Abstract

Front cover: Postoperative cognitive decline (POCD) is a common geriatric complication, and a breach in the blood-brain barrier (BBB) is involved in early POCD. Annexin A1 has shown protective effects on BBB function. The objective of the present study was to investigate both the effects of sevoflurane on the components of the BBB, and the underlying mechanism. In our in vivo study, treatment with 3.6% sevoflurane for 6 h disrupted BBB components, which led to fibrinogen invasion and down-regulation of Annexin A1 expression at 24 h after inhalation. The administration of human recombinant Annexin A1 (hr Annexin A1) attenuated the disruption of BBB components, thereby reducing fibrinogen invasion. In addition, the administration of hr Annexin A1 improved cognitive function after the inhalation of 3.6% sevoflurane for 6 h. Moreover, in cultured endothelial cells, the activation/inhibition of the Wnt/ß-catenin signalling pathway attenuated/worsened the sevofluraneinduced decrease in Annexin A1. The image shows that treatment with wnt-3a leads to a high expression of Annexin A1 in endothelial cells. Treatment with 3.6% sevoflurane for 6 h inhibits the Wnt/ß-catenin signalling pathway. By inhibiting this pathway, the gas anaesthetic sevoflurane down-regulated Annexin A1, which consequently breached the BBB and induced POCD. Read the full article ‘The role of the Wnt/ß-catenin-Annexin A1 pathway in the process of sevoflurane-induced cognitive dysfunction’ by N. Hu, C. Wang, Y. Zheng, J. Ao, C. Zhang, K. Xie, Y. Li, H. Wang, Y. Yu and G. Wang (J. Neurochem. 2016, vol. 137 (2), pp. 240–252) on doi: 10.1111/jnc.13569

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