1
|
Fereydouni-Forouzandeh P, Canet G, Diego-Diàz S, Rocaboy E, Petry S, Whittington RA, Planel E. Western Blot of Tau Protein from Mouse Brains Extracts: How to Avoid Signal Artifacts. Methods Mol Biol 2024; 2754:309-321. [PMID: 38512673 DOI: 10.1007/978-1-0716-3629-9_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Tau is a microtubule-associated protein enriched in the axonal compartment. Its most well-known function is to bind and stabilize microtubules. In Alzheimer's disease and other neurodegenerative diseases known as tauopathies, tau undergoes several abnormal post-translational modifications including hyperphosphorylation, conformational changes, oligomerization, and aggregation. Numerous mouse models of tauopathies have been developed, and Western blotting remains an invaluable tool in studying tau protein physiological and pathological changes in these models. However, many of the antibodies that have been developed to analyze tau post-translational modifications are mouse monoclonal, which are at risk of producing artifactual signals in Western blotting procedures. This risk does not arise due to their lack of specificity, but rather because the secondary antibodies used to detect them will also react with the heavy chain of endogenous mouse immunoglobulins (Igs), leading to a non-specific signal at the same molecular weight as tau protein (around 50 kDa). Here, we present the use of anti-light-chain secondary antibodies as a simple and efficient technique to prevent non-specific Ig signals around 50 kDa. We demonstrate the efficacy of this method by either eliminating or identifying artifactual signals when using monoclonal antibodies directed at non-phosphorylated epitopes (T49, Tau3R, Tau4R), phosphorylated epitopes (MC6, AT180, CP13), or an abnormal tau conformation (MC1), in wild-type (WT) mice with tau hyperphosphorylation (hypothermic), transgenic mice overexpressing human tau (hTau mice), and tau knockout (TKO) mice.
Collapse
Affiliation(s)
| | - Geoffrey Canet
- Université Laval, Faculté de Médecine, Département de Psychiatrie et Neurosciences, Quebec, QC, Canada
- Centre de Recherche du CHU de Québec - Université Laval, Axe Neurosciences, Quebec, QC, Canada
| | - Sofia Diego-Diàz
- Université Laval, Faculté de Médecine, Département de Psychiatrie et Neurosciences, Quebec, QC, Canada
- Centre de Recherche du CHU de Québec - Université Laval, Axe Neurosciences, Quebec, QC, Canada
| | - Emma Rocaboy
- Université Laval, Faculté de Médecine, Département de Psychiatrie et Neurosciences, Quebec, QC, Canada
- Centre de Recherche du CHU de Québec - Université Laval, Axe Neurosciences, Quebec, QC, Canada
| | - Serena Petry
- Université Laval, Faculté de Médecine, Département de Psychiatrie et Neurosciences, Quebec, QC, Canada
| | - Robert A Whittington
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Emmanuel Planel
- Université Laval, Faculté de Médecine, Département de Psychiatrie et Neurosciences, Quebec, QC, Canada.
- Centre de Recherche du CHU de Québec - Université Laval, Axe Neurosciences, Quebec, QC, Canada.
| |
Collapse
|
2
|
Shoob S, Buchbinder N, Shinikamin O, Gold O, Baeloha H, Langberg T, Zarhin D, Shapira I, Braun G, Habib N, Slutsky I. Deep brain stimulation of thalamic nucleus reuniens promotes neuronal and cognitive resilience in an Alzheimer's disease mouse model. Nat Commun 2023; 14:7002. [PMID: 37919286 PMCID: PMC10622498 DOI: 10.1038/s41467-023-42721-5] [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: 10/15/2022] [Accepted: 10/19/2023] [Indexed: 11/04/2023] Open
Abstract
The mechanisms that confer cognitive resilience to Alzheimer's Disease (AD) are not fully understood. Here, we describe a neural circuit mechanism underlying this resilience in a familial AD mouse model. In the prodromal disease stage, interictal epileptiform spikes (IESs) emerge during anesthesia in the CA1 and mPFC regions, leading to working memory disruptions. These IESs are driven by inputs from the thalamic nucleus reuniens (nRE). Indeed, tonic deep brain stimulation of the nRE (tDBS-nRE) effectively suppresses IESs and restores firing rate homeostasis under anesthesia, preventing further impairments in nRE-CA1 synaptic facilitation and working memory. Notably, applying tDBS-nRE during the prodromal phase in young APP/PS1 mice mitigates age-dependent memory decline. The IES rate during anesthesia in young APP/PS1 mice correlates with later working memory impairments. These findings highlight the nRE as a central hub of functional resilience and underscore the clinical promise of DBS in conferring resilience to AD pathology by restoring circuit-level homeostasis.
Collapse
Affiliation(s)
- Shiri Shoob
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Nadav Buchbinder
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Ortal Shinikamin
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Or Gold
- Edmond & Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Halit Baeloha
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Tomer Langberg
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Daniel Zarhin
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Ilana Shapira
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Gabriella Braun
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Naomi Habib
- Edmond & Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inna Slutsky
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel.
- Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel.
| |
Collapse
|
3
|
Min J, Rouanet J, Martini AC, Nashiro K, Yoo HJ, Porat S, Cho C, Wan J, Cole SW, Head E, Nation DA, Thayer JF, Mather M. Modulating heart rate oscillation affects plasma amyloid beta and tau levels in younger and older adults. Sci Rep 2023; 13:3967. [PMID: 36894565 PMCID: PMC9998394 DOI: 10.1038/s41598-023-30167-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 02/16/2023] [Indexed: 03/11/2023] Open
Abstract
Slow paced breathing via heart rate variability (HRV) biofeedback stimulates vagus-nerve pathways that counter noradrenergic stress and arousal pathways that can influence production and clearance of Alzheimer's disease (AD)-related proteins. Thus, we examined whether HRV biofeedback intervention affects plasma Αβ40, Αβ42, total tau (tTau), and phosphorylated tau-181 (pTau-181) levels. We randomized healthy adults (N = 108) to use slow-paced breathing with HRV biofeedback to increase heart rate oscillations (Osc+) or to use personalized strategies with HRV biofeedback to decrease heart rate oscillations (Osc-). They practiced 20-40 min daily. Four weeks of practicing the Osc+ and Osc- conditions produced large effect size differences in change in plasma Aβ40 and Aβ42 levels. The Osc+ condition decreased plasma Αβ while the Osc- condition increased Αβ. Decreases in Αβ were associated with decreases in gene transcription indicators of β-adrenergic signaling, linking effects to the noradrenergic system. There were also opposing effects of the Osc+ and Osc- interventions on tTau for younger adults and pTau-181 for older adults. These results provide novel data supporting a causal role of autonomic activity in modulating plasma AD-related biomarkers.Trial registration: NCT03458910 (ClinicalTrials.gov); first posted on 03/08/2018.
Collapse
Affiliation(s)
- Jungwon Min
- University of Southern California, Los Angeles, CA, USA
| | | | | | - Kaoru Nashiro
- University of Southern California, Los Angeles, CA, USA
| | - Hyun Joo Yoo
- University of Southern California, Los Angeles, CA, USA
| | - Shai Porat
- University of Southern California, Los Angeles, CA, USA
| | - Christine Cho
- University of Southern California, Los Angeles, CA, USA
| | - Junxiang Wan
- University of Southern California, Los Angeles, CA, USA
| | - Steve W Cole
- University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | | | - Mara Mather
- University of Southern California, Los Angeles, CA, USA.
| |
Collapse
|
4
|
Kinoshita M, Mutoh S, Kasai A, Kawanishi R, Tanaka K. General Anesthesia in a Patient With Neuronal Intranuclear Inclusion Disease: A Case Report. A A Pract 2022; 16:e01633. [PMID: 36599032 DOI: 10.1213/xaa.0000000000001633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Neuronal intranuclear inclusion disease (NIID) is a progressive neurodegenerative disease with diverse clinical manifestations, including dementia and muscle weakness. We summarize anesthetic considerations in reporting general anesthesia for a 58-year-old man with bladder dysfunction and cerebellar ataxia who was diagnosed with NIID. The patient developed postinduction hypotension relevant to autonomic neuropathy. The potential risks, such as prolonged reaction to neuromuscular blocking agent, postoperative delirium, and worsening of NIID-related symptoms, were also considered. The responsiveness to anesthetics may vary widely from case t case. As the number of NIID cases increases, a better understanding of NIID is needed.
Collapse
Affiliation(s)
- Michiko Kinoshita
- From the Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan
| | - Sarara Mutoh
- From the Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan
| | - Asuka Kasai
- Surgical Center, Tokushima University Hospital, Tokushima, Japan
| | | | - Katsuya Tanaka
- From the Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan
| |
Collapse
|
5
|
Ozsahin I. Identifying a Personalized Anesthetic with Fuzzy PROMETHEE. Healthc Inform Res 2020; 26:201-211. [PMID: 32819038 PMCID: PMC7438688 DOI: 10.4258/hir.2020.26.3.201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/20/2020] [Indexed: 11/23/2022] Open
Abstract
Objective During an anesthetic evaluation, the individual's medical history and overall fitness for the whole medical procedure should be carefully examined. The objective of this study was to apply a multi-criteria decision-making technique to determine the proper anesthetic agent for specific patients. Methods The fuzzy PROMETHEE (Preference Ranking Organization Method for Enrichment of Evaluations) method was applied to determine the most appropriate agent. Minimum alveolar concentration, blood:gas and oil:gas partition coefficients, onset of action, recovery time, duration, induction and maintenance doses, and washout time were used as the criteria for the analysis. After defining the values of each criteria, the criteria weights and the preference function were set, and finally the results for two different examples, one for general ranking and one for a specific individual were obtained. RESULTS The results show that nitrous oxide and xenon are among the preferred inhaled anesthetics in the ranking of the inhaled anesthetics, whereas midazolam was identified as the preferred injected agent. When the weights are selected according to a specific patient's condition, namely a 70-year-old woman to undergo an emergent laparoscopic appendectomy with comorbidities, including severe chronic obstructive pulmonary disease as a consequence of a life-long smoking habit, morbid obesity, and type II diabetes, the results changed significantly. In this case, desflurane and etomidate come first in the ranking of inhaled and injected anesthetics, respectively, while nitrous oxide is the least preferred anesthetic agent. Conclusion Expert opinion is always needed. Assigning weights to criteria and grading alternatives are the major challenges in multi-criteria decision-making studies. Fuzzy PROMETHEE is proposed to solve a multi-criteria decision-making problem in selecting a general anesthetic.
