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Effects of surgery and propofol-remifentanil total intravenous anesthesia on cerebrospinal fluid biomarkers of inflammation, Alzheimer's disease, and neuronal injury in humans : A cohort study

Pikwer, Andreas LU ; Castegren, Markus; Namdar, Sijal; Blennow, Kaj LU ; Zetterberg, Henrik LU and Mattsson, Niklas LU (2017) In Journal of Neuroinflammation 14(1).
Abstract

Background: Surgery and anesthesia have been linked to postoperative cognitive disturbance and increased risk of Alzheimer's disease. It is not clear by which mechanisms this increased risk for cognitive disease is mediated. Further, amyloid β production has been suggested to depend on the sleep-wake cycle and neuronal activity. The aim of the present study was to examine if cerebrospinal fluid (CSF) concentrations of a number of biomarkers for Alzheimer's disease-related processes, including amyloid β, neuronal injury, and inflammation, changed over time during intravenous anesthesia in surgical patients. Methods: We included patients scheduled for hysterectomy via laparotomy during general anesthesia with intravenous propofol and... (More)

Background: Surgery and anesthesia have been linked to postoperative cognitive disturbance and increased risk of Alzheimer's disease. It is not clear by which mechanisms this increased risk for cognitive disease is mediated. Further, amyloid β production has been suggested to depend on the sleep-wake cycle and neuronal activity. The aim of the present study was to examine if cerebrospinal fluid (CSF) concentrations of a number of biomarkers for Alzheimer's disease-related processes, including amyloid β, neuronal injury, and inflammation, changed over time during intravenous anesthesia in surgical patients. Methods: We included patients scheduled for hysterectomy via laparotomy during general anesthesia with intravenous propofol and remifentanil. CSF samples were obtained before, during, and after surgery (5h after induction) and tested for 27 biomarkers. Changes over time were tested with linear mixed effects models. Results: A total of 22 patients, all females, were included. The mean age was 50years (±9 SD). The mean duration of the anesthesia was 145min (±40 SD). Interleukin (IL)-6, IL-8, monocyte chemoattractant protein 1, and vascular endothelial growth factor A increased over time. IL-15 and IL-7 decreased slightly over time. Macrophage inflammatory protein 1β and placental growth factor also changed significantly. There were no significant effects on amyloid β (Aβ) or tau biomarkers. Conclusions: Surgery and general anesthesia with intravenous propofol and remifentanil induce, during and in the short term after the procedure, a neuroinflammatory response which is dominated by monocyte attractants, without biomarker signs of the effects on Alzheimer's disease pathology or neuronal injury.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anesthesia, Biomarkers, Cerebrospinal fluid, Inflammation, Surgery
in
Journal of Neuroinflammation
volume
14
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85030211279
  • wos:000412016400001
ISSN
1742-2094
DOI
10.1186/s12974-017-0950-2
language
English
LU publication?
yes
id
285a741b-7b3a-4cb9-845e-e9c8b17e2ab9
date added to LUP
2017-11-28 12:32:54
date last changed
2018-01-16 13:26:43
@article{285a741b-7b3a-4cb9-845e-e9c8b17e2ab9,
  abstract     = {<p>Background: Surgery and anesthesia have been linked to postoperative cognitive disturbance and increased risk of Alzheimer's disease. It is not clear by which mechanisms this increased risk for cognitive disease is mediated. Further, amyloid β production has been suggested to depend on the sleep-wake cycle and neuronal activity. The aim of the present study was to examine if cerebrospinal fluid (CSF) concentrations of a number of biomarkers for Alzheimer's disease-related processes, including amyloid β, neuronal injury, and inflammation, changed over time during intravenous anesthesia in surgical patients. Methods: We included patients scheduled for hysterectomy via laparotomy during general anesthesia with intravenous propofol and remifentanil. CSF samples were obtained before, during, and after surgery (5h after induction) and tested for 27 biomarkers. Changes over time were tested with linear mixed effects models. Results: A total of 22 patients, all females, were included. The mean age was 50years (±9 SD). The mean duration of the anesthesia was 145min (±40 SD). Interleukin (IL)-6, IL-8, monocyte chemoattractant protein 1, and vascular endothelial growth factor A increased over time. IL-15 and IL-7 decreased slightly over time. Macrophage inflammatory protein 1β and placental growth factor also changed significantly. There were no significant effects on amyloid β (Aβ) or tau biomarkers. Conclusions: Surgery and general anesthesia with intravenous propofol and remifentanil induce, during and in the short term after the procedure, a neuroinflammatory response which is dominated by monocyte attractants, without biomarker signs of the effects on Alzheimer's disease pathology or neuronal injury.</p>},
  articleno    = {193},
  author       = {Pikwer, Andreas and Castegren, Markus and Namdar, Sijal and Blennow, Kaj and Zetterberg, Henrik and Mattsson, Niklas},
  issn         = {1742-2094},
  keyword      = {Anesthesia,Biomarkers,Cerebrospinal fluid,Inflammation,Surgery},
  language     = {eng},
  month        = {09},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Journal of Neuroinflammation},
  title        = {Effects of surgery and propofol-remifentanil total intravenous anesthesia on cerebrospinal fluid biomarkers of inflammation, Alzheimer's disease, and neuronal injury in humans : A cohort study},
  url          = {http://dx.doi.org/10.1186/s12974-017-0950-2},
  volume       = {14},
  year         = {2017},
}