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与损伤相关的分子模式在外科手术期间神经认知障碍中的作用:叙述性综述

Wiriya Maisat¹, Koichi Yuki^2,3

¹From the Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Anesthesia and analgesia

|August 5, 2025

概括

在手术期间释放的与损伤相关的分子模式 (DAMPs) 驱动神经炎症,在老年患者中引起外科期神经认知障碍 (PND). 准DAMP通路显示有望预防手术后的认知衰退.

科学领域:

神经科学是一个神经科学.
免疫学免疫学免疫学
老年医学老年医学

背景情况:

术后神经认知障碍 (PND),包括术后妄 (POD) 和认知功能障碍 (POCD),对老年手术患者产生重大影响.
在手术期间从受伤细胞中释放的与损伤相关的分子模式 (DAMPs) 与PND病变发生有关.
DAMP激活先天性免疫受体 (PRR),导致系统性炎症,神经炎症和认知障碍.

研究的目的:

审查 DAMP 特定机制在 PND 病原发生中的作用.
探索针对DAMP介导的PND途径的新兴治疗干预措施.
支持未来对生物标志物和向PND治疗的研究.

主要方法:

关于DAMPs,PRRs,神经炎症和PND的科学文献的审查.
对针对DAMP通路的治疗策略的临床前数据的分析.
综合目前对DAMP在PND.的背景下对DAMP的理解.

主要成果:

DAMPs激活PRRs (TLRs,RAGE),触发炎症级联,破坏血脑屏障并导致神经炎症.
持续的炎症会产生一个反循环,放大DAMP释放和认知功能障碍.
治疗药物,如甘油,德克斯梅德托米丁和TLR4抑制剂,在缓解PND方面显示出临床前的前景.

结论:

在手术患者中,DAMP介导的途径是PND发展的核心.
针对DAMPs提供了一个有希望的治疗途径,用于预防和治疗PND.
进一步的临床试验和生物标志物验证对于将这些发现转化为实践至关重要.

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