Collapse
Affiliation(s)
- Ilker Ozsahin
- Department of Biomedical Engineering, Faculty of Engineering, Near East University, Nicosia/TRNC, Mersin, Turkey.,DESAM Institute, Near East University, Nicosia/TRNC, Mersin, Turkey
| |
Collapse
|
6
|
Deiner S, Baxter MG, Mincer JS, Sano M, Hall J, Mohammed I, O'Bryant S, Zetterberg H, Blennow K, Eckenhoff R. Human plasma biomarker responses to inhalational general anaesthesia without surgery. Br J Anaesth 2020; 125:282-290. [PMID: 32536445 DOI: 10.1016/j.bja.2020.04.085] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/07/2020] [Accepted: 04/22/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Postoperative neurocognitive disorders may arise in part from adverse effects of general anaesthetics on the CNS, especially in older patients or individuals otherwise vulnerable to neurotoxicity because of systemic disease or the presence of pre-existing neuropathology. Previous studies have documented cytokine and injury biomarker responses to surgical procedures that included general anaesthesia, but it is not clear to what degree anaesthetics contribute to these responses. METHODS We performed a prospective cohort study of 59 healthy volunteers aged 40-80 yr who did not undergo surgery. Plasma markers of neurological injury and inflammation were measured immediately before and 5 h after induction of general anaesthesia with 1 minimum alveolar concentration of sevoflurane. Biomarkers included interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α), C-reactive protein (CRP), and neural injury (tau, neurofilament light [NF-L], and glial fibrillary acidic protein [GFAP]). RESULTS Baseline biomarkers were in the normal range, although NF-L and GFAP were elevated as a function of age. At 5 h after induction of anaesthesia, plasma tau, NF-L, and GFAP were significantly decreased relative to baseline. Plasma IL-6 was significantly increased after anaesthesia, but by a biologically insignificant degree (<1 pg ml-1); plasma TNF-α and CRP were unchanged. CONCLUSIONS Sevoflurane general anaesthesia without surgery, even in older adults, did not provoke an inflammatory state or neuronal injury at a concentration that is detectable by an acute elevation of measured plasma biomarkers in the early hours after exposure. CLINICAL TRIAL REGISTRATION NCT02275026.
Collapse
Affiliation(s)
- Stacie Deiner
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Mark G Baxter
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua S Mincer
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, New York, NY, USA
| | - Mary Sano
- Department of Psychiatry, James J. Peters VA Medical Center, Bronx, NY, USA
| | - James Hall
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ismail Mohammed
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sid O'Bryant
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; UK Dementia Research Institute at UCL, London, UK; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Roderic Eckenhoff
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| |
Collapse
|
7
|
Iqbal F, Thompson AJ, Riaz S, Pehar M, Rice T, Syed NI. Anesthetics: from modes of action to unconsciousness and neurotoxicity. J Neurophysiol 2019; 122:760-787. [PMID: 31242059 DOI: 10.1152/jn.00210.2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Modern anesthetic compounds and advanced monitoring tools have revolutionized the field of medicine, allowing for complex surgical procedures to occur safely and effectively. Faster induction times and quicker recovery periods of current anesthetic agents have also helped reduce health care costs significantly. Moreover, extensive research has allowed for a better understanding of anesthetic modes of action, thus facilitating the development of more effective and safer compounds. Notwithstanding the realization that anesthetics are a prerequisite to all surgical procedures, evidence is emerging to support the notion that exposure of the developing brain to certain anesthetics may impact future brain development and function. Whereas the data in support of this postulate from human studies is equivocal, the vast majority of animal research strongly suggests that anesthetics are indeed cytotoxic at multiple brain structure and function levels. In this review, we first highlight various modes of anesthetic action and then debate the evidence of harm from both basic science and clinical studies perspectives. We present evidence from animal and human studies vis-à-vis the possible detrimental effects of anesthetic agents on both the young developing and the elderly aging brain while discussing potential ways to mitigate these effects. We hope that this review will, on the one hand, invoke debate vis-à-vis the evidence of anesthetic harm in young children and the elderly, and on the other hand, incentivize the search for better and less toxic anesthetic compounds.
Collapse
Affiliation(s)
- Fahad Iqbal
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andrew J Thompson
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Neuroscience, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Saba Riaz
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marcus Pehar
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tiffany Rice
- Department of Anesthesiology, Perioperative and Pain Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Naweed I Syed
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
8
|
Ge X, Zhang Y, Zuo Y, Israr M, Li B, Yu P, Gao G, Chang YZ, Shi Z. Transcriptomic analysis reveals the molecular mechanism of Alzheimer-related neuropathology induced by sevoflurane in mice. J Cell Biochem 2019; 120:17555-17565. [PMID: 31134678 DOI: 10.1002/jcb.29020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/13/2019] [Accepted: 04/18/2019] [Indexed: 12/18/2022]
Abstract
Anesthetics could induce cognitive dysfunctions, such as Alzheimer's disease in humans or mice. However, the precise molecular mechanism is unclear. Sevoflurane is a common anesthetic widely used in clinical practice. Here, we demonstrated the induction of cognitive dysfunction induced by Sev in mice to corroborate the signaling pathway and the differentially expressed genes (DEGs) followed by analyzing their functions. The cognitive function of mice was measured by the Morris water maze test. Transcriptomic data were annotated with Illumina HiSeq. 2000. Further, the changes in related proteins or genes were analyzed by western blotting and real-time quantitative polymerase chain reaction. Our results showed that Sev could cause a decline in cognitive competence in mice. The transcriptomic data indicated that adding up to 566 genes were upregulated and 1073 genes were downregulated. The genes of Plin4, Lcn2, Lrg1, Foxf1, and Ctla2a were significantly upregulated, while the genes of Arc, Npas4, Egr2, Hes5, and Cdh9 were downregulated dramatically. The Gene Ontology term with the highest enrichment of DEGs are involved in the regulation of cellular and macromolecule metabolism and cation and nucleic acid binding, respectively. The Kyoto encyclopedia of genes and genomes analysis indicated that the mitogen-activated protein kinases (MAPK) pathway was one of the most important metabolic pathways. In addition, the metabolic pathways related to cognitive function, such as the nervous system and neurodegenerative disease showed significant changes. Furthermore, we found that p38, c-Jun N-terminal kinase, and extracellular signal-regulated kinase of the MAPK signaling pathway played important roles in this process. In conclusion, these results provide the first important clues for identifying the DEGs and signaling pathways in the hippocampus due to a Sev-induced cognitive deficiency in mice.
Collapse
Affiliation(s)
- Xing Ge
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Ying Zhang
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Yong Zuo
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Muhammad Israr
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Bowen Li
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Peng Yu
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Guofen Gao
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Yan-Zhong Chang
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Zhenhua Shi
- Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang, Hebei, China
| |
Collapse
|
9
|
Bürge M, Kratzer S, Mattusch C, Hofmann C, Kreuzer M, Parsons CG, Rammes G. The anaesthetic xenon partially restores an amyloid beta-induced impairment in murine hippocampal synaptic plasticity. Neuropharmacology 2019; 151:21-32. [PMID: 30940537 DOI: 10.1016/j.neuropharm.2019.03.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/15/2019] [Accepted: 03/26/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND It is controversially discussed whether general anaesthesia increases the risk of Alzheimer's disease (AD) or accelerates its progression. One important factor in AD pathogenesis is the accumulation of soluble amyloid beta (Aβ) oligomers which affect N-methyl-d-aspartate (NMDA) receptor function and abolish hippocampal long-term potentiation (LTP). NMDA receptor antagonists, at concentrations allowing physiological activation, can prevent Aβ-induced deficits in LTP. The anaesthetics xenon and S-ketamine both act as NMDA receptor antagonists and have been reported to be neuroprotective. In this study, we investigated the effects of subanaesthetic concentrations of these drugs on LTP deficits induced by different Aβ oligomers and compared them to the effects of radiprodil, a NMDA subunit 2B (GluN2B)-selective antagonist. METHODS We applied different Aβ oligomers to murine brain slices and recorded excitatory postsynaptic field potentials before and after high-frequency stimulation in the CA1 region of hippocampus. Radiprodil, xenon and S-ketamine were added and recordings evoked from a second input were measured. RESULTS Xenon and radiprodil, applied at low concentrations, partially restored the LTP deficit induced by pre-incubated Aβ1-42. S-ketamine showed no effect. None of the drugs tested were able to ameliorate Aβ1-40-induced LTP-deficits. CONCLUSIONS Xenon administered at subanaesthetic concentrations partially restored Aβ1-42-induced impairment of LTP, presumably via its weak NMDA receptor antagonism. The effects were in a similar range than those obtained with the NMDA-GluN2B antagonist radiprodil. Our results point to protective properties of xenon in the context of pathological distorted synaptic physiology which might be a meaningful alternative for anaesthesia in AD patients.
