Abstract

Post-operative cognitive dysfunction is associated with morbidity and mortality. However, its neuropathogenesis remains largely to be determined. Neuroinflammation and accumulation of β-amyloid (Aβ) have been reported to contribute to cognitive dysfunction in humans and cognitive impairment in animals. Our recent studies have established a pre-clinical model in mice, and have found that the peripheral surgical wounding without the influence of general anesthesia induces an age-dependent Aβ accumulation and cognitive impairment in mice. We therefore set out to assess the effects of peripheral surgical wounding, in the absence of general anesthesia, on neuroinflammation in mice with different ages. Abdominal surgery under local anesthesia was established in 9 and 18 month-old mice. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), Iba1 positive cells (the marker of microglia activation), CD33, and cognitive function in mice were determined. The peripheral surgical wounding increased the levels of TNF-α, IL-6, and Iba1 positive cells in the hippocampus of both 9 and 18 month-old mice, and age potentiated these effects. The peripheral surgical wounding increased the levels of CD33 in the hippocampus of 18, but not 9, month-old mice. Finally, anti-inflammatory drug ibuprofen ameliorated the peripheral surgical wounding-induced cognitive impairment in 18 month-old mice. These data suggested that the peripheral surgical wounding could induce an age-dependent neuroinflammation and elevation of CD33 levels in the hippocampus of mice, which could lead to cognitive impairment in aged mice. Pending further studies, anti-inflammatory therapies may reduce the risk of postoperative cognitive dysfunction in elderly patients.

Highlights

  • Post-operative cognitive dysfunction (POCD) is one of the most common post-operative complications in senior patients [1], and is associated with increased cost, morbidity, and mortality [2,3,4]

  • We have established a pre-clinical model of open abdominal surgery under local anesthesia in mice to determine the effects of peripheral surgical wounding without the influence of general anesthesia on Ab accumulation and cognitive impairment [5]

  • The peripheral surgical wounding did not significantly alter the tumor necrosis factor-a (TNF-a) levels in the hippocampus of mice of 9 and 18 month-old mice at 12 hours after the peripheral surgical wounding. These data suggested that the peripheral surgical wounding without the influence of general anesthesia induced a time- and age-dependent increase in the pro-inflammatory cytokine TNF-a levels in the hippocampus of mice

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Summary

Introduction

Post-operative cognitive dysfunction (POCD) is one of the most common post-operative complications in senior patients [1], and is associated with increased cost, morbidity, and mortality [2,3,4]. We have established a pre-clinical model of open abdominal surgery under local anesthesia in mice to determine the effects of peripheral surgical wounding without the influence of general anesthesia on Ab accumulation and cognitive impairment [5]. We have found that the peripheral surgical wounding without the influence of general anesthesia can induce an age dependent Ab accumulation and cognitive impairment [5]. Neuroinflammation, including increases in levels of proinflammatory cytokine tumor necrosis factor-a (TNF-a) and interleukin-6 (IL-6), as well as microglia activation, has been reported to contribute to the cognitive impairment induced by surgery under anesthesia ([6,7,8,9], reviewed in [10]). Whether the peripheral surgical wounding without the influence of general anesthesia can induce an age dependent neuroinflammation has not been investigated

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