Mechanistic insight into sevoflurane-associated developmental neurotoxicity

With the development of technology, more infants receive general anesthesia for surgery, other interventions, or clinical examination at an early stage after birth. However, whether general anesthetics can affect the function and structure of the developing infant brain remains an important, complex...

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Bibliographic Details
Published in:Cell biology and toxicology 2022-12, Vol.38 (6), p.927-943
Main Authors: Sun, Mingyang, Xie, Zhongcong, Zhang, Jiaqiang, Leng, Yufang
Format: Article
Language:English
Subjects:
Anesthesia
Anesthetics
Apoptosis
Assembly
Biochemistry
Biomedical and Life Sciences
Brain damage
Cell Biology
Cell death
Circuits
Cognitive ability
Exposure
Hippocampus
Infants
Interleukin 6
Life Sciences
Mitochondria
Neural networks
Neuroendocrine system
Neurons
Neuroplasticity
Neurotoxicity
Pharmacology/Toxicology
Phosphorylation
Plastic properties
Plasticity
Review
Sevoflurane
Sevoflurane - adverse effects
Structure-function relationships
Tau protein
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Summary:With the development of technology, more infants receive general anesthesia for surgery, other interventions, or clinical examination at an early stage after birth. However, whether general anesthetics can affect the function and structure of the developing infant brain remains an important, complex, and controversial issue. Sevoflurane is the most-used anesthetic in infants, but this drug is potentially neurotoxic. Short or single exposure to sevoflurane has a weak effect on cognitive function, while long or repeated exposure to general anesthetics may cause cognitive dysfunction. This review focuses on the mechanisms by which sevoflurane exposure during development may induce long-lasting undesirable effects on the brain. We review neural cell death, neural cell damage, impaired assembly and plasticity of neural circuits, tau phosphorylation, and neuroendocrine effects as important mechanisms for sevoflurane-induced developmental neurotoxicity. More advanced technologies and methods should be applied to determine the underlying mechanism(s) and guide prevention and treatment of sevoflurane-induced neurotoxicity. Highlights 1. We discuss the mechanisms underlying sevoflurane-induced developmental neurotoxicity from five perspectives: neural cell death, neural cell damage, assembly and plasticity of neural circuits, tau phosphorylation, and neuroendocrine effects. 2. Tau phosphorylation, IL-6, and mitochondrial dysfunction could interact with each other to cause a nerve damage loop. 3. miRNAs and lncRNAs are associated with sevoflurane-induced neurotoxicity.
ISSN:0742-2091
1573-6822
DOI:10.1007/s10565-021-09677-y