Collapse
Affiliation(s)
- Martina Bürge
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; Department of Perioperative Medicine, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, United Kingdom.
| | - Stephan Kratzer
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Corinna Mattusch
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; Hexal AG, Industriestr. 25, 83607 Holzkirchen, Germany
| | - Carolin Hofmann
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Matthias Kreuzer
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | | | - Gerhard Rammes
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| |
Collapse
|
10
|
Mohamad FH, Has ATC. The α5-Containing GABA A Receptors-a Brief Summary. J Mol Neurosci 2019; 67:343-351. [PMID: 30607899 DOI: 10.1007/s12031-018-1246-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 12/17/2018] [Indexed: 12/21/2022]
Abstract
GABAA receptors are the major inhibitory neurotransmitter receptor in the human brain. The receptors are assembled from combination of protein subunits in pentameric complex which may consist of α1-6, β1-3, γ1-3, ρ1-3, δ, ε, θ, or π subunits. There are a theoretical > 150,000 possible assemblies and arrangements of GABAA subunits, although only a few combinations have been found in human with the most dominant consists of 2α1, 2β2, and 1γ2 in a counterclockwise arrangement as seen from the synaptic cleft. The receptors also possess binding sites for various unrelated substances including benzodiazepines, barbiturates, and anesthetics. The α5-containing GABAARs only make up ≤ 5% of the entire receptor population, but up to 25% of the receptor subtype is located in the crucial learning and memory-associated area of the brain-the hippocampus, which has ignited myriads of hypotheses and theories in regard to its role. As well as exhibiting synaptic phasic inhibition, the α5-containing receptors are also extrasynaptic and mediate tonic inhibition with continuously occurring smaller amplitude. Studies on negative-allosteric modulators for reducing this tonic inhibition have been shown to enhance learning and memory in neurological disorders such as schizophrenia, Down syndrome, and autism with a possible alternative benzodiazepine binding site. Therefore, a few α5 subunit-specific compounds have been developed to address these pharmacological needs. With its small population, the α5-containing receptors could be the key and also the answer for many untreated cognitive dysfunctions and disorders.
Collapse
Affiliation(s)
- Fatin H Mohamad
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kampus Kesihatan, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Ahmad Tarmizi Che Has
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kampus Kesihatan, 16150, Kubang Kerian, Kelantan, Malaysia.
| |
Collapse
|
11
|
Woodhouse A, Fernandez-Martos CM, Atkinson RAK, Hanson KA, Collins JM, O'Mara AR, Terblanche N, Skinner MW, Vickers JC, King AE. Repeat propofol anesthesia does not exacerbate plaque deposition or synapse loss in APP/PS1 Alzheimer's disease mice. BMC Anesthesiol 2018; 18:47. [PMID: 29699479 PMCID: PMC5921792 DOI: 10.1186/s12871-018-0509-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/13/2018] [Indexed: 12/14/2022] Open
Abstract
Background There is increasing interest in whether anesthetic agents affect the risk or progression of Alzheimer’s disease (AD). To mitigate many of the methodological issues encountered in human retrospective cohort studies we have used a transgenic model of AD to investigate the effect of propofol on AD pathology. Methods Six month-old amyloid precursor protein/presenilin 1 (APP/PS1) transgenic AD mice and control mice were exposed to 3 doses of propofol (200 mg/kg) or vehicle, delivered at monthly intervals. Results There was no difference in the extent of β-amyloid (Aβ) immunolabeled plaque deposition in APP/PS1 mice in vehicle versus propofol treatment groups. We also detected no difference in plaque-associated synapse loss in APP/PS1 mice following repeat propofol exposure relative to vehicle. Western blotting indicated that there was no difference in post-synaptic density protein 95, synaptophysin or glutamic acid decarboxylase 65/67 expression in control or APP/PS1 mice subjected to repeat propofol treatment relative to vehicle. Conclusions These data suggest that repeat propofol anesthesia may not exacerbate plaque deposition or associated synapse loss in AD. Interestingly, this data also provides some of the first evidence suggesting that repeat propofol exposure in adult wild-type mice does not result in robust long-term alterations in the levels of key excitatory and inhibitory synaptic markers. Electronic supplementary material The online version of this article (10.1186/s12871-018-0509-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Adele Woodhouse
- Wicking Dementia Research and Education Centre , University of Tasmania, Hobart, Australia.
| | | | | | - Kelsey Anne Hanson
- Wicking Dementia Research and Education Centre , University of Tasmania, Hobart, Australia
| | - Jessica Marie Collins
- Wicking Dementia Research and Education Centre , University of Tasmania, Hobart, Australia
| | - Aidan Ryan O'Mara
- Wicking Dementia Research and Education Centre , University of Tasmania, Hobart, Australia
| | - Nico Terblanche
- Tasmanian Health Service, Royal Hobart Hospital, Hobart, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,School of Medicine, University of Tasmania, Hobart, Australia
| | - Marcus Welby Skinner
- Department of Health and Human Services Tasmania, Royal Hobart Hospital, Hobart, Australia.,School of Medicine, University of Tasmania, Hobart, Australia
| | - James Clement Vickers
- Wicking Dementia Research and Education Centre , University of Tasmania, Hobart, Australia
| | - Anna Elizabeth King
- Wicking Dementia Research and Education Centre , University of Tasmania, Hobart, Australia
| |
Collapse
|
12
|
Coghlan M, Richards E, Shaik S, Rossi P, Vanama RB, Ahmadi S, Petroz C, Crawford M, Maynes JT. Inhalational Anesthetics Induce Neuronal Protein Aggregation and Affect ER Trafficking. Sci Rep 2018; 8:5275. [PMID: 29588456 PMCID: PMC5869676 DOI: 10.1038/s41598-018-23335-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 03/07/2018] [Indexed: 12/27/2022] Open
Abstract
Anesthetic agents have been implicated in the causation of neurological and cognitive deficits after surgery, the exacerbation of chronic neurodegenerative disease, and were recently reported to promote the onset of the neurologic respiratory disease Congenital Central Hypoventilation Syndrome (CCHS), related to misfolding of the transcription factor Phox2B. To study how anesthetic agents could affect neuronal function through alterations to protein folding, we created neuronal cell models emulating the graded disease severity of CCHS. We found that the gas anesthetic isoflurane and the opiate morphine potentiated aggregation and mislocalization of Phox2B variants, similar to that seen in CCHS, and observed transcript and protein level changes consistent with activation of the endoplasmic reticulum (ER) unfolded protein response. Attenuation of ER stress pathways did not result in a correction of Phox2B misfolding, indicating a primary effect of isoflurane on protein structure. We also observed that isoflurane hindered the folding and activity of proteins that rely heavily on ER function, like the CFTR channel. Our results show how anesthetic drugs can alter protein folding and induce ER stress, indicating a mechanism by which these agents may affect neuronal function after surgery.
Collapse
Affiliation(s)
- Matthew Coghlan
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Canada
| | - Elizabeth Richards
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Canada
| | - Sadiq Shaik
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Canada
| | - Pablo Rossi
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Canada
| | - Ramesh Babu Vanama
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Canada
| | - Saumel Ahmadi
- Program in Molecular Medicine, SickKids Research Institute, Toronto, Canada.,Department of Physiology, University of Toronto, Toronto, Canada
| | - Christelle Petroz
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Canada
| | - Mark Crawford
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Canada.,Department of Anesthesia, University of Toronto, Toronto, Canada
| | - Jason T Maynes
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Canada. .,Department of Anesthesia, University of Toronto, Toronto, Canada. .,Program in Molecular Medicine, SickKids Research Institute, Toronto, Canada.
| |
Collapse
|
13
|
Anestesia e doença de Alzheimer – Percepções atuais. Braz J Anesthesiol 2018; 68:174-182. [DOI: 10.1016/j.bjan.2017.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 04/17/2017] [Accepted: 09/27/2017] [Indexed: 11/23/2022] Open
|
14
|
Marques AFVDSF, Lapa TASC. Anesthesia and Alzheimer disease – Current perceptions. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2018. [PMID: 29137871 PMCID: PMC9391716 DOI: 10.1016/j.bjane.2017.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background and objectives It has been speculated that the use of anesthetic agents may be a risk factor for the development of Alzheimer disease. The objective of this review is to describe and discuss pre-clinical and clinical data related to anesthesia and this disease. Content Alzheimer disease affects about 5% of the population over 65 years old, with age being the main risk factor and being associated with a high morbidity. Current evidence questions a possible association between anesthesia, surgery, and long-term cognitive effects, including Alzheimer disease. Although data from some animal studies suggest an association between anesthesia and neurotoxicity, this link remains inconclusive in humans. We performed a review of the literature in which we selected scientific articles in the PubMed database, published between 2005 and 2016 (one article from 1998 due to its historical relevance), in English, which address the possible relationship between anesthesia and Alzheimer disease. 49 articles were selected. Conclusion The possible relationship between anesthetic agents, cognitive dysfunction, and Alzheimer disease remains to be clarified. Prospective cohort studies or randomized clinical trials for a better understanding of this association will be required.
Collapse
|
15
|
Almeida MC, Carrettiero DC. Hypothermia as a risk factor for Alzheimer disease. HANDBOOK OF CLINICAL NEUROLOGY 2018; 157:727-735. [PMID: 30459036 DOI: 10.1016/b978-0-444-64074-1.00044-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Alzheimer disease (AD), which is associated with chronic and progressive neurodegeneration, is the most prevalent cause of dementia linked to aging. Among the risk factors for AD, age stands as the greatest one, with the vast majority of people with AD being 65 years of age or older. Nevertheless, the pathophysiologic mechanisms underlying the link between aging and the development of AD, although not completely understood, might reveal important aspects for the understanding of this pathology. Thus, there is significant evidence that the impaired thermal homeostasis associated with normal aging leads to a variety of metabolic changes that could be associated with AD development. In this chapter, we assess the clinical and biochemical evidence implicating hypothermia as a risk factor for the development of AD and the impact of hypothermia on the two pathologic hallmarks of AD: accumulation of senile plaques of amyloid-beta and neurofibrillary tangles of aberrant hyperphosphorylated tau protein.
Collapse
Affiliation(s)
- Maria Camila Almeida
- Natural and Human Sciences Center, Federal University of ABC, São Bernardo do Campo, SP, Brazil.
| | | |
Collapse
|
16
|
Palibrk I, Veličković J. Anesthesia in patients with neurological diseases: Coma (neurological disorders and anesthesia). SERBIAN JOURNAL OF ANESTHESIA AND INTENSIVE THERAPY 2018. [DOI: 10.5937/sjait1802045p] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
17
|
So E, Kim HJ, Karm MH, Seo KS, Chang J, Lee JH. A retrospective analysis of outpatient anesthesia management for dental treatment of patients with severe Alzheimer's disease. J Dent Anesth Pain Med 2017; 17:271-280. [PMID: 29349349 PMCID: PMC5766088 DOI: 10.17245/jdapm.2017.17.4.271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 12/22/2017] [Accepted: 12/26/2017] [Indexed: 01/25/2023] Open
Abstract
Background The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012–2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ≥ 6. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.
