围手术期神经认知障碍：分子机制和生物活性分子的研究进展

IF 12.4 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-09-04 DOI:10.1016/j.arr.2025.102885

Liwei Mao , Lian Wang , Zhihai Huang , Jeffrey A. Switzer , David C. Hess , Quanguang Zhang

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引用次数: 0

摘要

围手术期神经认知障碍（PNDs）是手术后常见的并发症，特别是在老年患者中，其特征是记忆丧失、注意力缺陷和执行功能受损。pnd的发病机制涉及神经炎症、神经递质失衡、表观遗传修饰和肠-脑轴破坏等复杂的相互作用。本文综述了PNDs机制的最新发现，重点关注小胶质细胞激活、白细胞介素失衡和NLRP3炎症小体介导的焦亡。我们进一步讨论了麻醉和手术如何通过破坏神经递质系统，特别是GABAA和NMDA受体来损害突触可塑性。此外，我们强调表观遗传调控和肠道微生物群失调在维持神经炎症和认知缺陷中的作用。最后，我们探讨了潜在的治疗策略，包括生物活性化合物和神经保护药物，为pnd的预防和治疗提供了新的方向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Perioperative neurocognitive disorders: Advances in molecular mechanisms and bioactive molecules

Perioperative neurocognitive disorders (PNDs) are common complications following surgery, especially in elderly patients, and are characterized by memory loss, attention deficits, and impaired executive function. The pathogenesis of PNDs involves a complex interplay of neuroinflammation, neurotransmitter imbalance, epigenetic modifications, and gut–brain axis disruption. This review summarizes the latest findings on the mechanisms underlying PNDs, with a focus on microglial activation, interleukin imbalance, and NLRP3 inflammasome-mediated pyroptosis. We further discuss how anesthesia and surgery impair synaptic plasticity by disrupting neurotransmitter systems, particularly GABA_A and NMDA receptors. Additionally, we highlight the roles of epigenetic regulation and gut microbiota dysbiosis in sustaining neuroinflammation and cognitive deficits. Finally, we explore potential therapeutic strategies, including bioactive compounds and neuroprotective agents, offering new directions for the prevention and treatment of PNDs.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.