline in mice. RESULTS We revealed that Lcn2 mRNA and protein levels were greatly increased in mouse hippocampal neurons after surgery. This surgery-induced elevation of LCN2 was independent of the presence of microglia. Gain of function by intracranial injection of rLCN2 protein into hippocampus disrupted fear memory in naive mice without surgery. Conversely, silencing LCN2 in hippocampus by AAV-shRNA protected mice from surgery-induced microglia morphological changes, neuroinflammation and cognitive decline. In vitro, application of rLCN2 protein induced the expression of several pro-inflammatory cytokines in both BV-2 and primary microglia culture. CONCLUSIONS These data suggest LCN2 acts as a signal from neuron to induce proinflammatory microglia, which contributes to surgery-induced neuroinflammation and cognitive decline in mice.
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Affiliation(s)
- Xuwu Xiang
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Xiaodong Tang
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Yang Yu
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Shulan Xie
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Lu Liu
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - ManLi Chen
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Rong Zhang
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Xianhui Kang
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Yueying Zheng
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Guang Yang
- 2Department of Anesthesiology, Columbia University Medical Center, New York, NY, 10032, USA
| | - Shuyuan Gan
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China.
| | - Shengmei Zhu
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, Zhejiang, 310003, People's Republic of China.
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Mcswain JR, Sirianni JM, Wilson SH. Perioperative Considerations for Patients with a Known Diagnosis of Dementia. Adv Anesth 2021; 39:113-132. [PMID: 34715970 DOI: 10.1016/j.aan.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Julie R Mcswain
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, 25 Courtenay Drive, Suite 4200 MSC 240, Charleston, SC 29425, USA.
| | - Joel M Sirianni
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, 167 Ashley Avenue, Suite 301 MSC 912, Charleston, SC, USA
| | - Sylvia H Wilson
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, 167 Ashley Avenue, Suite 301 MSC 912, Charleston, SC, USA
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Long-term probiotic intervention mitigates memory dysfunction through a novel H3K27me3-based mechanism in lead-exposed rats. Transl Psychiatry 2020; 10:25. [PMID: 32066679 PMCID: PMC7026181 DOI: 10.1038/s41398-020-0719-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/07/2019] [Accepted: 12/20/2019] [Indexed: 02/06/2023] Open
Abstract
Chronic lead exposure is associated with the development of neurodegenerative diseases, characterized by the long-term memory decline. However, whether this pathogenesis could be prevented through adjusting gut microbiota is not yet understood. To address the issue, pregnant rats and their female offspring were treated with lead (125 ppm) or separately the extra probiotics (1010 organisms/rat/day) till adulthood. For results, memory dysfunction was alleviated by the treatment of multispecies probiotics. Meanwhile, the gut microbiota composition was partially normalized against lead-exposed rats, which in turn mediated the memory repairment via fecal transplantation trials. In the molecular aspect, the decreased H3K27me3 (trimethylation of histone H3 Lys 27) in the adult hippocampus was restored with probiotic intervention, an epigenetic event mediated by EZH2 (enhancer of zeste homolog 2) at early developmental stage. In a neural cellular model, EZH2 overexpression showed the similar rescue effect with probiotics, whereas its blockade led to the neural re-damages. Regarding the gut-brain inflammatory mediators, the disrupted IL-6 (interleukin 6) expression was resumed by probiotic treatment. Intraperitoneal injection of tocilizumab, an IL-6 receptor antagonist, upregulated the hippocampal EZH2 level and consequently alleviated the memory injuries. In conclusion, reshaping gut microbiota could mitigate memory dysfunction caused by chronic lead exposure, wherein the inflammation-hippocampal epigenetic pathway of IL-6-EZH2-H3K27me3, was first proposed to mediate the studied gut-brain communication. These findings provided insight with epigenetic mechanisms underlying a unique gut-brain interaction, shedding light on the safe and non-invasive treatment of neurodegenerative disorders with environmental etiology.