Collapse
Affiliation(s)
- Eunsun So
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Hyun Jeong Kim
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Myong-Hwan Karm
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Kwang-Suk Seo
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Juhea Chang
- Special Care Clinic, Seoul National University Dental Hospital, Seoul, Korea
| | - Joo Hyung Lee
- Department of anesthesiology and pain medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| |
Collapse
|
18
|
Berger M, Nadler JW, Friedman A, McDonagh DL, Bennett ER, Cooter M, Qi W, Laskowitz DT, Ponnusamy V, Newman MF, Shaw LM, Warner DS, Mathew JP, James ML. The Effect of Propofol Versus Isoflurane Anesthesia on Human Cerebrospinal Fluid Markers of Alzheimer's Disease: Results of a Randomized Trial. J Alzheimers Dis 2017; 52:1299-310. [PMID: 27079717 DOI: 10.3233/jad-151190] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Preclinical studies have found differential effects of isoflurane and propofol on the Alzheimer's disease (AD)-associated markers tau, phosphorylated tau (p-tau) and amyloid-β (Aβ). OBJECTIVE We asked whether isoflurane and propofol have differential effects on the tau/Aβ ratio (the primary outcome), and individual AD biomarkers. We also examined whether genetic/intraoperative factors influenced perioperative changes in AD biomarkers. METHODS Patients undergoing neurosurgical/otolaryngology procedures requiring lumbar cerebrospinal fluid (CSF) drain placement were prospectively randomized to receive isoflurane (n = 21) or propofol (n = 18) for anesthetic maintenance. We measured perioperative CSF sample AD markers, performed genotyping assays, and examined intraoperative data from the electronic anesthesia record. A repeated measures ANOVA was used to examine changes in AD markers by anesthetic type over time. RESULTS The CSF tau/Aβ ratio did not differ between isoflurane- versus propofol-treated patients (p = 1.000). CSF tau/Aβ ratio and tau levels increased 10 and 24 h after drain placement (p = 2.002×10-6 and p = 1.985×10-6, respectively), mean CSF p-tau levels decreased (p = 0.005), and Aβ levels did not change (p = 0.152). There was no interaction between anesthetic treatment and time for any of these biomarkers. None of the examined genetic polymorphisms, including ApoE4, were associated with tau increase (n = 9 polymorphisms, p > 0.05 for all associations). CONCLUSION Neurosurgery/otolaryngology procedures are associated with an increase in the CSF tau/Aβ ratio, and this increase was not influenced by anesthetic type. The increased CSF tau/Aβ ratio was largely driven by increases in tau levels. Future work should determine the functional/prognostic significance of these perioperative CSF tau elevations.
Collapse
Affiliation(s)
- Miles Berger
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Jacob W Nadler
- Division Chief, Neurosurgical Anesthesiology Medical Director, Postanesthesia Care Unit; Department of Anesthesiology, University of Rochester, Rochester, NY, USA
| | - Allan Friedman
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - David L McDonagh
- Department of Anesthesiology & Pain Management, Neurological Surgery, Neurology and Neurotherapeutics, University of Texas, Southwestern, Dallas, TX, USA
| | - Ellen R Bennett
- Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | - Mary Cooter
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Wenjing Qi
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - Daniel T Laskowitz
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.,Department of Neurology, Duke University Medical Center, Durham, NC, USA.,Department of Neurobiology, Duke University Medical Center, Durham, NC, USA
| | | | - Mark F Newman
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.,Private Diagnostic Clinic, Duke University Medical Center, Durham, NC, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Warner
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.,Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.,Department of Neurobiology, Duke University Medical Center, Durham, NC, USA
| | - Joseph P Mathew
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Michael L James
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.,Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | | |
Collapse
|
19
|
Rahman MR, Tajmim A, Ali M, Sharif M. Overview and Current Status of Alzheimer's Disease in Bangladesh. J Alzheimers Dis Rep 2017; 1:27-42. [PMID: 30480227 PMCID: PMC6159651 DOI: 10.3233/adr-170012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Alzheimer’s disease (AD) is a complex neurological disorder with economic, social, and medical burdens which is acknowledged as leading cause of dementia marked by the accumulation and aggregation of amyloid-β peptide and phosphorylated tau (p-tau) protein and concomitant dementia, neuron loss and brain atrophy. AD is the most prevalent neurodegenerative brain disorder with sporadic etiology, except for a small fraction of cases with familial inheritance where familial forms of AD are correlated to mutations in three functionally related genes: the amyloid-β protein precursor and presenilins 1 and 2, two key γ-secretase components. The common clinical features of AD are memory impairment that interrupts daily life, difficulty in accomplishing usual tasks, confusion with time or place, trouble understanding visual images and spatial relationships. Age is the most significant risk factor for AD, whereas other risk factors correlated with AD are hypercholesterolemia, hypertension, atherosclerosis, coronary heart disease, smoking, obesity, and diabetes. Despite decades of research, there is no satisfying therapy which will terminate the advancement of AD by acting on the origin of the disease process, whereas currently available therapeutics only provide symptomatic relief but fail to attain a definite cure and prevention. This review also represents the current status of AD in Bangladesh.
Collapse
Affiliation(s)
- Md Rashidur Rahman
- Department of Pharmacy, Jessore University of Science and Technology, Jessore, Bangladesh
| | - Afsana Tajmim
- Department of Pharmacy, Jessore University of Science and Technology, Jessore, Bangladesh
| | - Mohammad Ali
- Department of Pharmacy, Jessore University of Science and Technology, Jessore, Bangladesh
| | - Mostakim Sharif
- Department of Pharmacy, Jessore University of Science and Technology, Jessore, Bangladesh
| |
Collapse
|
20
|
Best S, Pavel DG. Treatment of post-anesthesia dementia with perispinal etanercept injection and hyperbaric oxygen therapy: a case report. J Med Case Rep 2017; 11:105. [PMID: 28407792 PMCID: PMC5391550 DOI: 10.1186/s13256-017-1259-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 03/02/2017] [Indexed: 12/02/2022] Open
Abstract
Background We report on the first case of successful treatment for post-anesthesia dementia with perispinal etanercept injection combined with hyperbaric oxygen therapy. Case presentation Our patient was a 77-year-old Caucasian man of Mexican ethnicity who presented to our clinic 4.5 years after a knee replacement surgery. Immediately post-surgery, the patient began to show dramatic cognitive, physical, and emotional impairment compared with his presurgical state; these symptoms were still present when he arrived at our clinic. A clinical assessment and brain single-photon emission computer tomography were performed. Diagnoses of dementia with major cognitive deficits and aphasia were established. A 40-session course of hyperbaric oxygen therapy was initiated to address our patient’s impairments. After the first ten hyperbaric oxygen therapy treatments, our patient was administered 25 mg perispinal etanercept injections approximately once weekly for 5 months. Starting after the first perispinal etanercept injection, our patient began showing progressive improvements. By the 5-month follow-up, his cognitive and physical function were substantially restored. A follow-up single-photon emission computer tomography scan showed increased perfusion in several small, localized areas. Conclusions In this case of dementia and major cognitive disorder post major surgery and anesthesia, the very beneficial effect of combining hyperbaric oxygen therapy with perispinal etanercept is outlined.
Collapse
Affiliation(s)
- Steve Best
- The Neuroscience Center, 440 Lake Cook Road, Suite 2, Deerfield, IL, 60015, USA.
| | - Dan G Pavel
- PathFinder Brain SPECT, 440 Lake Cook Road, Suite 3, Deerfield, IL, 60015, USA
| |
Collapse
|
21
|
Sajadi A, Provost C, Pham B, Brouillette J. Neurodegeneration in an Animal Model of Chronic Amyloid-beta Oligomer Infusion Is Counteracted by Antibody Treatment Infused with Osmotic Pumps. J Vis Exp 2016:54215. [PMID: 27585306 PMCID: PMC5091865 DOI: 10.3791/54215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Decline in hippocampal-dependent explicit memory (memory for facts and events) is one of the earliest clinical symptom of Alzheimer's disease (AD). It is well established that synapse loss and ensuing neurodegeneration are the best predictors for memory impairments in AD. Latest studies have emphasized the neurotoxic role of soluble amyloid-beta oligomers (Aβo) that begin to accumulate in the human brain approximately 10 to 15 yr before the clinical symptoms become apparent. Many reports indicate that soluble Aβo correlate with memory deficits in AD models and humans. The Aβo-induced neurodegeneration observed in neuronal and brain slice cultures has been more challenging to reproduce in many animal models. The model of repeated Aβo infusions shown here overcome this issue and allow addressing two key domains for developing new disease modifying therapies: identify biological markers to diagnose early AD, and determine the molecular mechanisms underpinning Aβo-induced memory deficits at the onset of AD. Since soluble Aβo aggregate relatively fast into insoluble Aβ fibrils that correlate poorly with the clinical state of patients, soluble Aβo are prepared freshly and injected once per day during six days to produce marked cell death in the hippocampus. We used cannula specially design for simultaneous infusions of Aβo and continuous infusion of Aβo antibody (6E10) in the hippocampus using osmotic pumps. This innovative in vivo method can now be used in preclinical studies to validate the efficiency of new AD therapies that might prevent the deposition and neurotoxicity of Aβo in pre-dementia patients.
