Resveratrol-mediated NRF2/HO-1 signaling pathway to improve postoperative cognitive dysfunction in elderly rats

To investigate the effects of resveratrol (RES) on cognitive function and its modulation of the NRF2/HO-1 signaling pathway in a rodent model of postoperative cognitive dysfunction (POCD). A POCD model was established in aged Sprague-Dawley rats using sevoflurane anesthesia and laparotomy. Rats were divided into four groups: control, POCD, RES, and POCD + RES. Cognitive performance was assessed using the Morris water maze. Hippocampal tissues were analyzed for neuronal condition using hematoxylin and eosin and Nissl staining. The expression levels of inflammatory cytokines and oxidative stress markers were quantified by enzyme-linked immunosorbent assay. The messenger RNA and protein levels of NRF2, KEAP1, HO-1, and SOD2 were measured using real-time quantitative polymerase chain reaction and western blotting. RES treatment improved cognitive function, as evidenced by reduced escape latency and increased platform crossings in the Morris water maze. Histopathological analysis showed restoration of hippocampal structure and increased neuronal viability. RES significantly reduced proinflammatory cytokines interleukin (IL)-1 and IL-6 while increasing IL-10 levels. In addition, RES activated the NRF2/HO-1 pathway by upregulating NRF2, HO-1, and SOD2 expression while downregulating KEAP1. RES mitigates cognitive deficits in POCD by reducing neuroinflammation and oxidative stress through activation of the NRF2/HO-1 signaling pathway. These findings suggest RES is a potential therapeutic candidate for the treatment of POCD in elderly patients.