不同剂量异氟醚对中年小鼠认知功能及海马MBP和pNF-H表达的影响

目的:探讨异氟醚对中年小鼠认知功能及海马髓磷脂碱性蛋白(MBP, myelin basic protein)和磷酸化神经丝重亚单位(pNF-H,phosphorylated neurofilament heavy chain)表达的影响。方法:给予中年小鼠不同浓度的异氟醚处理,实验分为对照组和异氟醚处理组(0.5ISO,1.0ISO,1.5ISO),其中异氟醚组小鼠细胞分别给予0.5 MAC,1.0 MAC和1.5 MAC三个浓度的异氟醚处理4小时,对照组给予O_2处理4小时,随后通过水迷宫测试检测其学习记忆能力变化,通过免疫荧光检测海马形态结构及髓鞘相关蛋白MBP和pNF-H表达变化。结果:与对照组相比,(1)类临床浓度的异氟醚处理不影响中年小鼠的自发运动能力(总运动距离:sham:7275.17±1732.58; 0.5ISO:8057.58±1732.58; 1.0ISO:7540.98±1401.61; 1.5ISO:8243.79±1257.65;运动速度:sham:116.75±22.35; 0.5ISO:135.45±32.84; 1.0ISO:130.16±21.38; 1.5ISO:142.31±20.58),但1.0 MAC和1.5 MAC的异氟醚处理明显降低了中年小鼠在水迷宫目标象限的活动时间百分比(sham:58.62±13.70; 0.5ISO:48.92±7.22; 1.0ISO:31.23±13.16; 1.5ISO:30.29±15.76)(P 0.05),且高浓度异氟醚作用强于低浓度异氟醚;(2) 1.0 MAC和1.5 MAC的异氟醚处理明显下调了海马的MBP和p NF-H表达(MBP:sham:60.48±8.20; 0.5ISO:56.69±7.86; 1.0ISO:40.15±4.50; 1.5ISO:31.66±5.46; pNF-H:sham:62.23±9.45; 0.5ISO:55.47±6.98; 1.0ISO:40.16±6.97; 1.5ISO:30.94±5.89)(P 0.05),造成了小鼠海马髓鞘结构损伤,且高浓度损伤强于低浓度。结论:异氟醚可能通过下调中年小鼠海马MBP和pNF-H表达,破坏海马髓鞘完整性而损伤小鼠的学习认知能力。     

Carbon monoxide modulates cytochrome oxidase activity and oxidative stress in the developing murine brain during isoflurane exposure

Commonly used anesthetics induce widespread neuronal degeneration in the developing mammalian brain via the oxidative-stress-associated mitochondrial apoptosis pathway. Dysregulation of cytochrome oxidase (CcOX), the terminal oxidase of the electron transport chain, can result in reactive oxygen species (ROS) formation. Isoflurane has previously been shown to activate this enzyme. Carbon monoxide (CO), as a modulator of CcOX, is of interest because infants and children are routinely exposed to CO during low-flow anesthesia. We have recently demonstrated that low concentrations of CO limit and prevent isoflurane-induced neurotoxicity in the forebrains of newborn mice in a dose-dependent manner. However, the effect of CO on CcOX in the context of anesthetic-induced oxidative stress is unknown. Seven-day-old male CD-1 mice underwent 1 h exposure to 0 (air), 5, or 100 ppm CO in air with or without isoflurane. Exposure to isoflurane or CO independently increased CcOX kinetic activity and increased ROS within forebrain mitochondria. However, exposure to CO combined with isoflurane paradoxically limited CcOX activation and oxidative stress. There were no changes seen in steady-state levels of CcOX I protein, indicating post-translational modification of CcOX as an etiology for changes in enzyme activity. CO exposure led to differential effects on CcOX subunit I tyrosine phosphorylation depending on concentration, while combined exposure to isoflurane with CO markedly increased the enzyme phosphorylation state. Phosphorylation of tyrosine 304 of CcOX subunit I has been shown to result in strong enzyme inhibition, and the relative reduction in CcOX kinetics following exposure to CO combined with isoflurane may have been due, in part, to such phosphorylation. Taken together, the data suggest that CO modulates CcOX in the developing brain during isoflurane exposure, thereby limiting oxidative stress. These CO-mediated effects could have implications for the development of low-flow anesthesia in infants and children to prevent anesthesia-induced oxidative stress.     

