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Wu L, Wei S, Pei D, Yao Y, Xiang Z, Yu E, Chen Z, Du Z, Qu S. Activation of the Akt Attenuates Ropivacaine-Induced Myelination Impairment in Spinal Cord and Sensory Dysfunction in Neonatal Rats. Mol Neurobiol 2023; 60:7009-7020. [PMID: 37523045 DOI: 10.1007/s12035-023-03498-2] [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: 06/08/2022] [Accepted: 07/11/2023] [Indexed: 08/01/2023]
Abstract
Prolonged exposure to local anesthetics (LAs) or intrathecal administration of high doses of LAs can cause spinal cord damage. Intraspinal administration of LAs is increasingly being used in children and neonates. Therefore, it is important to study LA-related spinal cord damage and the underlying mechanism in developmental models. First, neonatal Sprague-Dawley rats received three intrathecal injections of 0.5% ropivacaine, 1% ropivacaine, 2% ropivacaine or saline (90-min interval) on postnatal day 7. Electron microscopy, luxol fast blue staining and behavioral tests were performed to evaluate the spinal neurotoxicity caused by ropivacaine at different concentrations. Western blot analysis and immunostaining was performed to detect the expression changes of p-Akt, Akt, myelin gene regulatory factor (MYRF) and myelin basic protein (MBP) in the spinal cord treated with different concentrations of ropivacaine. Our results showed that 1% or 2% ropivacaine impaired myelination in the spinal cord and induced sensory dysfunction, but 0.5% ropivacaine did not. Moreover, 1% or 2% ropivacaine decreased the expression of p-Akt, MYRF and MBP in the spinal cord. Then, in order to further explore the role of these proteins in this model, the Akt-specific activator (SC79) was intraperitoneally injected 30 min before 2% ropivacaine treatment. Interestingly, SC79-mediated activation of Akt partly rescued ropivacaine-induced myelination impairments and sensory dysfunction. Overall, the results showed that ropivacaine caused spinal neurotoxicity in a dose-dependent manner in neonatal rats and that activation of the Akt partly rescued ropivacaine-induced these changes. These data provide insight into the neurotoxicity to the developing spinal cord caused by LAs.
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Affiliation(s)
- Lei Wu
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China
| | - Siwei Wei
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China
| | - Dongjie Pei
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China
| | - Yiyi Yao
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China
| | - Zhen Xiang
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China
| | - Eryou Yu
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China
| | - Zheng Chen
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China
| | - Zhen Du
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China.
| | - Shuangquan Qu
- Department of Anesthesiology, Hunan Children's Hospital, No.86 Ziyuan Rd, Changsha, 410007, Hunan, China.
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Zeng L, Zhang F, Zhang Z, Xu M, Xu Y, Liu Y, Xu H, Sun X, Sang M, Luo H. P53 inhibitor pifithrin-α inhibits ropivacaine-induced neuronal apoptosis via the mitochondrial apoptosis pathway. J Biochem Mol Toxicol 2021; 35:e22822. [PMID: 34091999 DOI: 10.1002/jbt.22822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/09/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023]
Abstract
The neurotoxicity of local anesthetics (LAs) has attracted more and more attention, However, they lack preventive and therapeutic measures. Many studies have shown that apoptosis plays an important role in the process of LA-induced neurotoxicity. As an important signaling molecule to activate apoptosis, p53 has been proved to be involved in the neurotoxicity induced by LAs, but the mechanism is unclear. In this study, we explored the effect of pifithrin-α (PFT-α), a p53 inhibitor, on apoptosis by ropivacaine (Rop) in vivo and in vitro. Cell viability and apoptosis detected by CCK-8 and a JC-1 apoptosis detection kit, the changes of spinal cord structure observed after hematoxylin and eosin staining, apoptosis of the spinal cord measured by terminal deoxynucleotidyl transferase dUTP nick end labeling staining, behavioral assessment of the nerve Injury evaluated by the detection of sciatic nerve conduction velocity (SNCV) andmechanical withdrawal threshold (MWT), the expression of p53 and many apoptosis-related genes included Bax, Bcl-2, and caspase-3 detected by quantitative real-time polymerase chain reaction, Western blot analysis, immunofluorescence, and immunohistochemistry. Results showed that PC12 cell viability decreased because of Rop, but the pretreatment of PFT-α could protect it. And PFT-α reduced the injuries in the spinal cord by Rop included vacuoles or edema. The results of immunofluorescence and immunohistochemistry testing showed that PFT-α inhibited the p53 protein upregulated by Rop. Apoptosis rate and many proapoptotic genes include p53, Bax, caspase-3 messenger RNA, and proteins were increased by Rop, but PFT-α could decrease it. In conclusion, PFT-α inhibited cell apoptosis and spinal cord injuries induced by Rop.
