Emerging Roles of Immune Cells in Postoperative Cognitive Dysfunction

Area of Science:

• Neuroscience
• Immunology
• Pathology

Background:

• Postoperative cognitive dysfunction (POCD) is a significant clinical issue characterized by persistent cognitive decline following surgery.
• The underlying pathophysiological mechanisms of POCD remain unclear, hindering effective therapeutic strategies.
• Emerging evidence highlights the critical involvement of neuroinflammation in the development of POCD.

Purpose of the Study:

• To review the roles of major immune cells in the pathogenesis of POCD.
• To discuss the intricate crosstalk between immune cells and cytokines contributing to neuroinflammation in POCD.
• To identify potential therapeutic targets for POCD prevention and treatment based on immune cell functions.

Main Methods:

• Literature review of studies investigating immune cell involvement in POCD.
• Analysis of the mechanisms by which peripheral inflammation affects the central nervous system (CNS).
• Examination of the activation and cytokine secretion by CNS-resident immune cells like microglia, mast cells, and T cells.

Main Results:

• Surgery triggers the release of alarmins and increases peripheral proinflammatory cytokines.
• Cytokines can cross the blood-brain barrier, damaging hippocampal neurons crucial for memory.
• Activation of CNS immune cells exacerbates neuroinflammation, contributing to POCD.
• Experimental evidence shows that modulating the immune cell network alleviates POCD.

Conclusions:

• Neuroinflammation, orchestrated by diverse immune cells and their signaling molecules, is central to POCD.
• Understanding the complex interactions among immune cells offers promising avenues for novel POCD therapies.
• Targeting specific immune pathways presents a viable strategy for preventing and treating postoperative cognitive dysfunction.