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Blood-brain Barrier Disruption Leads to Postoperative Cognitive Dysfunction.
Curr Neurovasc Res 2017; 14(4):359-367CN

Abstract

BACKGROUND

Postoperative Cognitive Dysfunction (POCD) has received considerable attention as one of the main postoperative complications. The underlying mechanism of POCD in elderly subjects has not been fully elucidated to date. The Central Nervous System (CNS) is isolated from the bloodstream by the Blood Brain Barrier (BBB) that consists of endothelial cells, capillary blood vessels and tight junctions. The tight junctions carry out significant biological functions that are associated with the CNS and blood circulation.

METHODS

In this review, I present a hypothesis that blood-brain barrier disruption leads to postoperative cognitive dysfunction. A total of 81 healthy male Wistar rats were used for the present study. All the experimental animals were randomly divided into 3 groups: normal control group, isoflurane group and splenectomy group. The control group was not subjected to any form of treatment. The rats in isoflurane group were given 1.5-2% isoflurane under intubation and mechanical ventilation. The rats in splenectomy group underwent splenectomy under the same anesthesia as the isoflurane group. The Morris water maze was used to examine the learning and memory ability of the animals. The expression of the Tight Junctions Proteins (TJPs) in the hippocampus was analyzed using Western blotting. The concentration of Evans Blue (EB) in the supernatant was analyzed using UV spectroscopy. Ultrastructure changes in the basal laminas, the Tight Junctions (TJs), mitochondria and the endoplasmic reticulum surrounding the capillaries were assessed by Transmission Electron Microscopy (TEM).

RESULTS

Following splenectomy, the rats displayed concomitant significant cognitive deficits in the Morris water maze test. Taken together, the results indicate that the expression levels of occludin (65KD) following splenectomy were reduced on days one and three in aged rats. No significant difference was noted in the expression levels of claudin-5, except for a reduction after surgery on day one. The leakage of EB was higher following splenectomy than control group and isoflurane group. The ultrastructure of the neurovascular unit was monitored on the day prior to surgery and on the 1st, 3rd and 7th day following surgery using a transmission electronmicroscope.

CONCLUSION

The alterations in the levels of tight junction proteins following splenectomy may contribute to the BBB permeability increase, which in turn will induce postoperative cognitive dysfunction.

Authors+Show Affiliations

Department of Anesthesiology, Qingdao Municipal Hospital, NO. 5 Donghai Middle Road, Qingdao, Shandong, 266071, China.Department of General surgery, Qingdao Municipal Hospital, NO. 5 Donghai Middle Road, Qingdao, Shandong, 266071, China.Department of Neurology, Qingdao Municipal Hospital, NO. 5 Donghai Middle Road, Qingdao, Shandong, 266071, China.Department of Anesthesiology, Linyi People's Hospital, NO. 27 Jie Fang Road, Linyi, Shandong, 276005, China.Department of Anesthesiology, Qingdao Municipal Hospital, NO. 5 Donghai Middle Road, Qingdao, Shandong, 266071, China.Department of Anesthesiology, Qingdao Municipal Hospital, NO. 5 Donghai Middle Road, Qingdao, Shandong, 266071, China.Department of Anesthesiology, Qingdao Municipal Hospital, NO. 5 Donghai Middle Road, Qingdao, Shandong, 266071, China.Department of Anesthesiology, Qingdao Municipal Hospital, NO. 5 Donghai Middle Road, Qingdao, Shandong, 266071, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28990533

Citation

Wang, Bin, et al. "Blood-brain Barrier Disruption Leads to Postoperative Cognitive Dysfunction." Current Neurovascular Research, vol. 14, no. 4, 2017, pp. 359-367.
Wang B, Li S, Cao X, et al. Blood-brain Barrier Disruption Leads to Postoperative Cognitive Dysfunction. Curr Neurovasc Res. 2017;14(4):359-367.
Wang, B., Li, S., Cao, X., Dou, X., Li, J., Wang, L., ... Bi, Y. (2017). Blood-brain Barrier Disruption Leads to Postoperative Cognitive Dysfunction. Current Neurovascular Research, 14(4), pp. 359-367. doi:10.2174/1567202614666171009105825.
Wang B, et al. Blood-brain Barrier Disruption Leads to Postoperative Cognitive Dysfunction. Curr Neurovasc Res. 2017;14(4):359-367. PubMed PMID: 28990533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blood-brain Barrier Disruption Leads to Postoperative Cognitive Dysfunction. AU - Wang,Bin, AU - Li,Siyuan, AU - Cao,Xipeng, AU - Dou,Xinghui, AU - Li,Jingzhu, AU - Wang,Ling, AU - Wang,Mingshan, AU - Bi,Yanlin, PY - 2017/09/05/received PY - 2017/09/24/revised PY - 2017/09/26/accepted PY - 2017/10/11/pubmed PY - 2019/5/9/medline PY - 2017/10/10/entrez KW - Postoperative cognitive dysfunction (POCD) KW - blood-brain barrier (BBB) KW - hippocampus KW - splenectomy KW - surgery KW - tight junction SP - 359 EP - 367 JF - Current neurovascular research JO - Curr Neurovasc Res VL - 14 IS - 4 N2 - BACKGROUND: Postoperative Cognitive Dysfunction (POCD) has received considerable attention as one of the main postoperative complications. The underlying mechanism of POCD in elderly subjects has not been fully elucidated to date. The Central Nervous System (CNS) is isolated from the bloodstream by the Blood Brain Barrier (BBB) that consists of endothelial cells, capillary blood vessels and tight junctions. The tight junctions carry out significant biological functions that are associated with the CNS and blood circulation. METHODS: In this review, I present a hypothesis that blood-brain barrier disruption leads to postoperative cognitive dysfunction. A total of 81 healthy male Wistar rats were used for the present study. All the experimental animals were randomly divided into 3 groups: normal control group, isoflurane group and splenectomy group. The control group was not subjected to any form of treatment. The rats in isoflurane group were given 1.5-2% isoflurane under intubation and mechanical ventilation. The rats in splenectomy group underwent splenectomy under the same anesthesia as the isoflurane group. The Morris water maze was used to examine the learning and memory ability of the animals. The expression of the Tight Junctions Proteins (TJPs) in the hippocampus was analyzed using Western blotting. The concentration of Evans Blue (EB) in the supernatant was analyzed using UV spectroscopy. Ultrastructure changes in the basal laminas, the Tight Junctions (TJs), mitochondria and the endoplasmic reticulum surrounding the capillaries were assessed by Transmission Electron Microscopy (TEM). RESULTS: Following splenectomy, the rats displayed concomitant significant cognitive deficits in the Morris water maze test. Taken together, the results indicate that the expression levels of occludin (65KD) following splenectomy were reduced on days one and three in aged rats. No significant difference was noted in the expression levels of claudin-5, except for a reduction after surgery on day one. The leakage of EB was higher following splenectomy than control group and isoflurane group. The ultrastructure of the neurovascular unit was monitored on the day prior to surgery and on the 1st, 3rd and 7th day following surgery using a transmission electronmicroscope. CONCLUSION: The alterations in the levels of tight junction proteins following splenectomy may contribute to the BBB permeability increase, which in turn will induce postoperative cognitive dysfunction. SN - 1875-5739 UR - https://www.unboundmedicine.com/medline/citation/28990533/Blood_brain_Barrier_Disruption_Leads_to_Postoperative_Cognitive_Dysfunction_ L2 - http://www.eurekaselect.com/156271/article DB - PRIME DP - Unbound Medicine ER -