Collapse
Affiliation(s)
- Ahmadali Sajadi
- Department of Pharmacology, Université de Montréal; Hôpital du Sacré-coeur de Montréal Research Center, Université de Montréal
| | - Chloé Provost
- Hôpital du Sacré-coeur de Montréal Research Center, Université de Montréal
| | - Brendon Pham
- Department of Neuroscience, Université de Montréal
| | - Jonathan Brouillette
- Department of Pharmacology, Université de Montréal; Hôpital du Sacré-coeur de Montréal Research Center, Université de Montréal;
| |
Collapse
|
22
|
Intranasal Insulin Prevents Anesthesia-Induced Spatial Learning and Memory Deficit in Mice. Sci Rep 2016; 6:21186. [PMID: 26879001 PMCID: PMC4754754 DOI: 10.1038/srep21186] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/19/2016] [Indexed: 01/13/2023] Open
Abstract
Elderly individuals are at increased risk of cognitive decline after anesthesia. General anesthesia is believed to be a risk factor for Alzheimer’s disease (AD). At present, there is no treatment that can prevent anesthesia-induced postoperative cognitive dysfunction. Here, we treated mice with daily intranasal administration of insulin (1.75 U/day) for one week before anesthesia induced by intraperitoneal injection of propofol and maintained by inhalation of sevoflurane for 1 hr. We found that the insulin treatment prevented anesthesia-induced deficit in spatial learning and memory, as measured by Morris water maze task during 1–5 days after exposure to anesthesia. The insulin treatment also attenuated anesthesia-induced hyperphosphorylation of tau and promoted the expression of synaptic proteins and insulin signaling in the brain. These findings show a therapeutic potential of intranasal administration of insulin before surgery to reduce the risk of anesthesia-induced cognitive decline and AD.
Collapse
|
23
|
Aiello Bowles EJ, Larson EB, Pong RP, Walker RL, Anderson ML, Yu O, Gray SL, Crane PK, Dublin S. Anesthesia Exposure and Risk of Dementia and Alzheimer's Disease: A Prospective Study. J Am Geriatr Soc 2016; 64:602-7. [PMID: 26865152 DOI: 10.1111/jgs.14024] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To evaluate the associations between anesthesia and dementia or Alzheimer's disease (AD) risk using prospectively collected data. DESIGN Cohort study. PARTICIPANTS Community-dwelling members of the Adult Changes in Thought cohort aged 65 and older and free of dementia at baseline (N = 3,988). MEASUREMENTS Participants self-reported all prior surgical procedures with general or neuraxial (spinal or epidural) anesthesia at baseline and reported new procedures every 2 years. People undergoing high-risk surgery with general anesthesia, other surgery with general anesthesia, and other surgery with neuraxial anesthesia exposures were compared with those with no surgery and no anesthesia. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia and AD associated with time-varying lifetime and recent (past 5 years) anesthesia exposures. RESULTS At baseline, 254 (6%) people reported never having anesthesia; 248 (6%) had had one or more high-risk surgeries with general anesthesia, 3,363 (84%) had had one or more other surgeries with general anesthesia, and 123 (3%) had had one or more surgeries with neuraxial anesthesia. High-risk surgery with general anesthesia was not associated with greater risk of dementia (HR = 0.86, 95% CI = 0.58-1.28) or AD (HR = 0.95, 95% CI = 0.61-1.49) than no history of anesthesia. People with any history of other surgery with general anesthesia had a lower risk of dementia (HR = 0.63, 95% CI = 0.46-0.85) and AD (HR = 0.65, 95% CI = 0.46-0.93) than people with no history of anesthesia. There was no association between recent anesthesia exposure and dementia or AD. CONCLUSION Anesthesia exposure was not associated with of dementia or AD in older adults.
Collapse
Affiliation(s)
| | - Eric B Larson
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington.,Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington
| | - Ryan P Pong
- Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington
| | - Rod L Walker
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington
| | - Melissa L Anderson
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington
| | - Onchee Yu
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington
| | - Shelly L Gray
- School of Pharmacy, University of Washington, Seattle, Washington
| | - Paul K Crane
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington
| | - Sascha Dublin
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington.,Department of Epidemiology, University of Washington, Seattle, Washington
| |
Collapse
|
24
|
Liebert AD, Chow RT, Bicknell BT, Varigos E. Neuroprotective Effects Against POCD by Photobiomodulation: Evidence from Assembly/Disassembly of the Cytoskeleton. J Exp Neurosci 2016; 10:1-19. [PMID: 26848276 PMCID: PMC4737522 DOI: 10.4137/jen.s33444] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 12/09/2015] [Accepted: 12/15/2015] [Indexed: 02/07/2023] Open
Abstract
Postoperative cognitive dysfunction (POCD) is a decline in memory following anaesthesia and surgery in elderly patients. While often reversible, it consumes medical resources, compromises patient well-being, and possibly accelerates progression into Alzheimer's disease. Anesthetics have been implicated in POCD, as has neuroinflammation, as indicated by cytokine inflammatory markers. Photobiomodulation (PBM) is an effective treatment for a number of conditions, including inflammation. PBM also has a direct effect on microtubule disassembly in neurons with the formation of small, reversible varicosities, which cause neural blockade and alleviation of pain symptoms. This mimics endogenously formed varicosities that are neuroprotective against damage, toxins, and the formation of larger, destructive varicosities and focal swellings. It is proposed that PBM may be effective as a preconditioning treatment against POCD; similar to the PBM treatment, protective and abscopal effects that have been demonstrated in experimental models of macular degeneration, neurological, and cardiac conditions.
Collapse
Affiliation(s)
| | - Roberta T. Chow
- Brain and Mind Institute, University of Sydney, Sydney, NSW, Australia
| | | | | |
Collapse
|
25
|
Huang C, Ng OTW, Ho YS, Irwin MG, Chang RCC, Wong GTC. Effect of Continuous Propofol Infusion in Rat on Tau Phosphorylation with or without Temperature Control. J Alzheimers Dis 2016; 51:213-26. [PMID: 26836157 DOI: 10.3233/jad-150645] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Several studies suggest a relationship between anesthesia-induced tau hyperphosphorylation and the development of postoperative cognitive dysfunction. This study further characterized the effects of continuous propofol infusion on tau protein phosphorylation in rats, with or without temperature control. Propofol was administered intravenously to 8-10-week-old male Sprague-Dawley rats and infused to the loss of the righting reflex for 2 h continuously. Proteins from cortex and hippocampus were examined by western blot and immunohistochemistry. Rectal temperature was significantly decreased during propofol infusion. Propofol with hypothermia significantly increased phosphorylation of tau at AT8, AT180, Thr205, and Ser199 in cortex and hippocampus except Ser396. With temperature maintenance, propofol still induced significant elevation of AT8, Thr205, and Ser199 in cortex and hippocampus; however, increase of AT180 and Ser396 was only found in hippocampus and cortex, respectively. Differential effects of propofol with or without hypothermia on multiple tau related kinases, such as Akt/GSK3β, MAPK pathways, or phosphatase (PP2A), were demonstrated in region-specific manner. These findings indicated that propofol increased tau phosphorylation under both normothermic and hypothermic conditions, and temperature control could partially attenuate the hyperphosphorylation of tau. Further studies are warranted to determine the long-term impact of propofol on the tau pathology and cognitive functions.
Collapse
Affiliation(s)
- Chunxia Huang
- Department of Anaesthesiology, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Olivia Tsz-Wa Ng
- Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Yuen-Shan Ho
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Michael Garnet Irwin
- Department of Anaesthesiology, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Research Centre of Heart, Brain, Hormone and Healthy Aging, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Raymond Chuen-Chung Chang
- Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Research Centre of Heart, Brain, Hormone and Healthy Aging, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Gordon Tin-Chun Wong
- Department of Anaesthesiology, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Research Centre of Heart, Brain, Hormone and Healthy Aging, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| |
Collapse
|
26
|
Jia Z, Geng L, Xie G, Chu Q, Zhang W. Sevoflurane impairs acquisition learning and memory function in transgenic mice model of Alzheimer's disease by induction of hippocampal neuron apoptosis. Int J Clin Exp Med 2015; 8:15490-15497. [PMID: 26629039 PMCID: PMC4658928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/03/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To investigate the mechanism and effect of sevoflurane on learning and memory function in transgenic mice model of Alzheimer's disease (AD). METHODS A total of 45 Tg2576 mice were used and randomly assigned to control, sham, and sevoflurane group. Spatial learning and memory ability were measured before and after sevoflurane exposure using morris water maze (MWM) and Y-maze behavioral tests. Moreover, TUNEL assay was carried out to determine the cell death in hippocampal cornuammonis (CA) 1, CA3, and dentate gyrus (DG) region. Apoptosis-related protein (caspase-3 and Bcl-xL) expression in the hippocampus was analyzed by Western blotting. RESULTS The MWM results showed that there were no significant differences in the swimming speed after sevoflurane exposure among the three groups. However, the escape latency, time spent in original quadrant, and the number of correct trials (Y-maze) were significantly lower after sevoflurane anesthesia exposure in the sevoflurane group than the sham group and control group (P < 0.05). Besides, the apoptotic cell numbers of the CA1 and CA3 region in the sevoflurane group were significantly higher than those in the sham group and control group (P < 0.05). Western blotting results showed that the protein expression levels of Bcl-xL were significantly higher, but the caspase-3 levels were significantly lower in the sevoflurane group than those in the control group and sham group (both P < 0.05). CONCLUSION Our results indicate that sevoflurane might impair acquisition learning and memory function in AD by induction of hippocampal neuron apoptosis.
