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Dexmedetomidine attenuates sevoflurane‑induced neurocognitive impairment through α2‑adrenoceptors
Yufeng Zhang1, Mao Li1, Enhui Cui1
1Department of Anesthesiology, The Huai'an Maternity and Child Clinical College of Xuzhou Medical University, Huai'an, Jiangsu 223002, P.R. China.
Insights
Dexmedetomidine protects the developing brain from sevoflurane-induced neurotoxicity. This anesthetic agent prevents neuroapoptosis, inflammation, and cognitive impairment by acting on alpha2 adrenoceptors.
Area of Science:
- Neuroscience
- Anesthesiology
- Pharmacology
Background:
- Sevoflurane anesthesia can cause neurotoxicity in developing brains.
- Dexmedetomidine is used to prevent sevoflurane-induced agitation in children.
Purpose of the Study:
- To determine if dexmedetomidine prevents sevoflurane-induced neuroapoptosis, neuroinflammation, oxidative stress, and cognitive impairment.
- To assess the role of alpha2 adrenoceptors in dexmedetomidine's neuroprotective effects.
Main Methods:
- Postnatal day 6 mice were exposed to sevoflurane with or without dexmedetomidine pretreatment.
- Yohimbine, an alpha2 adrenoceptor inhibitor, was used to test receptor involvement.
- Neuroapoptosis markers, inflammatory cytokines, oxidative stress markers, and cognitive function (Morris water maze) were assessed.
Main Results:
- Dexmedetomidine significantly reduced sevoflurane-induced apoptosis, neuroinflammation (TNF-α, IL-1β, IL-6), and oxidative stress (MDA).
- Dexmedetomidine increased superoxide dismutase activity and reversed learning and memory deficits.
- Yohimbine co-administration attenuated dexmedetomidine's neuroprotective effects.
Conclusions:
- Dexmedetomidine provides neuroprotection against sevoflurane-induced neurotoxicity in the developing brain.
- The protective effects are mediated, at least in part, by alpha2 adrenoceptors.
- Dexmedetomidine may be a promising agent to mitigate sevoflurane-related neurodevelopmental risks.
Abstract:
It has been reported that sevoflurane induces neurotoxicity in the developing brain. Dexmedetomidine is an α2 adrenoceptor agonist used for the prevention of sevoflurane‑induced agitation in children in clinical practice. The aim of the present study was to determine whether dexmedetomidine could prevent sevoflurane‑induced neuroapoptosis, neuroinflammation, oxidative stress and neurocognitive impairment. Additionally, the involvement of α2 adrenoceptors in the neuroprotective effect of dexmedetomidine was assessed. Postnatal day (P)6 C57BL/6 male mice were randomly divided into four groups (n=6 in each group). Mice were pretreated with dexmedetomidine, either alone or together with yohimbine, an α2 adrenoceptor inhibitor, then exposed to 3% sevoflurane in 25% oxygen. Control mice either received normal saline alone or with sevoflurane exposure. Following sevoflurane exposure, the expression of cleaved caspase‑3 was detected by immunohistochemistry in hippocampal tissue sections. In addition, the levels of tumor necrosis factor‑α (TNF‑α), interleukin (IL)‑1β, IL‑6 and malondialdehyde, as well as superoxide dismutase (SOD) activity in the hippocampus were measured. At P35, the learning and memory abilities were assessed in each mouse using a Morris water maze test. Dexmedetomidine significantly decreased the expression of activated caspase‑3 following sevoflurane exposure. Moreover, dexmedetomidine significantly decreased the levels of TNF‑α, IL‑1β and IL‑6 in the hippocampus. SOD activity also increased in a dose‑dependent manner in dexmedetomidine‑treated mice. MDA decreased in a dose‑dependent manner in dexmedetomidine‑treated mice. Lastly, sevoflurane‑induced learning and memory impairment was reversed by dexmedetomidine treatment. By contrast, co‑administration of yohimbine significantly attenuated the neuroprotective effects of dexmedetomidine. These findings suggested that dexmedetomidine exerted a neuroprotective effect against sevoflurane‑induced apoptosis, inflammation, oxidative stress and neurocognitive impairment, which was mediated, at least in part, by α2 adrenoceptors.
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