Blood–brain barrier disruption caused by neonatal sevoflurane-induced depends on exposure time and is reversible in mice

Sun, Zhenyu; Satomoto, Maiko; Kim, Young Ree; Makita, Koshi

doi:10.4097/kja.d.19.00029

Cited by 5 publications

(12 citation statements)

References 5 publications

(11 reference statements)

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“…Additionally, the structural changes in BBB-associated BVECs were observed in this study, resulting in a general flattening of the BVEC luminal surface and subsequent death. Similarly, Sun et al (2019) observed enlarged perivascular spaces after the sevoflurane exposure in a duration-dependent manner, in which 78% of the capillaries were destroyed after 6 h of 2% sevoflurane treatment.…”

Section: Permeability Changes Of Blood-brain Barriermentioning

confidence: 62%

“…Aside from the inflammation initiated in the CNS, sevoflurane might also mediate the permeability of the blood-brain barrier (BBB) (Sun et al, 2019) and affect peripheral factors, such as peripheral immune cells and gut microbiota (Han et al, 2021), which have been widely explored in recent years (Figure 1). Another factor, the cholinergic synaptic transmission, has also been found to be involved in the inflammation modulation (Kalb et al, 2013), in which sevoflurane might play a proinflammatory role via the suppression of cholinergic neurotransmission (Yin et al, 2019; Figure 2).…”

Section: Introductionmentioning

confidence: 99%

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The Mechanisms of Sevoflurane-Induced Neuroinflammation

Huang

Ying

Yang

et al. 2021

Front. Aging Neurosci.

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Sevoflurane is one of the most commonly used inhaled anesthetics due to its low blood gas coefficient, fast onset, low airway irritation, and aromatic smell. However, recent studies have reported that sevoflurane exposure may have deleterious effects on cognitive function. Although neuroinflammation was most widely mentioned among the established mechanisms of sevoflurane-induced cognitive dysfunction, its upstream mechanisms have yet to be illustrated. Thus, we reviewed the relevant literature and discussed the most mentioned mechanisms, including the modulation of the microglial function, blood–brain barrier (BBB) breakdown, changes in gut microbiota, and ease of cholinergic neurotransmission to help us understand the properties of sevoflurane, providing us new perspectives for the prevention of sevoflurane-induced cognitive impairment.

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Section: Permeability Changes Of Blood-brain Barriermentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

The Mechanisms of Sevoflurane-Induced Neuroinflammation

Huang

Ying

Yang

et al. 2021

Front. Aging Neurosci.

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“…Sun et al reported that 48 hours after sevoflurane exposure, the percentage of capillaries that were destroyed decreased to 29%, as compared to 47% at 24 hours after exposure. 12…”

Section: Resultsmentioning

confidence: 99%

“…A total of 121 articles were screened and out of those, 14 articles were finally included in the study (Table 1). 2,[5][6][7][8][12][13][14][15][16][17][18][19][20] Nine reports were of level II evidence and five were of level III evidence. 21 The articles included nine randomized control studies (64.3%) and five quasi-experimental studies (35.7%).…”

Section: Resultsmentioning

confidence: 99%

“…BBB structural deficits following the administration of an anesthetic agent included ultrastructural deficits, decreases in tight junctions, and decreases in BBB components such as F-actin, occludin, claudin-3, claudin-5, and VE-cadherin. 2,[5][6][7][8]12,17 Primary findings commenting on BBB function also suggest evidence of BBB permeability increases following exposure to volatile anesthetics, as characterized by IgG, NaF, fibrinogen, and Evans Blue markers. 2,[5][6][7][8]14,17 However, one study found decreased BBB permeability as captured by [14C]alpha-aminoisobutyric acid after pentobarbital or ketamine exposure.…”

Section: Primary Findings (Table 2)mentioning

confidence: 99%

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Effects of Anesthetic Agents on Blood Brain Barrier Integrity: A Systematic Review

Rizk

Plitman

Senthil

et al. 2022

Can. J. Neurol. Sci.

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Background: The blood brain barrier (BBB) is a highly selective permeable barrier that separates the blood and the central nervous system. Anesthesia is an integral part of surgery, and there is little known about the impact of anesthetics on the BBB. Therefore, it is imperative to explore reversible or modifiable variables such as anesthetic agents that influence BBB integrity. We aimed to synthesize the literature pertaining to the various effects of anesthetics on the BBB. Methods: MEDLINE, Embase, and Cochrane were searched from inception up to September 2022. Results: A total of 14 articles met inclusion into the review. The articles included nine randomized control studies (64.3%) and five quasi-experimental studies (35.7%). Twelve studies used volatile anesthetics, one study used fentanyl intravenously, and one study used pentobarbital or ketamine intraperitoneally. BBB structural deficits following the administration of an anesthetic agent included ultrastructural deficits, decreases in tight junctions, and decreases in BBB components. BBB functional deficits included permeability increases following exposure to volatile anesthetics. However, two studies found decreased permeability after fentanyl, pentobarbital, or ketamine exposure. Moreover, the impact of anesthetics on the BBB seems to be related to the duration of exposure. Notably, study findings also suggest that changes following anesthetic exposure demonstrate some reversibility over the short-term. Conclusion: Overall, our systematic review highlights interesting findings pertaining to the impact of anesthetic agents on BBB integrity in previously healthy models. These findings and mechanisms should inspire future work to aid practitioners and healthcare teams potentially better care for patients.

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