Correlation Between Plasma CircRNA-089763 and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Non-cardiac Surgery.

Hongli Zhou,Li Liu,Xiaobin Wang,Maozhou Wang,Xian Zhou,Wanlin Ye,Jianguo Feng,Fuyu Li

doi:10.3389/fnbeh.2020.587715

Abstract

In our previous experiment, we found that there were abnormal levels of circRNA-089763 in the plasma exosomes of patients with postoperative cognitive dysfunction (POCD) after cardiac surgery. Therefore, the aim of this study was to further investigate the relationship between plasma circRNA-089763 level and POCD in elderly patients after non-cardiac surgery. A prospective cohort study was conducted to select elderly patients undergoing elective non-cardiac surgery. A total of 72 patients were enrolled in this study, and cognitive functions were assessed 1 day before and 3 days after surgery by a series of neuropsychological measurements. Next, patients were divided into POCD and non-POCD (NPOCD) groups according to the Z score method. Blood was collected the day before and 3 days after surgery, and the plasma circRNA-089763 level was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Then, the difference and correlation in plasma circRNA-089763 levels between the POCD and NPOCD groups were analyzed. On the third day after surgery, the incidence of POCD was 30.56%. The relative level of circRNA-089763 in the POCD group was 2.41 times higher than that in the NPOCD group (t = 4.711, p < 0.001), patients in POCD group had higher age (t = 5.971, p < 0.001), higher American Society of Anesthesiologists classification (χ2 = 14.726, p < 0.001), less years of education (t = 2.449, p = 0.017), more intraoperative blood loss (t = 3.196, p = 0.002), and higher visual analog scale (VAS) scores (t = 10.45, p < 0.001). The binary logistic regression analysis showed that the circRNA-089763 level, age, and intraoperative blood loss were independently associated with POCD (OR: 2.75, 95% CI: 1.261–5.999, p = 0.011; OR: 1.32, 95% CI: 1.114–1.565, p = 0.001; OR: 1.017, 95% CI: 1.004–1.03, p = 0.011). These results demonstrated that the circRNA-089763 plasma level was related to POCD after non-cardiac surgery in elderly patients.

Highlights

Circular RNAs (CircRNAs) are a novel type of non-coding RNA with a closed loop structure (Li et al, 2018)
CircRNA is widely present in the eukaryotic transcriptome and can regulate target gene expression by the competitive endogenous RNA mechanism (Tay et al, 2014)
According to “Z-score method” (Moller et al, 1998), postoperative cognitive dysfunction (POCD) was defined as the presence of at least two cognitive function scales of |Z| ≥ 1.96

Summary

Introduction

Circular RNAs (CircRNAs) are a novel type of non-coding RNA with a closed loop structure (Li et al, 2018). CircRNA is widely present in the eukaryotic transcriptome and can regulate target gene expression by the competitive endogenous RNA (ceRNA) mechanism (Tay et al, 2014). CircRNAs are predominantly transported in the form of exosomes, which can enter the blood circulation through the blood–brain barrier (Li et al, 2015). Zhang et al (2017) characterized circRNA-associated ceRNA networks in senescence-accelerated mouse prone 8 brain and found that these networks could affect the diagnosis and therapy of AD in the near future. The dysfunction of the circRNA-miRNA-mRNA regulatory system seems to represent another important aspect of epigenetic control of the human central nervous system’s pathogenic gene expression program. Postoperative cognitive dysfunction (POCD) and AD have similar pathogenesis (Hu et al, 2010; Hua et al, 2014)

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