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Stem cell-based therapy and its potential in perioperative neurocognitive disorders

神经认知 斯科普斯 神经炎症 围手术期 医学 首脑会议 梅德林 精神科 内科学 炎症 认知 外科 政治学 自然地理学 法学 地理
作者
Penghui Wei,Min Jia,P Liu,Liying Meng,Jianjun Li,Jianjun Yang
出处
期刊:BJA: British Journal of Anaesthesia [Elsevier BV]
卷期号:131 (4): e139-e142
标识
DOI:10.1016/j.bja.2023.07.014
摘要

Editor—Perioperative brain health is becoming a significant global health concern, with rapidly growing numbers of ageing patients receiving surgical procedures. Perioperative neurocognitive disorders (PNDs) are the most common postoperative neuropsychiatric complications among these ageing individuals. 1 Mahanna-Gabrielli E. Schenning K.J. Eriksson L.I. et al. State of the clinical science of perioperative brain health: report from the American society of anesthesiologists brain health initiative summit 2018. Br J Anaesth. 2019; 123: 464-478 Abstract Full Text Full Text PDF PubMed Scopus (113) Google Scholar Peripheral inflammation induced by surgical trauma can break down the integrity of the blood–brain barrier and cause a neuroinflammatory cascade, leading to brain damage. 2 Yang T. Velagapudi R. Terrando N. Neuroinflammation after surgery: from mechanisms to therapeutic targets. Nat Immunol. 2020; 21: 1319-1326 Crossref PubMed Scopus (95) Google Scholar Anti-inflammatory strategies have been explored as preventive and therapeutic approaches for PNDs 1 Mahanna-Gabrielli E. Schenning K.J. Eriksson L.I. et al. State of the clinical science of perioperative brain health: report from the American society of anesthesiologists brain health initiative summit 2018. Br J Anaesth. 2019; 123: 464-478 Abstract Full Text Full Text PDF PubMed Scopus (113) Google Scholar ; however, potential risks include immunosuppression and impaired wound healing. 2 Yang T. Velagapudi R. Terrando N. Neuroinflammation after surgery: from mechanisms to therapeutic targets. Nat Immunol. 2020; 21: 1319-1326 Crossref PubMed Scopus (95) Google Scholar Moreover, anti-inflammatory strategies are unlikely to aid repair or regeneration of already damaged neural tissues after surgery. Owing to a lack of identified key pathogenic mechanisms and molecular pathways that modulate disease progression, traditional pharmacological interventions focusing on small molecules or inflammation-based treatment for PNDs have had limited success. 3 Eckenhoff R.G. Maze M. Xie Z. et al. Perioperative neurocognitive disorder: state of the preclinical science. Anesthesiology. 2020; 132: 55-68 Crossref PubMed Scopus (94) Google Scholar Recent failure to translate anti-inflammatory therapies from preclinical studies to clinical settings has prompted exploration of novel therapeutic strategies. 4 Takazawa T. Horiuchi T. Orihara M. et al. Prevention of postoperative cognitive dysfunction by minocycline in elderly patients after total knee arthroplasty: a randomized, double-blind, placebo-controlled clinical trial. Anesthesiology. 2023; 138: 172-183 Crossref PubMed Scopus (5) Google Scholar
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