Iron overload contributes to general anaesthesia-induced neurotoxicity and cognitive deficits
Jing Wu, Jianjun Yang, Yan Cao, Huihui Li, Hongting Zhao, Shuofei Yang, Kuanyu Li
Journal of Neuroinflammation April 10, 2020 DOI: 10.1186/s12974-020-01777-6 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Experimental study with in vitro and in vivo models Peer reviewed |
|---|---|
| Population | Primary hippocampal neurons, young rats, and aged mice |
| Interventions | ketamine sevoflurane deferiprone |
| Topics | Ketamine |
| Keywords | Neurotoxicity Hippocampal formation Neurodegeneration Hippocampus Sevoflurane Cognitive decline |
| Citations | 140 |
| Key findings | General anesthesia causes iron overload via NMDAR-RASD1 signaling and DMT1, leading to ferroptosis and cognitive deficits, which are attenuated by iron chelation. |
Abstract
Abstract Background Increasing evidence suggests that multiple or long-time exposure to general anaesthesia (GA) could be detrimental to cognitive development in young subjects and might also contribute to accelerated neurodegeneration in the elderly. Iron is essential for normal neuronal function, and excess iron in the brain is implicated in several neurodegenerative diseases. However, the role of iron in GA-induced neurotoxicity and cognitive deficits remains elusive.
Methods: We used the primary hippocampal neurons and rodents including young rats and aged mice to examine whether GA impacted iron metabolism and whether the impact contributed to neuronal outcomes. In addition, a pharmacological suppression of iron metabolism was performed to explore the molecular mechanism underlying GA-mediated iron overload in the brain.
Results: Our results demonstrated that GA, induced by intravenous ketamine or inhalational sevoflurane, disturbed iron homeostasis and caused iron overload in both in vitro hippocampal neuron culture and in vivo hippocampus. Interestingly, ketamine- or sevoflurane-induced cognitive deficits, very likely, resulted from a novel iron-dependent regulated cell death, ferroptosis. Notably, iron chelator deferiprone attenuated the GA-induced mitochondrial dysfunction, ferroptosis, and further cognitive deficits. Moreover, we found that GA-induced iron overload was activated by NMDAR-RASD1 signalling via DMT1 action in the brain.
Conclusion: We conclude that disturbed iron metabolism may be involved in the pathogenesis of GA-induced neurotoxicity and cognitive deficits. Our study provides new vision for consideration in GA-associated neurological disorders.