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7
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Belrose JC, Noppens RR. Anesthesiology and cognitive impairment: a narrative review of current clinical literature. BMC Anesthesiol 2019; 19:241. [PMID: 31881996 PMCID: PMC6933922 DOI: 10.1186/s12871-019-0903-7] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022] Open
Abstract
Background The impact of general anesthesia on cognitive impairment is controversial and complex. A large body of evidence supports the association between exposure to surgery under general anesthesia and development of delayed neurocognitive recovery in a subset of patients. Existing literature continues to debate whether these short-term effects on cognition can be attributed to anesthetic agents themselves, or whether other variables are causative of the observed changes in cognition. Furthermore, there is conflicting data on the relationship between anesthesia exposure and the development of long-term neurocognitive disorders, or development of incident dementia in the patient population with normal preoperative cognitive function. Patients with pre-existing cognitive impairment present a unique set of anesthetic considerations, including potential medication interactions, challenges with cooperation during assessment and non-general anesthesia techniques, and the possibility that pre-existing cognitive impairment may impart a susceptibility to further cognitive dysfunction. Main body This review highlights landmark and recent studies in the field, and explores potential mechanisms involved in perioperative cognitive disorders (also known as postoperative cognitive dysfunction, POCD). Specifically, we will review clinical and preclinical evidence which implicates alterations to tau protein, inflammation, calcium dysregulation, and mitochondrial dysfunction. As our population ages and the prevalence of Alzheimer’s disease and other forms of dementia continues to increase, we require a greater understanding of potential modifiable factors that impact perioperative cognitive impairment. Conclusions Future research should aim to further characterize the associated risk factors and determine whether certain anesthetic approaches or other interventions may lower the potential risk which may be conferred by anesthesia and/or surgery in susceptible individuals.
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Affiliation(s)
- Jillian C Belrose
- Department of Anesthesia & Perioperative Medicine, Western University, London Health Sciences Center, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| | - Ruediger R Noppens
- Department of Anesthesia & Perioperative Medicine, Western University, London Health Sciences Center, 339 Windermere Rd, London, ON, N6A 5A5, Canada.
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8
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Tanner JJ, Amin M, Hardcastle C, Parvataneni H, Vaillancourt DE, Mareci TH, Price CC. Better Brain and Cognition Prior to Surgery Is Associated With Elevated Postoperative Brain Extracellular Free-Water in Older Adults. Front Aging Neurosci 2019; 11:117. [PMID: 31156423 PMCID: PMC6532420 DOI: 10.3389/fnagi.2019.00117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/01/2019] [Indexed: 12/23/2022] Open
Abstract
For adults age 65 and older, the brain shows acute functional connectivity decreases after total knee arthroplasty with the severity of change predicted by preoperative cognitive function and brain disease burden. The extent of acute structural microstructural brain changes acutely after surgery remains unknown within the literature. For the current study, we report on the severity of acute post-surgery microstructural brain changes as measured by diffusion imaging and free-water analysis. Participants who underwent total knee arthroplasty under general anesthesia and non-surgery peers were part of a federally funded prospective cohort investigation involving participants. Recruitment occurred between 2013 and 2017. Data were collected in outpatient and inpatient settings within a university-affiliated medical center. A total of 232 TKA patients were referred by the study surgeon and contacted for study inclusion. Of these, 78 met inclusion and exclusion criteria and completed assessment. Five participants were excluded due to anesthetic protocol changes (spinal instead of general) with an additional 12 excluded for imaging-related complications. The total included sample size was 61. A total of 127 non-surgery participants were screened with 66 enrolled. One non-surgery participant was excluded for an imaging-related complication. Total knee arthroplasty and general anesthetic protocols were standardized. Participants received preoperative neurocognitive assessment and brain magnetic resonance imaging, with repeat imaging 48 h after surgery or pseudo surgery. Free-water analyses were performed using diffusion weighted images and tract-based spatial statistics with baseline cognitive data used to predict free-water changes. Surgery participants had widespread increases in white matter free-water. Surgery participants with higher cognitive functions as measured by immediate memory and less evidence of brain atrophy and disease (i.e., brain integrity) had greater free-water increase. Non-surgery peers had no free-water change. We interpret the surgery group’s free-water change as indicating widespread brain white matter glial response, with greater change indicative of better brain response to the acute surgery/anesthesia experience.