Collapse
Affiliation(s)
- Zhen Jia
- Department of Anesthesiology, First Affiliated Hospital of Zhengzhou UniversityChina
- Department of Anesthesiology, Henan Provincial Corps HospitalChina
| | - Lina Geng
- Department of Information, Henan Provincial Corps HospitalChina
| | - Guanglun Xie
- Department of Pain Management, The Affiliated Tumor Hospital of Zhengzhou University, Henan Tumor HospitalZhengzhou 450052, Henan, China
| | - Qinjun Chu
- Department of Anesthesiology, First Affiliated Hospital of Zhengzhou UniversityChina
| | - Wei Zhang
- Department of Anesthesiology, First Affiliated Hospital of Zhengzhou UniversityChina
| |
Collapse
|
27
|
Abstract
Alzheimer's disease (AD) is known as the most fatal chronic neurodegenerative disease in adults along with progressive loss of memory and other cognitive function disorders. Cyclin-dependent kinase 5 (Cdk5), a unique member of the cyclin-dependent kinases (Cdks), is reported to intimately associate with the process of the pathogenesis of AD. Cdk5 is of vital importance in the development of CNS and neuron movements such as neuronal migration and differentiation, synaptic functions, and memory consolidation. However, when neurons suffer from pathological stimuli, Cdk5 activity becomes hyperactive and causes aberrant hyperphosphorylation of various substrates of Cdk5 like amyloid precursor protein (APP), tau and neurofilament, resulting in neurodegenerative diseases like AD. Deregulation of Cdk5 contributes to an array of pathological events in AD, ranging from formation of senile plaques and neurofibrillary tangles, synaptic damage, mitochondrial dysfunction to cell cycle reactivation as well as neuronal cell apoptosis. More importantly, an inhibition of Cdk5 activity with inhibitors such as RNA inference (RNAi) could protect from memory decline and neuronal cell loss through suppressing β-amyloid (Aβ)-induced neurotoxicity and tauopathies. This review will briefly describe the above-mentioned possible roles of Cdk5 in the physiological and pathological mechanisms of AD, further discussing recent advances and challenges in Cdk5 as a therapeutic target.
Collapse
|
28
|
Whittington RA, Virág L, Gratuze M, Petry FR, Noël A, Poitras I, Truchetti G, Marcouiller F, Papon MA, El Khoury N, Wong K, Bretteville A, Morin F, Planel E. Dexmedetomidine increases tau phosphorylation under normothermic conditions in vivo and in vitro. Neurobiol Aging 2015; 36:2414-28. [PMID: 26058840 DOI: 10.1016/j.neurobiolaging.2015.05.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 04/19/2015] [Accepted: 05/05/2015] [Indexed: 10/23/2022]
Abstract
There is developing interest in the potential association between anesthesia and the onset and progression of Alzheimer's disease. Several anesthetics have, thus, been demonstrated to induce tau hyperphosphorylation, an effect mostly mediated by anesthesia-induced hypothermia. Here, we tested the hypothesis that acute normothermic administration of dexmedetomidine (Dex), an intravenous sedative used in intensive care units, would result in tau hyperphosphorylation in vivo and in vitro. When administered to nontransgenic mice, Dex-induced tau hyperphosphorylation persisting up to 6 hours in the hippocampus for the AT8 epitope. Pretreatment with atipamezole, a highly specific α2-adrenergic receptor antagonist, blocked Dex-induced tau hyperphosphorylation. Furthermore, Dex dose-dependently increased tau phosphorylation at AT8 in SH-SY5Y cells, impaired mice spatial memory in the Barnes maze and promoted tau hyperphosphorylation and aggregation in transgenic hTau mice. These findings suggest that Dex: (1) increases tau phosphorylation, in vivo and in vitro, in the absence of anesthetic-induced hypothermia and through α2-adrenergic receptor activation, (2) promotes tau aggregation in a mouse model of tauopathy, and (3) impacts spatial reference memory.
Collapse
Affiliation(s)
- Robert A Whittington
- Department of Anesthesiology, Columbia University, College of Physicians and Surgeons, New York, NY, USA.
| | - László Virág
- Department of Anesthesiology, Columbia University, College of Physicians and Surgeons, New York, NY, USA
| | - Maud Gratuze
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Franck R Petry
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Anastasia Noël
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Isabelle Poitras
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Geoffrey Truchetti
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - François Marcouiller
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Marie-Amélie Papon
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Noura El Khoury
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Kevin Wong
- Department of Anesthesiology, Columbia University, College of Physicians and Surgeons, New York, NY, USA
| | - Alexis Bretteville
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | | | - Emmanuel Planel
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Québec, Canada; Neurosciences, CHUL, CRCHU, Québec, Québec, Canada
| |
Collapse
|
29
|
Yamamoto N, Arima H, Sugiura T, Hirate H, Kusama N, Suzuki K, Sobue K. Midazolam inhibits the formation of amyloid fibrils and GM1 ganglioside-rich microdomains in presynaptic membranes through the gamma-aminobutyric acid A receptor. Biochem Biophys Res Commun 2015; 457:547-53. [PMID: 25600806 DOI: 10.1016/j.bbrc.2015.01.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Accepted: 01/08/2015] [Indexed: 01/23/2023]
Abstract
Recent studies have suggested that a positive correlation exists between surgical interventions performed under general anesthesia and the risk of developing Alzheimer's disease (AD) in the late postoperative period. It has been reported that amyloid β-protein (Αβ) fibrillogenesis, which is closely related to AD, is accelerated by exposure to anesthetics. However, the mechanisms underlying these effects remain uncertain. This study was designed to investigate whether the anesthetic midazolam affects Αβ fibrillogenesis, and if so, whether it acts through GM1 ganglioside (GM1) on the neuronal surface. Midazolam treatment decreased GM1 expression in the detergent-resistant membrane microdomains of neurons, and these effects were regulated by the gamma-aminobutyric acid-A receptor. Midazolam inhibited Αβ fibril formation from soluble Αβ on the neuronal surface. In addition, midazolam suppressed GM1-induced fibril formation in a cell-free system. Moreover, midazolam inhibited the formation of Αβ assemblies in synaptosomes isolated from aged mouse brains. These finding suggested that midazolam has direct and indirect inhibitory effects on Αβ fibrillogenesis.
Collapse
Affiliation(s)
- Naoki Yamamoto
- Faculty of Pharmaceutical Sciences, Hokuriku University, Kanazawa, Ishikawa, Japan; Laboratory of Neurochemistry, Department of Pharmacy, College of Pharmaceutical Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan.
| | - Hajime Arima
- Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - Takeshi Sugiura
- Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - Hiroyuki Hirate
- Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - Nobuyoshi Kusama
- Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - Kenji Suzuki
- Laboratory of Molecular Medicinal Science, Department of Pharmacy, College of Pharmaceutical Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kazuya Sobue
- Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| |
Collapse
|
30
|
Chen Y, Run X, Liang Z, Zhao Y, Dai CL, Iqbal K, Liu F, Gong CX. Intranasal insulin prevents anesthesia-induced hyperphosphorylation of tau in 3xTg-AD mice. Front Aging Neurosci 2014; 6:100. [PMID: 24910612 PMCID: PMC4038959 DOI: 10.3389/fnagi.2014.00100] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 05/08/2014] [Indexed: 12/03/2022] Open
Abstract
Background: It is well documented that elderly individuals are at increased risk of cognitive decline after anesthesia. General anesthesia is believed to be a risk factor for Alzheimer’s disease (AD). Recent studies suggest that anesthesia may increase the risk for cognitive decline and AD through promoting abnormal hyperphosphorylation of tau, which is crucial to neurodegeneration seen in AD. Methods: We treated 3xTg-AD mice, a commonly used transgenic mouse model of AD, with daily intranasal administration of insulin (1.75 U/day) for one week. The insulin- and control-treated mice were then anesthetized with single intraperitoneal injection of propofol (250 mg/kg body weight). Tau phosphorylation and tau protein kinases and phosphatases in the brains of mice 30 min and 2 h after propofol injection were then investigated by using Western blots and immunohistochemistry. Results: Propofol strongly promoted hyperphosphorylation of tau at several AD-related phosphorylation sites. Intranasal administration of insulin attenuated propofol-induced hyperphosphorylation of tau, promoted brain insulin signaling, and led to up-regulation of protein phosphatase 2A, a major tau phosphatase in the brain. Intranasal insulin also resulted in down-regulation of several tau protein kinases, including cyclin-dependent protein kinase 5, calcium/calmodulin-dependent protein kinase II, and c-Jun N-terminal kinase. Conclusion: Our results demonstrate that pretreatment with intranasal insulin prevents AD-like tau hyperphosphorylation. These findings provide the first evidence supporting that intranasal insulin administration might be used for the prevention of anesthesia-induced cognitive decline and increased risk for AD and dementia.
Collapse
Affiliation(s)
- Yanxing Chen
- Department of Neurochemistry, New York State Institute for Basic Research in Developmental Disabilities Staten Island, NY, USA ; Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, Hubei, China
| | - Xiaoqin Run
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, Hubei, China
| | - Zhihou Liang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, Hubei, China
| | - Yang Zhao
- Department of Neurochemistry, New York State Institute for Basic Research in Developmental Disabilities Staten Island, NY, USA ; Department of Neurology, The First Hospital of Jilin University Changchun, China
| | - Chun-Ling Dai
- Department of Neurochemistry, New York State Institute for Basic Research in Developmental Disabilities Staten Island, NY, USA
| | - Khalid Iqbal
- Department of Neurochemistry, New York State Institute for Basic Research in Developmental Disabilities Staten Island, NY, USA
| | - Fei Liu
- Department of Neurochemistry, New York State Institute for Basic Research in Developmental Disabilities Staten Island, NY, USA
| | - Cheng-Xin Gong
- Department of Neurochemistry, New York State Institute for Basic Research in Developmental Disabilities Staten Island, NY, USA
| |
Collapse
|
31
|
El Khoury NB, Gratuze M, Papon MA, Bretteville A, Planel E. Insulin dysfunction and Tau pathology. Front Cell Neurosci 2014; 8:22. [PMID: 24574966 PMCID: PMC3920186 DOI: 10.3389/fncel.2014.00022] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/16/2014] [Indexed: 01/26/2023] Open
Abstract
The neuropathological hallmarks of Alzheimer's disease (AD) include senile plaques of β-amyloid (Aβ) peptides (a cleavage product of the Amyloid Precursor Protein, or APP) and neurofibrillary tangles (NFT) of hyperphosphorylated Tau protein assembled in paired helical filaments (PHF). NFT pathology is important since it correlates with the degree of cognitive impairment in AD. Only a small proportion of AD is due to genetic variants, whereas the large majority of cases (~99%) is late onset and sporadic in origin. The cause of sporadic AD is likely to be multifactorial, with external factors interacting with biological or genetic susceptibilities to accelerate the manifestation of the disease. Insulin dysfunction, manifested by diabetes mellitus (DM) might be such factor, as there is extensive data from epidemiological studies suggesting that DM is associated with an increased relative risk for AD. Type 1 diabetes (T1DM) and type 2 diabetes (T2DM) are known to affect multiple cognitive functions in patients. In this context, understanding the effects of diabetes on Tau pathogenesis is important since Tau pathology show a strong relationship to dementia in AD, and to memory loss in normal aging and mild cognitive impairment. Here, we reviewed preclinical studies that link insulin dysfunction to Tau protein pathogenesis, one of the major pathological hallmarks of AD. We found more than 30 studies reporting Tau phosphorylation in a mouse or rat model of insulin dysfunction. We also payed attention to potential sources of artifacts, such as hypothermia and anesthesia, that were demonstrated to results in Tau hyperphosphorylation and could major confounding experimental factors. We found that very few studies reported the temperature of the animals, and only a handful did not use anesthesia. Overall, most published studies showed that insulin dysfunction can promote Tau hyperphosphorylation and pathology, both directly and indirectly, through hypothermia.
