Abstract

Accumulating evidence has demonstrated that damages of gut microbiota are strongly associated with central nervous system (CNS) diseases, such as perioperative neurocognitive disorders (PND). The present study investigated the role of gut microbial metabolite short-chain fatty acids (SCFAs) in surgery-induced cognitive deficits and neuroinflammation in the hippocampus. Adult male C57BL/6J mice received either SCFA mixture or saline orally for 4 weeks, and then partial hepatectomy was performed. The fecal supernatant of surgical mice was transplanted to normal mice for 3 weeks. The Morris water maze (MWM) and open-field tests were used to evaluate behavioral performance on postoperative or post-transplantation days 3 and 7. In the MWM test, pretreatment with exogenous SCFAs partially reversed surgery-induced impairments in crossing times and the time spent in the target quadrant on postoperative day 3 (p < 0.05, p < 0.05, respectively). In the open-field test, compared with the surgical mice, exogenous SCFA administration prior to surgery partially improved the locomotor activity (p < 0.05) and anxiety-like behavior (p < 0.05) on postoperative day 3. Surgical trauma and anesthesia enhanced ionized calcium-binding adapter molecule 1 (Iba-1) expression (p < 0.001), increased the levels of interleukin (IL)-1β (p < 0.001) and IL-6 (p < 0.001), and inhibited SCFA production (p < 0.001) on postoperative day 3. The expression of the brain-derived neurotrophic factor (BDNF) was also decreased (p < 0.001). Overall, surgical trauma and anesthesia exacerbated cognitive impairment, enhanced neuroinflammatory responses, and inhibited SCFA production. Pretreatment with SCFAs attenuated these effects partially by reversing microglial overactivation, inhibiting neuroinflammatory responses, and enhancing BDNF expression.

Highlights

  • Perioperative neurocognitive disorders (PND), characterized by reversible impairment in memory, mental concentration, is one of the most common postoperative complications in elderly patients

  • A post-test showed that surgical trauma, anesthesia, and fecal microbiota transplantation significantly decreased the time spent in target quadrant compared with the control group on postoperative or posttransplantation day 3 (p < 0.001, p < 0.001) and improved on day 7 (p > 0.05, p > 0.05) in the probe trial test (Figure 2D)

  • Compared with surgical mice, pretreatment with exogenous short-chain fatty acids (SCFAs) partially reversed the impairments in crossing times and the time spent in the target quadrant in the SCFAs + surgery group on postoperative day 3 (p < 0.05, p < 0.05)

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Summary

Introduction

Perioperative neurocognitive disorders (PND), characterized by reversible impairment in memory, mental concentration, is one of the most common postoperative complications in elderly patients. PND may result in delayed recovery, prolonged hospitalization, and an increased risk of disability and mortality (Cao et al, 2010). The neurobiological basis of PND remains unknown. Multiple surgeries, and duration of anesthesia have been implicated as the risk factors for PND. Accumulating evidence has suggested that neuroinflammation plays a crucial role in the pathogenesis of PND (Steinmetz et al, 2009; Li Z. et al, 2018). Our previous studies indicated that surgical trauma and anesthesia induced microglial activation, leading to cytokine cascade activation and inflammatory mediator release in the hippocampus (Wang et al, 2017; Jiang et al, 2018; Zhou et al, 2019)

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