Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Anesthesiology, Hubei Province Corps Hospital of The Chinese Armed Police Force (CAPF), Wuhan, China.
Neuropharmacology. 2024 Dec 1;260:110119. doi: 10.1016/j.neuropharm.2024.110119. Epub 2024 Aug 27.
Perioperative neurocognitive disorders (PND) are intractable, indistinct, and considerably diminish the postoperative quality of life of patients. It has been proved that Peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) was involved in neurodegenerative diseases by regulating mitochondrial biogenesis. The underlying mechanisms of PGC-1α and Nod-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome in PND are not well understood. In this study, we constructed a model of laparotomy in aged mice, and then examined the cognition changes with novel object recognition tests and fear condition tests. The protein levels of PGC-1α and NLRP3 in the hippocampus were detect after surgery. Our results showed that NLRP3 and downstream PI3K/AKT pathway expressions were augmented in the hippocampus after surgery, whereas, the expressions of PGC-1α/estrogen-related receptor α (ERRα)/Unc-51-like autophagy activating kinase 1 (ULK1) pathway were diminished after surgery. In addition, we found that NLRP3 was mainly co-localized with neurons in the hippocampus, and synaptic-related proteins were reduced after surgery. At the same time, transmission electron microscopy (TEM) showed that mitochondria were impaired after surgery. Pharmacological treatment of MCC950, a selective NLRP3 inhibitor, effectively alleviated PND. Activation of PGC-1α with ZLN005 significantly ameliorated PND by enhancing the PGC-1α/ERRα/ULK1 signaling pathway, and further suppressing NLRP3 activation. As a result, we conclude that suppression of the PGC-1α/ERRα/ULK1 signaling pathway is the primary mechanism of PND which caused mitochondrial dysfunction, and activated NLRP3 inflammasome and downstream PI3K/AKT pathway, eventually improved cognitive dysfunction.
围手术期神经认知障碍(PND)是棘手的、不明确的,并且极大地降低了患者术后的生活质量。已经证明过过氧化物酶体增殖物激活受体-γ共激活因子-1α(PGC-1α)通过调节线粒体生物发生参与神经退行性疾病。PGC-1α和核苷酸结合寡聚化结构域样受体含pyrin 结构域蛋白 3(NLRP3)炎性小体在 PND 中的潜在机制尚不清楚。在本研究中,我们构建了老年小鼠剖腹手术模型,然后使用新物体识别测试和恐惧条件测试检查认知变化。手术后检测海马体中 PGC-1α 和 NLRP3 的蛋白水平。结果显示,手术后海马体中 NLRP3 和下游 PI3K/AKT 通路的表达增加,而 PGC-1α/雌激素相关受体α(ERRα)/未结合 51 样自噬激活激酶 1(ULK1)通路的表达则减少。此外,我们发现 NLRP3 主要与海马体中的神经元共定位,手术后突触相关蛋白减少。同时,透射电子显微镜(TEM)显示手术后线粒体受损。选择性 NLRP3 抑制剂 MCC950 的药物治疗可有效缓解 PND。ZLN005 激活 PGC-1α 通过增强 PGC-1α/ERRα/ULK1 信号通路,进一步抑制 NLRP3 激活,显著改善 PND。因此,我们得出结论,抑制 PGC-1α/ERRα/ULK1 信号通路是导致线粒体功能障碍的 PND 的主要机制,激活 NLRP3 炎性小体和下游 PI3K/AKT 通路,最终改善认知功能障碍。