Collapse
Affiliation(s)
- Noura B El Khoury
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval Québec, QC, Canada ; Axe Neurosciences, Centre Hospitalier de l'Université Laval Québec, QC, Canada
| | - Maud Gratuze
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval Québec, QC, Canada ; Axe Neurosciences, Centre Hospitalier de l'Université Laval Québec, QC, Canada
| | - Marie-Amélie Papon
- Axe Neurosciences, Centre Hospitalier de l'Université Laval Québec, QC, Canada
| | - Alexis Bretteville
- Axe Neurosciences, Centre Hospitalier de l'Université Laval Québec, QC, Canada
| | - Emmanuel Planel
- Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval Québec, QC, Canada ; Axe Neurosciences, Centre Hospitalier de l'Université Laval Québec, QC, Canada
| |
Collapse
|
32
|
Seitz DP, Reimer CL, Siddiqui N. A review of epidemiological evidence for general anesthesia as a risk factor for Alzheimer's disease. Prog Neuropsychopharmacol Biol Psychiatry 2013; 47:122-7. [PMID: 22771690 DOI: 10.1016/j.pnpbp.2012.06.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 06/22/2012] [Accepted: 06/28/2012] [Indexed: 10/28/2022]
Abstract
Exposure to surgery and general anesthesia (GA) has been hypothesized to be a potential risk factor for the development of Alzheimer's disease (AD). Some basic science research studies have demonstrated AD pathology in animals following exposure to inhalational anesthetics. However, controversy exists as to whether GA is associated with an elevated risk of developing AD in human populations. While randomized controlled clinical trials would provide the strongest evidence for a causal relationship between exposure to surgery under GA and the subsequent development of AD, to date there have not been any trials to address this important question. Therefore, a potential relationship between GA and AD must currently be examined using observational methods. A recent meta-analysis of case-control studies (N = 15) did not find that AD was associated with prior exposure to GA (OR = 1.05, 95% CI: 0.93-1.19, p = 0.4). A limited number of retrospective cohort studies have likewise not provided definitive information supporting an association. Therefore, at the present time there is limited information to support the hypothesis of AD developing as a consequence of GA, although there are few high quality studies in this area. Given the high prevalence and impact of AD, and the relatively frequent exposure of large populations to surgical procedures, the association between AD and GA requires further study.
Collapse
Affiliation(s)
- Dallas P Seitz
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
| | | | | |
Collapse
|
33
|
Hogan KJ. Hereditary vulnerabilities to post-operative cognitive dysfunction and dementia. Prog Neuropsychopharmacol Biol Psychiatry 2013; 47:128-34. [PMID: 23562862 DOI: 10.1016/j.pnpbp.2013.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 02/26/2013] [Accepted: 02/27/2013] [Indexed: 11/18/2022]
Abstract
In view of multiple prospective investigations reporting an incidence of 10% or greater in elderly patients after cardiac and non-cardiac procedures, it is surprising that no families, twins or even individual cases have been reported with persistent post-operative cognitive dysfunction (POCD) or post-operative dementia (POD) that is otherwise unexplained. As POCD and POD research has shifted in recent years from surgical and anesthetic variables to predictors of intrinsic, patient-specific susceptibility, a number of markers based on DNA sequence variation have been investigated. Nevertheless, no heritable, genomic indices of persistent POCD or post-operative dementia lasting 3 months or longer after surgery have been identified to date. The present manuscript surveys challenges confronting the search for markers of heritable vulnerability to POCD and POD, and proposes steps forward to be taken now, including the addition of surgical and anesthetic descriptors to ongoing longitudinal dementia protocols and randomized clinical trials (RCTs) comprising serial psychometric testing, and a fresh focus on phenotypes and genotypes shared between outliers with "extreme" POCD and POD traits.
Collapse
Affiliation(s)
- Kirk J Hogan
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, B6/319 Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53792, USA.
| |
Collapse
|
34
|
Whittington RA, Bretteville A, Dickler MF, Planel E. Anesthesia and tau pathology. Prog Neuropsychopharmacol Biol Psychiatry 2013; 47:147-55. [PMID: 23535147 PMCID: PMC3741335 DOI: 10.1016/j.pnpbp.2013.03.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 03/15/2013] [Accepted: 03/15/2013] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease (AD) is the most common form of dementia and remains a growing worldwide health problem. As life expectancy continues to increase, the number of AD patients presenting for surgery and anesthesia will steadily rise. The etiology of sporadic AD is thought to be multifactorial, with environmental, biological and genetic factors interacting together to influence AD pathogenesis. Recent reports suggest that general anesthetics may be such a factor and may contribute to the development and exacerbation of this neurodegenerative disorder. Intra-neuronal neurofibrillary tangles (NFT), composed of hyperphosphorylated and aggregated tau protein are one of the main neuropathological hallmarks of AD. Tau pathology is important in AD as it correlates very well with cognitive dysfunction. Lately, several studies have begun to elucidate the mechanisms by which anesthetic exposure might affect the phosphorylation, aggregation and function of this microtubule-associated protein. Here, we specifically review the literature detailing the impact of anesthetic administration on aberrant tau hyperphosphorylation as well as the subsequent development of neurofibrillary pathology and degeneration.
Collapse
Affiliation(s)
- Robert A. Whittington
- Department of Anesthesiology, Columbia University, New York, NY 10032,Corresponding Author: Robert A. Whittington, MD, Columbia University, College of Physicians and Surgeons, Department of Anesthesiology, 622 West 168th Street PH 5, New York, NY 10032, Tel: 212-305-1567, Fax: 212-305-0777,
| | - Alexis Bretteville
- Centre de Recherche du CHU de Québec, Axe Neurosciences, Québec (QC), Canada, G1V 4G2
| | - Maya F. Dickler
- Centre de Recherche du CHU de Québec, Axe Neurosciences, Québec (QC), Canada, G1V 4G2
| | - Emmanuel Planel
- Centre de Recherche du CHU de Québec, Axe Neurosciences, Québec (QC), Canada, G1V 4G2,Université Laval, Département de Psychiatrie et Neurosciences, Québec (QC), Canada, G1V 0A6
| |
Collapse
|
35
|
Zhang L, Zhang Y. Halothane increases neuronal cell death vulnerability by downregulating miR-214 and upregulating Bax. Int J Clin Exp Med 2013; 6:452-460. [PMID: 23844269 PMCID: PMC3703116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 05/25/2013] [Indexed: 06/02/2023]
Abstract
Inhalational general anesthesia is widely used in clinical practice, but there have been plenty of evidence shows that application of inhalational anesthetics may increase the risk of Alzheimer's disease (AD). Halothane is a common inhalational anesthetics. We cultured rat primary neurons as study model to investigate cytotoxicity of halothane in neurons. We found that halothane could enhance the cytotoxicity induced by intracellular or extracellular amyloid β (Aβ) with or without serum deprivation. In addition, halothane induced the enhanced cytotoxicity through downregulation of miR-214 level which can lead to increasing expression of Bax. Therefore our data suggest that halothane increases cell death induced by Aβ through increasing Bax level by downregulating miR-214. Our study indicates a probable connection between anesthetic application and AD, while provides a new perspective for the studies of inhalational anesthetics cytotoxicity.
Collapse
Affiliation(s)
- Lei Zhang
- State Key Laboratory of Biomembrane and Membrane Biotechnology, College of Life Sciences, Peking University Beijing, 100871, China
| | | |
Collapse
|
36
|
Jevtovic-Todorovic V, Absalom AR, Blomgren K, Brambrink A, Crosby G, Culley DJ, Fiskum G, Giffard RG, Herold KF, Loepke AW, Ma D, Orser BA, Planel E, Slikker W, Soriano SG, Stratmann G, Vutskits L, Xie Z, Hemmings HC. Anaesthetic neurotoxicity and neuroplasticity: an expert group report and statement based on the BJA Salzburg Seminar. Br J Anaesth 2013; 111:143-51. [PMID: 23722106 DOI: 10.1093/bja/aet177] [Citation(s) in RCA: 208] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Although previously considered entirely reversible, general anaesthesia is now being viewed as a potentially significant risk to cognitive performance at both extremes of age. A large body of preclinical as well as some retrospective clinical evidence suggest that exposure to general anaesthesia could be detrimental to cognitive development in young subjects, and might also contribute to accelerated cognitive decline in the elderly. A group of experts in anaesthetic neuropharmacology and neurotoxicity convened in Salzburg, Austria for the BJA Salzburg Seminar on Anaesthetic Neurotoxicity and Neuroplasticity. This focused workshop was sponsored by the British Journal of Anaesthesia to review and critically assess currently available evidence from animal and human studies, and to consider the direction of future research. It was concluded that mounting evidence from preclinical studies reveals general anaesthetics to be powerful modulators of neuronal development and function, which could contribute to detrimental behavioural outcomes. However, definitive clinical data remain elusive. Since general anaesthesia often cannot be avoided regardless of patient age, it is important to understand the complex mechanisms and effects involved in anaesthesia-induced neurotoxicity, and to develop strategies for avoiding or limiting potential brain injury through evidence-based approaches.
