Abstract

BackgroundSide effects of sevoflurane in anterograde and retrograde memory have been widely reported. However, there is no convincing evidence that sevoflurane directly causes the development of neurotoxicity. miR-424 has the potential to regulate the neurotoxicity caused by isoflurane anesthesia, and it has a complementary sequence with the 3’UTR region of TLR4. Thus, our study aims to explore whether sevoflurane directly causes neurotoxicity, the effects of miR-424 on sevoflurane induced apoptosis and inflammation, and the underlying mechanism.MethodsSevoflurane effects were identified both in mouse and in PC12 cells. Western blots and ELISA were used for protein detection, while micro (mi) RNA expression was measured with RT-qPCR. Dual luciferase reporter assays were employed to study the interaction between miR-424 and Toll-like receptor 4 (TLR4) using miR-424 mimics and TLR4 over-expression.ResultsSevoflurane stimulated expression of Bax2 and Caspase-3, and increased apoptosis ratio both in vivo and vitro (P < 0.05). Inflammatory cytokines, such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6, were up-regulated by sevoflurane, while IL-10 was downregulated (P < 0.05). Sevoflurane treatment enhanced the phosphorylation of NF-κB, and up-regulated the expressions of TLR4 and MyD88 (P < 0.05), which demonstrated that sevoflurane inhibited proliferation and differentiation of neuronal cells by activating TLR4/MyD88/NF-κB signaling both in vitro and vivo. However, up-regulation of miR-424 attenuated the negative effects of sevoflurane by targeting the 3′-untranslated region (UTR) of TLR4 and inducing the degradation of mRNA (P < 0.05).ConclusionsIn vitro, sevoflurane induces activation of the endogenous TLR4 signaling pathway, thereby promoting apoptosis and inflammatory cytokine expression. Exogenous TLR4 acts as an agonist to stimulate TLR4 signaling, whereas miR-424 inhibits both endogenous and exogenous TLR4 signaling, thereby preserving proliferation and differentiation of neuronal cells.

Highlights

  • Sevoflurane is a common inhaled anesthetic agent used during intravenous anesthesia, especially in pediatric surgery because of its high induction efficiency and quick recovery

  • Compared with the control group, miR-424 expression was decreased by 50% after sevoflurane treatment, while this effect was reversed by exogenous addition of mimic miR-424 (Fig. 1A)

  • transferase dUTP nick end labeling (TUNEL) staining was used to detect apoptosis, which was significantly increased after sevoflurane, while this trend was reversed by miR-424 addition (Fig. 1B and C)

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Summary

Introduction

Sevoflurane is a common inhaled anesthetic agent used during intravenous anesthesia, especially in pediatric surgery because of its high induction efficiency and quick recovery. The precise mechanism of sevoflurane in inducing and maintaining general anesthesia is unknown. Sevoflurane has potential neurotoxicity, nephrotoxicity and hepatotoxicity; there is no convincing evidence that sevoflurane directly causes the development of neurotoxicity [2]. Side effects of sevoflurane in anterograde and retrograde memory have been widely reported. There is no convincing evidence that sevoflurane directly causes the development of neurotoxicity. MiR-424 has the potential to regulate the neurotoxicity caused by isoflurane anesthesia, and it has a complementary sequence with the 3’UTR region of TLR4. Our study aims to explore whether sevoflurane directly causes neurotoxicity, the effects of miR-424 on sevoflurane induced apoptosis and inflammation, and the underlying mechanism

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