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Affiliation(s)
- Jared J Tanner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Manish Amin
- Department of Physics, University of Florida, Gainesville, FL, United States
| | - Cheshire Hardcastle
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Hari Parvataneni
- Department of Orthopedic Surgery, University of Florida, Gainesville, FL, United States
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, Biomedical Engineering, and Neurology, University of Florida, Gainesville, FL, United States
| | - Thomas H Mareci
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, United States
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Anesthesiology, University of Florida, Gainesville, FL, United States
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Wang Y, Qiu R, Kong G, Liu J. Effects of propofol combined with remifentanil anesthesia on the NO, endothelin and inflammatory cytokines in the plasma of patients with liver cirrhosis during the perioperative period. Exp Ther Med 2019; 17:3694-3700. [PMID: 30988754 PMCID: PMC6447789 DOI: 10.3892/etm.2019.7367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/28/2019] [Indexed: 01/08/2023] Open
Abstract
The effects of propofol combined with remifentanil on the nitric oxide (NO), endothelin (ET-1) and inflammatory cytokines in the plasma of patients with liver cirrhosis were investigated. A retrospective analysis of 68 patients with liver cirrhosis who underwent hepatectomy in the Hunan Provincial People's Hospital from March 2016 to July 2018 was made. According to different anesthesia methods, 30 patients anesthetized with propofol were enrolled into Group A. The other 38 patients anesthetized with propofol combined with remifentanil were enrolled into Group B, and the operation time, amount of bleeding during operation and postoperative awake time of the two groups were recorded. At three separate time-points T1 (30 min before the anesthesia), T2 (after the portal triad clamping), T3 (3 days after the operation), aspartate transaminase (AST) and alanine transaminase (ALT) levels in the plasma were measured by rate method, and the levels of NO, ET-1, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in plasma were detected by enzyme-linked immunosorbent assay (ELISA). The plasma NO levels at the T2 time-point were significantly lower than those at the T1 and T3 time-points (P<0.05); at the T2 time-point, the concentrations of AST, ALT, ET-1, IL-6 and TNF-α in the plasma in Group A were significantly higher than those of Group B (P<0.05), while the levels of plasma NO in Group A were the opposite (P<0.05). The anesthesia of propofol combined with remifentanil could contribute to the balance of NO/ET-1 and the inhibition of inflammatory factors during the hepatectomy operation in patients with liver cirrhosis, and help to protect the liver function of patients, reducing the incidence of liver ischemia-reperfusion injury in patients.
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Affiliation(s)
- Yongsheng Wang
- Department of Anesthesiology, Hunan Provincial People's Hospital, Changsha, Hunan 410005, P.R. China
| | - Rongen Qiu
- Department of Anesthesiology, Xiangtan Central Hospital, Xiangtan, Hunan 411413, P.R. China
| | - Gaoyin Kong
- Department of Anesthesiology, Hunan Provincial People's Hospital, Changsha, Hunan 410005, P.R. China
| | - Jitong Liu
- Department of Anesthesiology, Hunan Provincial People's Hospital, Changsha, Hunan 410005, P.R. China
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10
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Xiang X, Yu Y, Tang X, Chen M, Zheng Y, Zhu S. Transcriptome Profile in Hippocampus During Acute Inflammatory Response to Surgery: Toward Early Stage of PND. Front Immunol 2019; 10:149. [PMID: 30804943 PMCID: PMC6370675 DOI: 10.3389/fimmu.2019.00149] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/17/2019] [Indexed: 01/08/2023] Open
Abstract
Perioperative neurocognitive disorders (PND) are common complications observed in surgical patients, but there are no effective treatments and the detailed mechanisms remain largely unknown. In this study, transcriptome analysis was performed to investigate the hippocampal changes after surgery and underlying molecular mechanisms of PND. Tibial fracture surgery was performed in 3–4 months old C57BL/6J mice to mimic human orthopedic surgery. We demonstrated that memory consolidation of the hippocampal-dependent trace-fear conditioning task was significantly impaired. By using ELISA, a significant elevated IL-6 was observed both in circulating system and central nervous system and peaked at 6 h post-surgery, but transiently returned to baseline thereafter. Hippocampus were collected at 6 h post-surgery then processed for RNA-Seq. A total of 268 genes were screened differentially expressed between the Surgery and Control group, including 170 up-regulated genes and 98 down-regulated genes. By functional enrichment analysis of differently expressed genes, several KEGG pathways involved in inflammatory mediator regulation of TRP channels, neuroactive ligand-receptor interaction and cholinergic synapse were overrepresented. Quantitative real-time PCR confirmed 15 dysregulated genes of interest. These results provide a comprehensive insight into global gene expression changes during the acute presence of hippocampal inflammation and a better understanding on early stage of PND.
