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Systemic inflammation, neuroinflammation and perioperative neurocognitive disorders

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Abstract

Perioperative neurocognitive disorder (PND) is a common disorder following anesthesia and surgery, especially in the elderly. The complex cellular and molecular processes are involved in PND, but the underlying pathogenesis of which remains inconclusive due to conflicting data. A growing body of evidence has been shown that perioperative systemic inflammation plays important roles in the development of PND. We reviewed the relevant literature retrieved by a search in the PubMed database (on July 20, 2023). The search terms used were “delirium”, “post operative cognitive dysfunction”, “perioperative neurocognitive disorder”, “inflammation” and “systemic”, alone and in combination. All articles identified were English-language, full-text papers. The ones cited in the review are those that make a substantial contribution to the knowledge about systemic inflammation and PNDs. The aim of this review is to bring together the latest evidence for the understanding of how perioperative systemic inflammation mediates neuroinflammation and brain injury, how the inflammation is regulated and how we can translate these findings into prevention and/or treatment for PND.

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Abbreviations

PND:

Perioperative neurocognitive disorders

POCD:

Postoperative neurocognitive disorder

LPS:

Lipopolysaccharide

TNF-α:

Tumor necrosis factor α

IL:

Interleukin

IFN:

Interferon

DAMP:

Damage-associated molecular pattern

HMGB1:

High mobility group box 1

BMDMs:

Bone marrow-derived monocytes

TLR:

Toll-like receptor

NF-κB:

Nuclear factor-kappa B

MCP-1:

Monocyte chemotactic protein-1

MIP:

Macrophage inflammatory protein

NVU:

Neurovascular unit

CNS:

Central nervous system

BBB:

Blood–brain barrier

CSF:

Cerebrospinal fluid

BCB:

Blood-cerebrospinal fluid barrier

CP:

Choroid plexus

CVO:

Circumventricular organ

ECs:

Endothelial cells

CCL2:

C–C motif chemokine ligand 2

NSAIDs:

Non-steroidal anti-inflammatory drugs

DEX:

Dexmedetomidine

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This work was supported partly by the National Natural Science Foundation of China (No. 82270997).

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  1. Department of Anesthesiology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China

    Shilin Jia & Wenguo Fan

  2. Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China

    Shilin Jia, Hui Yang, Fang Huang & Wenguo Fan

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SJ and WF conceived the idea of this review. SJ, HY and WF performed literature searching and drafted the manuscript. WF created the figures. WF and FH critically reviewed the manuscript. All authors read and approved the final manuscript.

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Jia, S., Yang, H., Huang, F. et al. Systemic inflammation, neuroinflammation and perioperative neurocognitive disorders. Inflamm. Res. 72, 1895–1907 (2023). https://doi.org/10.1007/s00011-023-01792-2

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