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Resolving postoperative neuroinflammation and cognitive decline.

Publication ,  Journal Article
Terrando, N; Eriksson, LI; Ryu, JK; Yang, T; Monaco, C; Feldmann, M; Jonsson Fagerlund, M; Charo, IF; Akassoglou, K; Maze, M
Published in: Ann Neurol
December 2011

OBJECTIVE: Cognitive decline accompanies acute illness and surgery, especially in the elderly. Surgery engages the innate immune system that launches a systemic inflammatory response that, if unchecked, can cause multiple organ dysfunction. We sought to understand the mechanisms whereby the brain is targeted by the inflammatory response and how this can be resolved. METHODS: C57BL/6J, Ccr2(RFP/+)Cx3cr1(GFP/+), Ikk(F/F) mice and LysM-Cre/Ikk(F/F) mice underwent stabilized tibial fracture operation under analgesia and general anesthesia. Separate cohorts of mice were tested for systemic and hippocampal inflammation, integrity of the blood-brain barrier (BBB), and cognition. The putative resolving effects of the cholinergic pathway on these postoperative responses were also studied. RESULTS: Peripheral surgery disrupts the BBB via release of tumor necrosis factor-alpha (TNFα), which facilitates the migration of macrophages into the hippocampus. Macrophage-specific deletion of Ikappa B kinase (IKK)β, a central coordinator of TNFα signaling through activation of nuclear factor (NF) κB, prevents BBB disruption and macrophage infiltration in the hippocampus following surgery. Activation of the α7 subtype of nicotinic acetylcholine receptors, an endogenous inflammation-resolving pathway, prevents TNFα-induced NF-κB activation, macrophage migration into the hippocampus, and cognitive decline following surgery. INTERPRETATION: These data reveal the mechanisms for bidirectional communication between the brain and immune system following aseptic trauma. Pivotal molecular mechanisms can be targeted to prevent and/or resolve postoperative neuroinflammation and cognitive decline.

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Published In

Ann Neurol

DOI

EISSN

1531-8249

Publication Date

December 2011

Volume

70

Issue

6

Start / End Page

986 / 995

Location

United States

Related Subject Headings

  • Tumor Necrosis Factor-alpha
  • Receptors, Chemokine
  • Receptors, CCR2
  • Postoperative Complications
  • Nicotinic Agonists
  • Neurology & Neurosurgery
  • NF-kappa B
  • Motor Activity
  • Mice, Transgenic
  • Mice, Inbred C57BL
 

Citation

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Terrando, N., Eriksson, L. I., Ryu, J. K., Yang, T., Monaco, C., Feldmann, M., … Maze, M. (2011). Resolving postoperative neuroinflammation and cognitive decline. Ann Neurol, 70(6), 986–995. https://doi.org/10.1002/ana.22664
Terrando, Niccolò, Lars I. Eriksson, Jae Kyu Ryu, Ting Yang, Claudia Monaco, Marc Feldmann, Malin Jonsson Fagerlund, Israel F. Charo, Katerina Akassoglou, and Mervyn Maze. “Resolving postoperative neuroinflammation and cognitive decline.Ann Neurol 70, no. 6 (December 2011): 986–95. https://doi.org/10.1002/ana.22664.
Terrando N, Eriksson LI, Ryu JK, Yang T, Monaco C, Feldmann M, et al. Resolving postoperative neuroinflammation and cognitive decline. Ann Neurol. 2011 Dec;70(6):986–95.
Terrando, Niccolò, et al. “Resolving postoperative neuroinflammation and cognitive decline.Ann Neurol, vol. 70, no. 6, Dec. 2011, pp. 986–95. Pubmed, doi:10.1002/ana.22664.
Terrando N, Eriksson LI, Ryu JK, Yang T, Monaco C, Feldmann M, Jonsson Fagerlund M, Charo IF, Akassoglou K, Maze M. Resolving postoperative neuroinflammation and cognitive decline. Ann Neurol. 2011 Dec;70(6):986–995.
Journal cover image

Published In

Ann Neurol

DOI

EISSN

1531-8249

Publication Date

December 2011

Volume

70

Issue

6

Start / End Page

986 / 995

Location

United States

Related Subject Headings

  • Tumor Necrosis Factor-alpha
  • Receptors, Chemokine
  • Receptors, CCR2
  • Postoperative Complications
  • Nicotinic Agonists
  • Neurology & Neurosurgery
  • NF-kappa B
  • Motor Activity
  • Mice, Transgenic
  • Mice, Inbred C57BL