Ulinastatin Alleviates Repetitive Ketamine Exposure-Evoked Cognitive Impairment in Adolescent Mice

Abstract

Ketamine (KET) is widely used for induction and maintenance of anesthesia, and long-term use is required for treatment of depression patients. Repeated use of KET is associated with mood and memory disorders. Ulinastatin (UTI), a urinary trypsin inhibitor, has been widely undertaken as an anti-inflammatory drug and proved to have neuroprotective effects. The aim of this work was to determine whether prophylactic use of UTI could attenuate KET-induced cognitive impairment. It was found that repetitive KET anesthesia cause cognitive and emotional disorders in adolescent mice in WMZ and OFT test, while UTI pretreatment reversed the poor performance compared to the AK group, and the platform finding time and center crossing time were obviously short in the CK+UTI group ( P < 0.05 ). Our ELISA experiment results discovered that UTI pretreatment reduced the expression levels of IL-1β and IL-6 induced by CK anesthesia compared to AK ( P < 0.05 ). In addition, UTI pretreatment protected the cognitive function by restraining the expression levels of Tau protein, Tau phospho-396 protein, and Aβ protein in the CK group compared to the AK group in Western blotting ( P < 0.05 ). The results suggested that UTI could act as a new strategy to prevent the neurotoxicity of KET, revealing a significant neuroprotective effect of UTI.

Efficacy of intraoperative subanesthetic dose of ketamine/esketamine in preventing postoperative cognitive dysfunction: a systematic review and meta-analysis

“…One study reported that intravenous administration of ketamine disrupts iron homeostasis and overloads hippocampal neuronal iron in vitro and in vivo cultures, thereby contributing to the development of neurodegenerative diseases in the elderly. 40 Hong et al 41 also found that repetitive ketamine use may cause memory impairment or emotional disorders in adolescent mice.…”

Effects of ulinastatin combined with dexmedetomidine on cognitive dysfunction and emergence agitation in elderly patients who underwent total hip arthroplasty

“…As reported previously, ulinastatin has an excellent anti-inflammatory response, reduces the level of inflammatory mediators, relieves postoperative pain, and reduces the postoperative stress response. The clearance rate of the drug in elderly patients is slower than that in young patients, and because the kidney does not metabolize the drug, it can be used even if it the patient has impaired renal function[ 23 ]. In this study, we observed that the combination of ulinastatin and Dex could effectively reduce the stress response and improve the quality of life of patients after the operation.…”