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Current Progress on Neuroinflammation-mediated Postoperative Cognitive Dysfunction: An Update.

Wenyong Peng1, Wei Lu2, Xiaofeng Jiang1

  • 1Department of Anesthesiology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang 321000, China.

Current Molecular Medicine
|November 22, 2022
PubMed
Summary

Postoperative cognitive dysfunction (POCD) in elderly patients is linked to central nervous system inflammation. Targeting neuroinflammation may prevent and treat POCD, improving patient outcomes.

Keywords:
Neuroinflammationanesthesiabiomarkerdysfunctionmicrogliapostoperative cognitive

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Area of Science:

  • Neuroscience
  • Gerontology
  • Immunology

Background:

  • Postoperative cognitive dysfunction (POCD) is a prevalent central nervous system complication in elderly surgical patients, impacting cognition and potentially progressing to Alzheimer's disease.
  • Elderly patients face increased POCD risk due to age, surgical trauma, anesthesia, and pre-existing conditions, exacerbated by heightened inflammatory responses.
  • Low diagnostic rates for POCD hinder prognosis and increase postoperative mortality, underscoring the need for better understanding and management.

Approach:

  • This review synthesizes current research on neuroinflammation's role in POCD pathogenesis.
  • It examines the involvement of glial cells (microglia, astrocytes), pro-inflammatory cytokines (TNF-α, IL-1β), and signaling pathways (PI3K/Akt/mTOR, NF-κB).
  • The review also covers predictive biomarkers, risk factors, and the therapeutic potential of anti-inflammatory strategies.

Key Points:

  • Central nervous system inflammation, involving specific cells and cytokines, is a critical factor in POCD development.
  • Identifying predictive biomarkers and understanding risk factors are crucial for early POCD detection.
  • Anti-inflammatory therapies show promise for preventing and treating POCD.

Conclusions:

  • Neuroinflammation is a key mechanism underlying POCD, offering therapeutic targets.
  • Further research into POCD pathogenesis is vital for early diagnosis and effective long-term treatment.
  • Interventions targeting central neuroinflammation are significant for managing and preventing POCD.