国际麻醉学与复苏杂志   2021, Issue (9): 9-9
    
组蛋白去乙酰化酶抑制剂在全身麻醉药致发育期脑神经毒性中的作用及机制
吴子怡, 薛杭, 赵平1()
1.中国医科大学附属盛京医院麻醉科
Neuroprotective effects of histone deacetylase inhibitors on anesthesia‑induced developmental neurotoxicity
 全文:
摘要:

全身麻醉药对发育期大脑具有潜在神经毒性作用。组蛋白去乙酰化酶抑制剂(histone deacetylase inhibitors, HDACIs)可通过提高细胞内组蛋白乙酰化修饰,重塑染色质结构,调节基因转录表达。大量基础研究发现,HDACIs能够减轻七氟醚、异氟醚、丙泊酚等多种全身麻醉药致发育期大脑神经损伤和认知功能障碍,有望成为治疗新靶点。文章就HDACIs在全身麻醉药致发育期脑神经毒性中的保护作用,以及调节环磷酸腺苷反应元件结合蛋白(cyclic adenosine monophosphate response element binding protein, CREB)转录因子活性、促进神经营养因子表达、降低谷氨酸兴奋性毒性、促进突触可塑性相关蛋白表达、纠正神经网络电活动紊乱等可能的机制进行归纳总结,为临床寻求相关神经保护措施提供理论依据。

关键词: 麻醉药,全身; 神经毒性; 组蛋白乙酰化; 组蛋白去乙酰化酶抑制剂; 脑
Abstract:

General anesthetics may exert potential neurotoxic effects on the developing brain. Histone deacetylase inhibitors (HDACIs) can restore or increase the level of histone acetylation, remodel chromatin structure, and regulate gene transcription and expression. A large number of basic studies have found that HDACIs display a wide range of neuroprotective effects on neurotoxicity and cognitive dysfunction caused by various general anesthetics such as sevoflurane, isoflurane, and propofol. HDACIs are a class of promising therapeutics with potential as neuroprotective agents. This review summarized basic research shreds of evidence of the protective role of HDACIs against anesthesia‑induced developmental neurotoxicity, as well as possible mechanisms including regulating cyclic adenosine monophosphate response element‑binding protein (CREB) transcription factor activity, promoting brain‑derived neurotrophic factor expression, reducing glutamate excitotoxicity, promoting synaptic plasticity‑related protein expression, and correcting abnormal neural electrical activity. This review provides a theoretical basis for the clinically reasonable use of HDACIs as neuroprotective agents against anesthesia neurotoxicity.

Key words: Anesthetics, general; Neurotoxicity; Histone acetylation; Histone deacetylase inhibitors; Cerebral protection