Collapse
|
37
|
Yan H, Xu T, Zhao H, Lee KC, Wang HY, Zhang Y. Isoflurane increases neuronal cell death vulnerability by downregulating miR-214. PLoS One 2013; 8:e55276. [PMID: 23408966 PMCID: PMC3568119 DOI: 10.1371/journal.pone.0055276] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 12/30/2012] [Indexed: 01/05/2023] Open
Abstract
Since accumulating evidence suggests the application of anesthetics may increase the risk of Alzheimer’s disease (AD), we investigated the cytotoxicity of inhaled general anesthesia in neurons and its underlying mechanism. Using primary cultured rat hippocampal neurons as the study model, here we show that isoflurane increases vulnerability to intracellular or extracellular amyloid β with or without serum deprivation. This isoflurane-induced effect is mediated by the downregulation of miR-214 level that lead to an elevated expression of Bax, a prominent target for miR-214. We conclude that isoflurane increases cell death in the presence of amyloid β by increasing Bax level through downregulating miR-214. Our data provide a new insight for inhaled anesthetics toxicity and indicate a possible mechanistic link between anesthetic application and neurodegenration in AD.
Collapse
Affiliation(s)
- Hailiang Yan
- State Key Laboratory of Biomembrane and Membrane Biotechnology, College of Life Sciences, Peking University, Beijing, China
- Department of Urology, Peking University People’s Hospital, Beijing, China
| | - Tao Xu
- State Key Laboratory of Biomembrane and Membrane Biotechnology, College of Life Sciences, Peking University, Beijing, China
- Department of Urology, Peking University People’s Hospital, Beijing, China
| | | | - Kuo-Chieh Lee
- Department of Pharmacology, Physiology and Neuroscience, Sophie Davis School of Biomedical Education/City University of New York Medical School, New York, New York, United States of America
| | - Hoau-Yan Wang
- Department of Pharmacology, Physiology and Neuroscience, Sophie Davis School of Biomedical Education/City University of New York Medical School, New York, New York, United States of America
| | - Yan Zhang
- State Key Laboratory of Biomembrane and Membrane Biotechnology, College of Life Sciences, Peking University, Beijing, China
- Department of Urology, Peking University People’s Hospital, Beijing, China
- * E-mail:
| |
Collapse
|
38
|
Repetitive Mild Traumatic Brain Injury Augments Tau Pathology and Glial Activation in Aged hTau Mice. J Neuropathol Exp Neurol 2013; 72:137-51. [DOI: 10.1097/nen.0b013e3182814cdf] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
39
|
Clinical, methodological and theoretical issues in the assessment of cognition after anaesthesia and surgery: a review. Eur J Anaesthesiol 2012; 29:409-22. [PMID: 22828386 DOI: 10.1097/eja.0b013e328356bd6e] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
As people live longer, the burden of cognitive impairment to elderly patients, their families and society becomes increasingly common and important. The loss of independence, a reduction in the quality of life and increased mortality are possible correlates to the mental disintegration. Cognitive dysfunction following major surgery on the elderly is a significant problem which adds to other cognitive impairments caused by neurodegeneration, cerebrovascular impairments and other causes. There are challenges in reviewing the literature because of many methodological concerns. There is no standard definition; the diagnosis is made only by the results of neuropsychological tests which are not standardised for this purpose; test results are analysed by different statistical methods (some of them inappropriate); controls are often absent or poorly matched; and pre-existing mild cognitive impairment, which affects 10 to 20% of people older than 65 years and is similar to the subtle cognitive impairment following surgery, is not sought for and recognised. Reviews of the subject have varied from descriptions such as 'a well recognised and significant problem' to 'a hypothetical phenomenon for which there is no International Statistical Classification of Disease (ICD-9) code, and no Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) code'. This article examines both sides of the spectrum in a detailed review which explains the necessary psychological 'jargon', discusses the methods used and points to areas of future research.
Collapse
|
40
|
Qu X, Xu C, Wang H, Xu J, Liu W, Wang Y, Jia X, Xie Z, Xu Z, Ji C, Wu A, Yue Y. Hippocampal glutamate level and glutamate aspartate transporter (GLAST) are up-regulated in senior rat associated with isoflurane-induced spatial learning/memory impairment. Neurochem Res 2012; 38:59-73. [PMID: 23070469 DOI: 10.1007/s11064-012-0889-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 08/31/2012] [Accepted: 09/10/2012] [Indexed: 12/30/2022]
Abstract
Postoperative cognitive decline is a clinical concern especially for senior patients. It is generally recognized that glutamatergic system plays a crucial role in the physiopathologic process of neurocognitive deterioration. However, alterations of glutamatergic system in prolonged isoflurane-induced learning/memory decline are still unclear. This study investigates the question whether glutamate concentration and corresponding transporters or receptors display any alternations in aged rat suffering from isoflurane-induced learning/memory impairment. 111 male Sprague-Dawley rats (>18 months) were randomly divided into two main groups: hippocampal microdialysis group (n = 38) and western blotting group (n = 73). Each group was subdivided into three subgroups including (1) control subgroup (n = 6 and 10, receiving no behavioral trial, anesthesia or air exposure); (2) air-exposed subgroup (n = 7 and 15, receiving behavioral trial and air exposure but not anesthesia); (3) isoflurane anesthesia subgroup (n = 25 and 48, receiving both behavioral trial and anesthesia). The isoflurane-exposed rats were further divided into a learning/memory-impaired subgroup and a non-learning/memory-impaired subgroup according to their behavioral performance, which was measured using Morris water maze. Hippocampal glutamate concentrations in microdialysates were determined by high-performance liquid chromatography. Expression levels of GLAST, GLT-1, NMDAR1, NMDAR2A/B, AMPAR and tau in hippocampus were assessed via quantitative Western blotting. The incidences of learning/memory impairment of isoflurane-exposed rats in hippocampal microdialysis group and western blotting group were 12.0 (3/25) and 10.4 % (5/48) respectively. The intra-anesthesia hippocampal glutamate levels were significantly lower than those of non-anesthesized rats. The learning/memory-impaired rats showed a long-lasting increased glutamate level from 24 h after isoflurane exposure to the end of the study, but the other 22 isoflurane-exposed rats did not. The learning/memory-impaired subgroup displayed a significantly higher GLAST level than the other three subgroups (p = 0.026, 0.02 and 0.032 respectively). The expression levels of GLT-1, NMDAR1, NMDAR2A/B and AMPAR of every subgroup were comparable. We found a continuous raised hippocampal glutamate and an up-regulation of GLAST rather than GLT-1, NMDAR1, NMDAR2A/B, AMPAR or tau in hippocampus of aged rats associated with isoflurane-induced learning/memory impairment.
Collapse
Affiliation(s)
- Xiangdong Qu
- Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Schmidt C, Karch A, Korth C, Zerr I. On the issue of transmissibility of Alzheimer disease: a critical review. Prion 2012; 6:447-52. [PMID: 23052009 DOI: 10.4161/pri.22502] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Results from recent experiments with rodents imply that Alzheimer disease might be inducible by seeding Aβ peptides into recipient animals. In respect to this new experimental data, public health aspects as well as epidemiological data have to be reevaluated. In this article, the available experimental and epidemiological data are reviewed.
Collapse
Affiliation(s)
- Christian Schmidt
- Clinical Dementia Center, Department of Neurology, Georg-August University, Goettingen, Germany.
| | | | | | | |
Collapse
|
42
|
Hypothermia-induced hyperphosphorylation: a new model to study tau kinase inhibitors. Sci Rep 2012; 2:480. [PMID: 22761989 PMCID: PMC3386519 DOI: 10.1038/srep00480] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 06/13/2012] [Indexed: 12/22/2022] Open
Abstract
Tau hyperphosphorylation is one hallmark of Alzheimer's disease (AD) pathology. Pharmaceutical companies have thus developed kinase inhibitors aiming to reduce tau hyperphosphorylation. One obstacle in screening for tau kinase inhibitors is the low phosphorylation levels of AD-related phospho-epitopes in normal adult mice and cultured cells. We have shown that hypothermia induces tau hyperphosphorylation in vitro and in vivo. Here, we hypothesized that hypothermia could be used to assess tau kinase inhibitors efficacy. Hypothermia applied to models of biological gradual complexity such as neuronal-like cells, ex vivo brain slices and adult non-transgenic mice leads to tau hyperphosphorylation at multiple AD-related phospho-epitopes. We show that Glycogen Synthase Kinase-3 inhibitors LiCl and AR-A014418, as well as roscovitine, a cyclin-dependent kinase 5 inhibitor, decrease hypothermia-induced tau hyperphosphorylation, leading to different tau phosphorylation profiles. Therefore, we propose hypothermia-induced hyperphosphorylation as a reliable, fast, convenient and inexpensive tool to screen for tau kinase inhibitors.
Collapse
|
43
|
Deiner S, Silverstein JH. Long-term outcomes in elderly surgical patients. THE MOUNT SINAI JOURNAL OF MEDICINE, NEW YORK 2012; 79:95-106. [PMID: 22238042 PMCID: PMC3261586 DOI: 10.1002/msj.21288] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Anesthesia has developed to the point where long-term outcomes are important endpoints. Elderly patients are becoming an increasingly large part of most surgical practices, consistent with demographic shifts. Long-term outcomes are particularly important for this group. In this review, we discuss functional outcomes in the elderly. We describe the areas of cognitive change and frailty, both of which are specific to the elderly. We also discuss prevention of surgical infections and emerging evidence around hemodynamic alterations in the operating room and their impact on long-term outcomes.
Collapse
Affiliation(s)
- Stacie Deiner
- Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY, USA
| | | |
Collapse
|
44
|
Kapoor MC. Alzheimer's disease, anesthesia and the cholinergic system. J Anaesthesiol Clin Pharmacol 2011; 27:155-8. [PMID: 21772671 PMCID: PMC3127290 DOI: 10.4103/0970-9185.81817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mukul C Kapoor
- Department of Anesthesiology, Command Hospital (CC), Lucknow, Uttar Pradesh, India
| |
Collapse
|