NLRP3 inflammasomes are involved in the progression of postoperative cognitive dysfunction: from mechanism to treatment
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REVIEW
NLRP3 inflammasomes are involved in the progression of postoperative cognitive dysfunction: from mechanism to treatment Shuai Zhao 1
&
Fan Chen 2 & Dunwei Wang 1 & Wei Han 1 & Yuan Zhang 1 & Qiliang Yin 3
Received: 16 June 2020 / Revised: 25 August 2020 / Accepted: 3 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Postoperative cognitive dysfunction (POCD) involves patient memory and learning decline after surgery. POCD not only presents challenges for postoperative nursing and recovery but may also cause permanent brain damage for patients, including children and the aged, with vulnerable central nervous systems. Its occurrence is mainly influenced by surgical trauma, anesthetics, and the health condition of the patient. There is a lack of imaging and experimental diagnosis; therefore, patients can only be diagnosed by clinical observation, which may underestimate the morbidity, resulting in decreased treatment efficacy. Except for symptomatic support therapy, there is a relative lack of effective drugs specific for the treatment of POCD, because the precise mechanism of POCD remains to be determined. One current hypothesis is that postoperative inflammation promotes the progression of POCD. Accumulating research has indicated that overactivation of NOD-, LRR- and pyrin domain–containing protein 3 (NLRP3) inflammasomes contribute to the POCD progression, suggesting that targeting NLRP3 inflammasomes may be an effective therapy to treat POCD. In this review, we summarize recent studies and systematically describe the pathogenesis, treatment progression, and potential treatment options of targeting NLRP3 inflammasomes in POCD patients. Keywords NLRP3 inflammasomes . Postoperative cognitive dysfunction . POCD treatment
Introduction Postoperative cognitive dysfunction (POCD) refers to deterioration in cognition, which is temporally associated with surgery, and is accompanied by slowing of the brain processing speed [1]. POCD is well known by anesthesiologists as a clinical symptom is commonly seen in 25–40% of elderly patients after surgery [2]. POCD is strongly associated with Shuai Zhao and Fan Chenare equal first authors. * Yuan Zhang [email protected] * Qiliang Yin [email protected] 1
Department of Anesthesiology, First Hospital of Jilin University, 71 Xinmin Avenue, Changchun 130021, China
2
Department of Neurosurgery, University of Medicine Greifswald, Greifswald, Germany
3
Department of Oncology, First Hospital of Jilin University, Changchun, China
high mortality rates, early departure from the labor market, and new disabilities [3, 4]. Symptoms of cognitive function may last for several days, months, or years, with the possibility of further deterioration [5]. Studies support the possibility of permanent brain damage [6]. Broadly, the diagnosis of POCD requires both preoperative and postoperative neuropsychological tests to determine the magnitude of cognitive impairment [1]. The complexity of the diagnostic procedure and a poor understandi
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