5-脂氧合酶（5-LOX）及代谢产物在异氟醚预处理脑保护作用中的研究进展

缺血性脑血管疾病（Ischemia Cerebral Vascular Disease,ICVD）可造成不同程度的神经功能障碍,以其高发病率、高致残率、高复发率、高死亡率严重威胁着人们的身体健康。而脑组织缺血后再灌注损伤即脑缺血再灌注损伤（ischemia-reperfusion injury）是脑缺血性疾病的最主要的损伤原因之一,因此阐明脑缺血再灌注损伤发生发展的病理生理机制、探寻有效的预防保护措施成为当今研究的重点问题。本文回顾、归纳脑缺血再灌注损伤的相关分子机制及异氟醚预处理对脑缺血再灌注损伤的保护作用,分析5-脂氧合酶及其代谢产物在脑缺血再灌注损伤中的作用及其与其他分子的相互关系,旨在探讨5-脂氧合酶及其代谢产物在异氟醚预处理保护脑缺血再灌注损伤中可能起到的作用。为脑缺血再灌注损伤的防治提供更多的理论依据。     

PKC independent inhibition of voltage gated calcium channels by volatile anesthetics in freshly isolated vascular myocytes from the aorta

In this study we used barium currents through voltage gated L-type calcium channels (recorded in freshly isolated cells with a conventional patch-clamp technique) to elucidate the cellular action mechanism for volatile anesthetics. It was found that halothane and isoflurane inhibited (dose-dependently and voltage independently) Ba²⁺ currents through voltage gated Ca²⁺ channels. Half maximal inhibitions occurred at 0.64 ± 0.07 mM and 0.86 ± 0.1 mM. The Hill slope value was 2 for both volatile anesthetics, suggesting the presence of more than one interaction site. Current inhibition by volatile anesthetics was prominent over the whole voltage range without changes in the peak of the current voltage relationship. Intracellular infusion of the GDPβS (100 μM) together with staurosporine (200 nM) did not prevent the inhibitory effect of volatile anesthetics. Unlike pharmacological Ca²⁺ channel blockers, volatile anesthetics blocked Ca²⁺ channel currents at resting membrane potentials. In other words, halothane and isoflurane induced an ‘initial block’. After the first 4–7 control pulses, the cells were left unstimulated and anesthetics were applied. The first depolarization after the pause evoked a Ca²⁺ channel current whose amplitude was reduced to 41 ± 3.4% and to 57 ± 4.2% of control values. In an analysis of the steady-state inactivation curve for voltage dependence, volatile anesthetics induced a negative shift of the 50% inactivation of the calcium channels. By contrast, the steepness factor characterizing the voltage sensitivity of the channels was unaffected. Unitary L-type Ca²⁺ channels blockade occurred under cell-attached configuration, suggesting a possible action of volatile anesthetics from within the intracellular space or from the part of the channel inside the lipid bilayer.     

Insights into Distinct Modulation of α7 and α7β2 Nicotinic Acetylcholine Receptors by the Volatile Anesthetic Isoflurane

Nicotinic acetylcholine receptors (nAChRs) are targets of general anesthetics, but functional sensitivity to anesthetic inhibition varies dramatically among different subtypes of nAChRs. Potential causes underlying different functional responses to anesthetics remain elusive. Here we show that in contrast to the α7 nAChR, the α7β2 nAChR is highly susceptible to inhibition by the volatile anesthetic isoflurane in electrophysiology measurements. Isoflurane-binding sites in β2 and α7 were found at the extracellular and intracellular end of their respective transmembrane domains using NMR. Functional relevance of the identified β2 site was validated via point mutations and subsequent functional measurements. Consistent with their functional responses to isoflurane, β2 but not α7 showed pronounced dynamics changes, particularly for the channel gate residue Leu-249(9′). These results suggest that anesthetic binding alone is not sufficient to generate functional impact; only those sites that can modulate channel dynamics upon anesthetic binding will produce functional effects.     