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Affiliation(s)
- Xuwu Xiang
- Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Yu
- Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaodong Tang
- Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Manli Chen
- Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yueying Zheng
- Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shengmei Zhu
- Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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11
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Berger M, Ponnusamy V, Greene N, Cooter M, Nadler JW, Friedman A, McDonagh DL, Laskowitz DT, Newman MF, Shaw LM, Warner DS, Mathew JP, James ML. The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial. Front Immunol 2017; 8:1528. [PMID: 29181002 PMCID: PMC5694037 DOI: 10.3389/fimmu.2017.01528] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/27/2017] [Indexed: 12/31/2022] Open
Abstract
Introduction Aside from direct effects on neurotransmission, inhaled and intravenous anesthetics have immunomodulatory properties. In vitro and mouse model studies suggest that propofol inhibits, while isoflurane increases, neuroinflammation. If these findings translate to humans, they could be clinically important since neuroinflammation has detrimental effects on neurocognitive function in numerous disease states. Materials and methods To examine whether propofol and isoflurane differentially modulate neuroinflammation in humans, cytokines were measured in a secondary analysis of cerebrospinal fluid (CSF) samples from patients prospectively randomized to receive anesthetic maintenance with propofol vs. isoflurane (registered with http://www.clinicaltrials.gov, identifier NCT01640275). We measured CSF levels of EGF, eotaxin, G-CSF, GM-CSF, IFN-α2, IL-1RA, IL-6, IL-7, IL-8, IL-10, IP-10, MCP-1, MIP-1α, MIP-1β, and TNF-α before and 24 h after intracranial surgery in these study patients. Results After Bonferroni correction for multiple comparisons, we found significant increases from before to 24 h after surgery in G-CSF, IL-10, IL-1RA, IL-6, IL-8, IP-10, MCP-1, MIP-1α, MIP-1β, and TNF-α. However, we found no difference in cytokine levels at baseline or 24 h after surgery between propofol- (n = 19) and isoflurane-treated (n = 21) patients (p > 0.05 for all comparisons). Increases in CSF IL-6, IL-8, IP-10, and MCP-1 levels directly correlated with each other and with postoperative CSF elevations in tau, a neural injury biomarker. We observed CSF cytokine increases up to 10-fold higher after intracranial surgery than previously reported after other types of surgery. Discussion These data clarify the magnitude of neuroinflammation after intracranial surgery, and raise the possibility that a coordinated neuroinflammatory response may play a role in neural injury after surgery.
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Affiliation(s)
- Miles Berger
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
| | - Vikram Ponnusamy
- University of Missouri School of Medicine, Columbia, MO, United States
| | - Nathaniel Greene
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
| | - Mary Cooter
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
| | - Jacob W Nadler
- Neurosurgical Anesthesiology, Postanesthesia Care Unit, Department of Anesthesiology, University of Rochester, Rochester, NY, United States
| | - Allan Friedman
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, United States
| | - David L McDonagh
- Department of Anesthesiology & Pain Management, Neurological Surgery, Neurology and Neurotherapeutics, University of Texas, Southwestern, Dallas, TX, United States
| | - Daniel T Laskowitz
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States.,Department of Neurology, Duke University Medical Center, Durham, NC, United States.,Department of Neurobiology, Duke University Medical Center, Durham, NC, United States
| | - Mark F Newman
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States.,Private Diagnostic Clinic, Duke University Medical Center, Durham, NC, United States
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - David S Warner
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States.,Department of Neurobiology, Duke University Medical Center, Durham, NC, United States.,Department of Surgery, Duke University Medical Center, Durham, NC, United States
| | - Joseph P Mathew
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
| | - Michael L James
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States.,Department of Neurology, Duke University Medical Center, Durham, NC, United States
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