Abstract
In the past decade there has been a resurgence of interest in the clinical use of inert gases. In the present paper we review the use of inert gases as anesthetics and neuroprotectants, with particular attention to the clinical use of xenon. We discuss recent advances in understanding the molecular pharmacology of xenon and we highlight specific pharmacological targets that may mediate its actions as an anesthetic and neuroprotectant. We summarize recent in vitro and in vivo studies on the actions of helium and the other inert gases, and discuss their potential to be used as neuroprotective agents.
Highlights
The inert or noble gases helium, neon, argon, krypton and xenon exist as monatomic gases with low chemical reactivity
Banks and colleagues [7] showed that acute xenon neuroprotection in an in vitro model of hypoxia/ischemia can be reversed by elevating the glycine concentration (Figure 4a), consistent with xenon neuroprotection being mediated by inhibition of the NMDA receptor at its glycine site [31]
The present review summarizes studies on the pharmacology and clinical uses of the inert gases as anesthetics and neuroprotectants
Summary
The inert or noble gases helium, neon, argon, krypton and xenon exist as monatomic gases with low chemical reactivity. Banks and colleagues [7] showed that acute xenon neuroprotection in an in vitro model of hypoxia/ischemia can be reversed by elevating the glycine concentration (Figure 4a), consistent with xenon neuroprotection being mediated by inhibition of the NMDA receptor at its glycine site [31]. Another study using a rat CPB model combined with artificially introduced air bubbles of 300 nl reported that exposure to 56% xenon resulted in increased infarct volume and neurological deficit compared with nitrogen [94]. The anesthetic inert gases (argon, krypton and xenon) can be distinguished from the nonanesthetic helium and neon by their greater polarizability [106] (Table 1), which results in larger favorable enthalpic interactions. That anesthesia and neuroprotection by the inert gases share similar mechanisms is, an interesting possibility
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