异氟烷预处理对电磁脉冲辐射所致脑损伤的保护作用研究

目的:探讨异氟烷预处理对电磁脉冲辐射所致脑损伤的保护作用。方法:选取成年雄性SD大鼠48只,采用随机数字表法,将其随机分为4组(n=12),分别为:假辐照组(CON组)、电磁辐照组(EMP组)、异氟烷预处理组(IP组)和异氟烷预处理+电磁辐照组(IP+EMP组)。EMP组场强为400 KV/m,脉冲为200次,连续辐照3天;IP组吸入2.0%异氟醚2h;IP+EMP组吸入2.0%异氟醚2 h,24 h后制备EMP损伤模型。于辐照后24 h处死大鼠,每组随机抽取3只大鼠,取脑组织,采用ELISA法检测大鼠海马IL-6和TNF-α的表达变化;尼氏染色法观察大鼠海马区神经元的凋亡;采用Western blot法检测大鼠海马区BDNF蛋白的表达情况;采用免疫荧光法检测大鼠海马区BDNF细胞水平的表达。结果:与CON组比较,EMP组、IP组、IP+EMP组的IL-6和TNF-α的表达增高,尼氏小体减少,BDNF蛋白及细胞水平的表达均下调(P0.05);与EMP组比较,IP组和IP+EMP组IL-6和TNF-α的表达降低,尼氏小体增多,BDNF蛋白及细胞水平的表达上调(P0.05)。结论:异氟烷预处理可减轻电磁脉冲辐射所致脑损伤,其机制可能与减轻大鼠炎症反应有关。     

Plasma Concentrations of Brain-derived Neurotrophic Factor in Patients Undergoing Minor Surgery: A Randomized Controlled Trial

We measured perioperative plasma concentrations of brain-derived neurotrophic factor (BDNF), a major mediator of synaptic plasticity in the central nervous system, in males, 30-65 years old, undergoing lumbar or cervical discotomy. Patients were randomly allocated to a general anesthetic with propofol induction and maintenance or with thiopental induction and isoflurane maintenance. BDNF plasma concentrations were measured before induction (baseline), 15 min after induction but before start of surgery, at skin closure, in the post-anesthetic care unit, and 24 h postoperatively. Data from 26 patients (13 in each group) were analyzed. At each time point, BDNF plasma concentrations showed large variability. At baseline, concentrations were 631 +/- 337 (mean +/- SD) pg ml(-1) in the propofol group and were 549 +/- 512 pg ml(-1) in the thiopental-isoflurane group (P = 0.31). At 15 min, concentrations significantly decreased in the propofol group (247 +/- 219 pg ml(-1), P = 0.0012 compared with baseline) but remained unchanged in the thiopental-isoflurane group (597 +/- 471 pg ml(-1), P = 0.798 compared with baseline). At skin closure and in the post-anesthetic care unit, concentrations were not different from baseline in both groups. At 24 h, concentrations significantly decreased below baseline in both groups (propofol: 232 +/- 129 pg ml(-1), P = 0.0015; thiopental-isoflurane: 253 +/- 250 pg ml(-1), P = 0.016). In the propofol group, there was a weak but statistically significant positive correlation (R2 = 0.38, P = 0.026) between the duration of surgery and BDNF plasma concentrations at skin closure. These data suggest that in males undergoing elective minor surgery, BDNF plasma concentrations show a specific pattern that is influenced by the anesthetic technique and, possibly, by the duration of surgery.     

Anesthetic effects on the structure and dynamics of the second transmembrane domains of nAChR α4β2