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Affiliation(s)
- Lian Zeng
- Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.,Hubei Clinical Research Center of Parkinson's disease, Xiangyang No.1 People s Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Fuyu Zhang
- Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Zhen Zhang
- Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Min Xu
- Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Yang Xu
- Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Ying Liu
- Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Hongxia Xu
- Central Laboratory, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.,Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Xiaodong Sun
- Hubei Clinical Research Center of Parkinson's disease, Xiangyang No.1 People s Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.,Central Laboratory, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.,Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Ming Sang
- Hubei Clinical Research Center of Parkinson's disease, Xiangyang No.1 People s Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.,Central Laboratory, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.,Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
| | - Huiyu Luo
- Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China
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Chen Y, Yan L, Zhang Y, Yang X. The role of DRP1 in ropivacaine-induced mitochondrial dysfunction and neurotoxicity. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:1788-1796. [PMID: 31062606 DOI: 10.1080/21691401.2019.1594858] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Ropivacaine is a commonly used local anaesthetic, but its side effects remain largely unknown. In the present study, we investigated the side effects of ropivacaine in human neuronal SH-5Y5Y cells. We show that 0.5% and 1% ropivacaine could cause fission-like mitochondrial morphological changes. Ropivacaine exclusively induces mitochondrial fission protein DRP1, generation of ROS and causes mitochondrial dysfunction including decreasing mitochondrial membrane potential, the activity of cytochrome C oxidase and ATP production. The side effects of ropivacaine appear to be dependent on DRP1 expression as silencing of DRP1 in neuronal cells abolishes ropivacaine-induced morphological changes and mitochondrial dysfunction. Silencing of DRP1 prevents ropivacaine-induced cellular LDH release and cell death. Moreover, DRP1-deficient neuronal cells are resistant to ropivacaine-induced apoptosis and silencing of DRP1 rescues the activity of cytochrome C oxidase and cellular ATP production. Collectively, our data indicate that imbalances in mitochondrial dynamics, mitochondrial dysfunction and cell death resulting from ropivacaine are all dependent on DRP1 expression. Our study provides valuable data to assess the safety of ropivacaine.
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Affiliation(s)
- Yan Chen
- a Department of anesthesiology, Second Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Lili Yan
- a Department of anesthesiology, Second Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Yan Zhang
- b Department of outpatient service, Second Affiliated Hospital of Zhengzhou Universitys , Zhengzhou , China
| | - Xianhui Yang
- a Department of anesthesiology, Second Affiliated Hospital of Zhengzhou University , Zhengzhou , China
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Abstract
PURPOSE OF REVIEW Neural toxicity of substances injected into the intrathecal space has been a matter of debate since the introduction of spinal anesthesia in clinical practice. In recent years, new local anesthetics and adjuvants have been proposed for intrathecal use, and new techniques such as the use of ultrasound have been propagated. The present review summarizes recent clinical and experimental data on the neurotoxic effects of drugs and substances used for or in conjunction with spinal anesthesia. RECENT FINDINGS Chloroprocaine has been demonstrated to be associated with a lower risk of transient neurologic symptoms compared with lidocaine. However, despite extensive research, the issue of chloroprocaine or bisulfite neurotoxicity has not yet been resolved.Recent experimental data have identified a smaller neurotoxic potential for ropivacaine compared to levobupivacaine, procaine and bupivacaine. The addition of epinephrine has not been shown to increase lidocaine neurotoxicity. In-vivo experimental data suggest that lidocaine and bupivacaine neurotoxicity is not enhanced in diabetic patients.Furthermore, intrathecal introduction of aqueous ultrasound gel has been demonstrated to cause a distinct neuroinflammatory reaction. Finally, a large cohort study did not find the use of chlorhexidine gluconate for skin disinfection before neuraxial block to be associated with the risk of adhesive arachnoiditis. SUMMARY Clinical data suggest a high safety profile for intrathecal drugs and substances used for or in conjunction with spinal anesthesia. Recent experimental models for toxicity have provided further insight into the mechanisms and demonstrated possible, albeit clinically small differences in the relative neurotoxic potential of intrathecal drugs. This may contribute to a further increase in the safe use of spinal anesthesia in the clinical setting.
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