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Review
. 2021 Nov 26:2021:3883204.
doi: 10.1155/2021/3883204. eCollection 2021.

Research Progress on the Role of Inflammatory Mechanisms in the Development of Postoperative Cognitive Dysfunction

Affiliations
Review

Research Progress on the Role of Inflammatory Mechanisms in the Development of Postoperative Cognitive Dysfunction

Xiao-Xiang Tan et al. Biomed Res Int. .

Abstract

Postoperative cognitive dysfunction (POCD), as one of the common postoperative complications, mainly occurs after surgery and anesthesia, especially in the elderly. It refers to cognitive function changes such as decreased learning and memory ability and inability to concentrate. In severe cases, there could be personality changes and a decline in social behavior. At present, a great deal of research had been carried out on POCD, but its specific mechanism remains unclear. The release of peripheral inflammation-related factors, the degradation and destruction of the blood-brain barrier, the occurrence of central inflammation, and the neuronal apoptosis and synaptic loss could be promoted by neuroinflammation indicating that inflammatory mechanisms may play key roles in the occurrence of POCD.

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Conflict of interest statement

The authors declare that there is no conflict of interests regarding the publication of this review.

Figures

Figure 1
Figure 1
Flowchart of inflammatory mechanisms. The picture shows that after anesthesia or surgery, the activation of multiple inflammatory and proinflammatory cytokines, as well as the reduction of BBB function, promoted the transfer of inflammation-related factors from the periphery to the center. With the neuroinflammation progressing, the function of neurons in the brain continued to decline over time. And the presence of the gut-brain axis also played a key role in the transport of these cytokines. Consequently, the inflammatory mechanism of POCD was a combination of multiple factors. Abbreviation: IL-1β: interleukin-1β; IL-6: interleukin-6; IL-17: interleukin-17; TNF-α: tumor necrosis factor-α; iNOS: inducible nitric oxide synthase; COX-2: cyclooxygenase-2; PGE: prostaglandin E; MMP: matrix metalloproteinase.

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References

    1. Kotekar N., Shenkar A., Nagaraj R. Postoperative cognitive dysfunction – current preventive strategies. Clinical Interventions in Aging . 2018;13:2267–2273. doi: 10.2147/CIA.S133896. - DOI - PMC - PubMed
    1. Lin X., Chen Y., Zhang P., Chen G., Zhou Y., Yu X. The potential mechanism of postoperative cognitive dysfunction in older people. Experimental Gerontology . 2020;130, article 110791 doi: 10.1016/j.exger.2019.110791. - DOI - PubMed
    1. Moller J. T., Cluitmans P., Rasmussen L. S., et al. Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study. Lancet . 1998;351(9106):857–861. doi: 10.1016/S0140-6736(97)07382-0. - DOI - PubMed
    1. Steinmetz J., Christensen K. B., Lund T., Lohse N., Rasmussen L. S., the ISPOCD Group Long-term consequences of postoperative cognitive dysfunction. Anesthesiology . 2009;110(3):548–555. doi: 10.1097/ALN.0b013e318195b569. - DOI - PubMed
    1. Vacas S., Degos V., Feng X., Maze M. The neuroinflammatory response of postoperative cognitive decline. British Medical Bulletin . 2013;106(1):161–178. doi: 10.1093/bmb/ldt006. - DOI - PMC - PubMed

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