Channel functions of the neuronal α4β2 nicotinic acetylcholine receptor (nAChR), one of the most widely expressed subtypes in the brain, can be inhibited by volatile anesthetics. Our Na⁺ flux experiments confirmed that the second transmembrane domains (TM2) of α4 and β2 in 2:3 stoichiometry, (α4)₂(β2)₃, could form pentameric channels, whereas the α4 TM2 alone could not. The structure, topology, and dynamics of the α4 TM2 and (α4)₂(β2)₃ TM2 in magnetically aligned phospholipid bicelles were investigated using solid-state NMR spectroscopy in the absence and presence of halothane and isoflurane, two clinically used volatile anesthetics. ²H NMR demonstrated that anesthetics increased lipid conformational heterogeneity. Such anesthetic effects on lipids became more profound in the presence of transmembrane proteins. PISEMA experiments on the selectively ¹⁵N-labeled α4 TM2 showed that the TM2 formed transmembrane helices with tilt angles of 12° ± 1° and 16° ± 1° relative to the bicelle normal for the α4 and (α4)₂(β2)₃ samples, respectively. Anesthetics changed the tilt angle of the α4 TM2 from 12° ± 1° to 14° ± 1°, but had only a subtle effect on the tilt angle of the (α4)₂(β2)₃ TM2. A small degree of wobbling motion of the helix axis occurred in the (α4)₂(β2)₃ TM2. In addition, a subset of the (α4)₂(β2)₃ TM2 exhibited counterclockwise rotational motion around the helix axis on a time scale slower than 10^- 4 s in the presence of anesthetics. Both helical tilting and rotational motions have been identified computationally as critical elements for ion channel functions. This study suggested that anesthetics could alter these motions to modulate channel functions.     

Reliable gas chromatographic–mass spectrometric method combined with a headspace autosampler for isoflurane determination in blood

Isoflurane is a nonflammable, liquid, volatile inhalation anesthetic administered by vaporizing. Although it is now commonly used, fatal cases resulting from its abuse or misuse have been reported. A combined system of a gas chromatograph–mass spectrometer and a headspace autosampler is therefore proposed for the detection of blood isoflurane. This analytic method showed sharp and well separated peaks, and revealed a good linear relationship (r=0.9994) with a function of y=7.3768x−0.0222 at concentrations between 18.7 and 299.2 μg/ml. The limits of detection and quantitation of this method were 1.2 and 4.7 μg/ml, respectively. The within- and between-run precision for spiked samples, assessed by the coefficient of variations, ranged from 1.7 to 10.0% and from 4.1 to 12.8%, respectively. The within- and between-run accuracy, assessed by errors from theoretical values, were 2.2–7.8% and 2.4–9.6%, respectively. In addition, practical sample analysis showed a good applicability, with a within-run precision rate of 5.6 to 7.7% and a between-run precision rate of 5.2–10.6%. In summary, the present work presents a valid alternative for blood isoflurane analysis.     

异氟烷单独或联合咪达唑仑对7日龄大鼠大脑caspase-3表达的影响

目的 观察异氟烷单独或联合咪达唑仑对7日龄大鼠大脑caspase-3表达的影响.方法 7日龄SD大鼠39只,随机分为对照组(C组,n=13),异氟烷组(I组,n=13)和咪达唑仑联合异氟烷组(MI组,n=13).C组:腹腔注射0.9%生理盐水10ml/kg,吸入30%O2 6 h;I组:在37℃恒温并通入1.5%异氟烷的麻醉小室内维持麻醉6h ;MI组:腹腔注射咪达唑仑9 mg/kg后,随即置于37℃恒温并通入1.5%异氟烷的麻醉小室内维持麻醉6h.麻醉结束即刻每组取3只大鼠,行动脉血气分析.麻醉结束2h 采用Realtime-PCR方法检测皮质和海马组织Caspase-3 mRNA水平的变化;并用免疫组织化学SABC法检测大脑Active caspase-3阳性神经细胞的分布情况,计数阳性细胞.结果 ⑴ I组和MI组大鼠麻醉结束即刻动脉血气分析结果与C组比较差异无统计学意义(P＞0.05).⑵ Realtime-PCR 结果显示,I组与MI组大鼠皮质和海马区Caspase-3 mRNA与对照组相比表达增多,且MI组与I组比较Caspase-3 mRNA表达增加(P<0.05).⑶免疫组化结果也显示:与对照组相比,I组与MI组大鼠在皮质、海马及丘脑部位Active caspase-3阳性神经细胞数量均明显增多 (P<0.05),而MI组与I组相比,在海马和丘脑部位Active caspase-3阳性神经细胞数量明显增多(P<0.05).结论 异氟烷麻醉能诱导脑发育高峰期大鼠重要脑区Caspase-3表达增加,联合应用咪达唑仑增加更明显;推测Caspase-3表达增加可能引起凋亡级联反应,导致神经细胞凋亡增加.