Early postoperative systemic inflammatory response is an important determinant for adverse 2-year neurodevelopment-associated outcomes after the Norwood procedure

Li, Xiaohui; Robertson, Charlene M.T.; Yu, Xiaoyang; Cheypesh, Andriy; Dinu, Irina; Li, Jia

doi:10.1016/j.jtcvs.2013.07.079

Cited by 24 publications

(43 citation statements)

References 20 publications

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“…In cardiac surgery, Parolari et al [23] compared the inflammatory response between on-pump and off-pump surgery. A study investigating the relationship between early postoperative serum CRP levels, as a marker of systemic inflammatory response, and 2-year neurodevelopment-associated outcomes among survivors undergoing the Norwood procedure reported that both cognitive and language scores significantly and negatively correlated only with peak CRP level [26]. In orthopedic surgery, IL-6 and CRP have been shown to increase after surgery [24], with these increases occurring regardless of whether spinal anesthesia or general anesthesia is administered [25], thereby abrogating the part played by general anesthesia in the inflammatory response.…”

Section: Measurement Of Perioperative Systemic Inflammationmentioning

confidence: 99%

Cerebral protection

Riedel

Browne

Silbert

2014

Current Opinion in Anaesthesiology

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Recent research points to a central role of a neuro-inflammatory cascade in POCD, with endothelial dysfunction potentially aggravating the insult. Investigating the genomic and molecular mechanisms that underlie the intervariation in the inflammatory response to surgery, improving the identification of appropriate endothelial and inflammatory biomarkers, and developing endothelial modulatory and anti-inflammatory (prevention and resolution) strategies are key areas of future translational research. This is important as the elderly, who show increased susceptibility to this and other perioperative illness syndromes, represent an ever-increasing proportion of patients presenting for surgery.

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Section: Measurement Of Perioperative Systemic Inflammationmentioning

confidence: 99%

Cerebral protection

Riedel

Browne

Silbert

2014

Current Opinion in Anaesthesiology

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“…Increasing evidence suggests that neuroinflammation is a key contributor to PND [ 4 , 5 ]. Li et al have shown that early postoperative inflammation is important for neurodevelopment-associated outcomes 2 years after the Norwood procedure [ 6 ]. Surgical trauma leads to an increase in systemic inflammatory mediators, such as Il-β and IL-6, which have been shown to influence neuroinflammatory cascade in the brain and impair cognitive function [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

IL-17A contributes to perioperative neurocognitive disorders through blood-brain barrier disruption in aged mice

Dong

Wang

et al. 2018

J Neuroinflammation

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BackgroundPerioperative neurocognitive disorders (PND) occur frequently after surgery, especially in aged patients. Surgery-induced neuroinflammation and blood-brain barrier (BBB) dysfunction play a crucial role in the pathogenesis of PND. Interleukin-17A (IL-17A) increases after surgical stress and will be involved in BBB dysfunction. However, the effect of IL-17A on BBB function during PND remains poorly understood.MethodsMale wild-type C57BL/6J mice (15 months old) received tibial fracture surgery and fixation to establish the PND model. All the mice were injected intraperitoneally with an IL-17A-neutralizing antibody (Abs) or isotype-control Abs 30 min before tibial fracture surgery. Animal behaviour tests conducted 24 h after surgery included the contextual fear conditioning and Y maze tests. Serum and hippocampus IL-17A levels and hippocampus IL-6 and IL-1β levels were detected by ELISA. BBB function was detected by Evans blue (EB) test. Hippocampus matrix metalloproteinase-2 (MMP-2)- and MMP-9-positive cells were detected by immunohistochemistry. Hippocampus albumin, occludin, claudin-5 and IL-17A receptors were detected by Western blot. For the in vitro experiment, bEnd.3 cells were incubated with IL-17A. Cell IL-17A receptors were detected by immunofluorescence. Cellular MMP-2, MMP-9, occludin, and claudin-5 were detected by Western blot.ResultsTibial fracture surgery promoted memory impairment, increased levels of IL-17A and IL-17A receptors, inflammatory factor production and BBB dysfunction. IL-17A Abs inhibited this effect, including improving memory function, decreasing inflammatory factor production and alleviating BBB disruption, indicated by decreased tight junctions (TJs) and increased MMPs after surgery. The in vitro study suggested that recombinant IL-17A could upregulate the expression of IL-17A receptors, decrease TJs and increase the level of MMPs in bEnd.3 cells.ConclusionsOur results suggested that IL-17A-promoted BBB disruption might play an important role in the pathogenesis of PND.Electronic supplementary materialThe online version of this article (10.1186/s12974-018-1374-3) contains supplementary material, which is available to authorized users.

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“…Other studies have focused on populations with specific medical conditions. In cross-sectional investigations, CRP has been associated with poorer cognitive ability (again, particularly in the domains of memory and executive function) in preterm infants ( O'Shea et al, 2013 , Rose et al, 2016 ), infants with congenital heart problems ( Li et al, 2014 ), children with obstructive sleep apnoea ( Huang et al, 2016 ), and in adults experiencing mild traumatic brain injury ( Su et al, 2014 ) or chronic obstructive pulmonary disease ( Crisan et al, 2014 ). Inconsistent findings characterise studies examining populations that are neither exclusively older in age nor characterised by physical health conditions.…”

Section: Introductionmentioning

confidence: 99%