Effect of dexmedetomidine on the cognitive function of patients undergoing gastric cancer surgery by regulating the PI3K/AKT signaling pathway

Wang, Zhiyuan; Shen, Zijin; Wang, Haibin; Zhang, Lin; Dong, Rong

doi:10.3892/ol.2019.11224

Cited by 14 publications

(17 citation statements)

References 20 publications

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“…DEX can effectively reduce the level of inflammatory factors in gastric cancer patients after operation. 24 Overall, these results suggested that DEX treatment can reduce perioperative OS and inflammation. miR-10a is abnormally expressed in many cancer types, such as colorectal cancer, breast cancer, and lung cancer.…”

Section: Discussionmentioning

confidence: 82%

Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Zhou¹,

Xia

Zhang³

2022

Thorac Cardiovasc Surg

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Objective Lung cancer is a primary cause of cancer death. This study assessed the action of dexmedetomidine (DEX) on oxidative stress (OS) and microRNA 10a (miR-10a) in patients with lung cancer. Methods Patients were given 1 µg/kg DEX before anesthesia and control patients were given saline. The duration of intraoperative one-lung ventilation (OLV) and fluid intake were determined, and mean arterial pressure, heart rate and bispectral index were observed at the time of before anesthesia (T0), immediately after endotracheal intubation (T1), 1 hour after OLV (T2), and 10 minutes before the end of surgery (T3). The expressions and correlations of miR-10a, inflammation and OS levels in the serum were analyzed. The effects of DEX intervention and miR-10a level on pulmonary complications were analyzed. Results Patients with DEX intervention had lower levels of inflammation and OS during perioperative period than the controls. DEX intervention reduced miR-10a levels in patients during perioperative period. miR-10a in serum of patients with DEX intervention after surgery was positively-correlated with the concentrations of malondialdehyde, and inflammatory factors, while negatively-correlated with superoxide dismutase. The total incidence of postoperative pulmonary complications after DEX intervention was lowered. Patients with high miR-10a expression had a higher cumulative incidence of pulmonary complications than those with low miR-10a expression. Conclusion DEX can reduce postoperative OS and plasma miR-10a level in patients with lung cancer, and high expression of miR-10a predicts a high incidence of postoperative pulmonary complications.

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Section: Discussionmentioning

confidence: 82%

Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Zhou¹,

Xia

Zhang³

2022

Thorac Cardiovasc Surg

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“…Random-effects model and fixed-effect model were used to synthesize the MMSE scores and the incidence of POCD at different time points after surgery in 7 RCTs to consider the effect of DEX on postoperative cognitive function comprehensively ( 17 , 28 , 31 – 33 , 35 , 36 ). As shown in Figure 5 , in digest tract tumor patients, DEX administration was associated with higher MMSE scores at 12h (SMD = 1.10, 95%CI: 0.74, 1.45), 24h (SMD = 0.85, 95%CI: 0.59, 1.11), 48h (SMD = 0.89, 95%CI: 0.50, 1.28) and 72h (SMD = 0.75, 95%CI: 0.38, 1.11) after surgery.…”

Section: Resultsmentioning

confidence: 99%

“…DEX could resemble natural sleep, increase physiological sleep-wake cycle for ICU patients, and reduce the risk of delirium ( 16 ). DEX could also reduce the level of postoperative inflammatory factors through PI3K-Akt signaling ( 17 ), and inhibit cancer development through the upregulation of miR-185 and inactivation of SOX9-Wnt-β-catenin signaling ( 18 ). Moreover, there is growing evidence that DEX has a potential role during perioperative period for the prevention and alleviation of inflammation and immune dysfunction ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of dexmedetomidine on postoperative systemic inflammation and recovery in patients undergoing digest tract cancer surgery: A meta-analysis of randomized controlled trials

Zheng²,

Suo³

et al. 2022

Front. Oncol.

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Perioperative immune function, postoperative cognitive function and prognosis are momentous issues for patients undergoing digestive tract cancer surgery. Studies have investigated the efficacy of dexmedetomidine (DEX) administration on these issues, but the results are inconsistent. Therefore, this meta-analysis aimed to summarize all the existing evidence and draw a conclusion more accurately on these associations. Trials were located through electronic searches of the PubMed, Embase, the Cochrane Library and Web of Science databases sources (from the establishment date of databases to April 2022). Bibliographies of the retrieved articles were checked. A total of 17 RCTs involving 1619 patients were included. The results showed that DEX decreased the level of C-reactive protein (SMD = -4.26, 95%CI: -6.16, -2.36), TNF-α (SMD = -4.22, 95%CI: -5.91, -2.54) and IL-6 (SMD = -2.71, 95%CI: -4.46, -0.97), and increased the level of IL-10 (SMD = 1.74, 95%CI: 0.25, 3.24). DEX also increased CD4+ T cells (SMD = 0.55, 95%CI: 0.29, 0.82) and CD4+/CD8+ ratio (SMD = 0.62, 95%CI: 0.24, 1.01). Thus, DEX was associated with alleviation of postoperative systemic inflammatory response and immune dysfunction. Furthermore, DEX increased mini-mental state examination scores at 12h (SMD = 1.10, 95%CI: 0.74,1.45), 24h (SMD = 0.85, 95%CI: 0.59, 1.11), 48h (SMD = 0.89, 95%CI: 0.50, 1.28) and 72h (SMD = 0.75, 95%CI: 0.38, 1.11) after surgery. DEX decreased the occurrence of postoperative cognitive dysfunction (POCD) at 24h (OR = 0.22, 95%CI: 0.11, 0.46) and 72h (OR = 0.39, 95%CI: 0.22, 0.68) after surgery. DEX decreased first flatus time (SMD = -1.55, 95%CI: -2.82, -0.27) and hospital stay (SMD = -1.23, 95%CI: -1.88, -0.59). Therefore, based on perioperative immune dysfunction alleviation, DEX attenuated POCD and potential neuroinflammation, improved postoperative recovery and clinical prognosis of patients undergoing digest tract cancer surgery. Further studies are necessary to elucidate the clinical application of DEX from an immunological perspective.

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“… 148 Dexmedetomidine could effectively decrease the expression levels of postoperative serum inflammatory factors (including TNF-α, IL-6) in patients undergoing gastric cancer surgery, enhance postoperative cognitive function by regulating the PI3K-Akt signaling pathway, and promote recovery of postoperative cognitive function. 149 Its application in tumor surgery in children including in abdominal malignancy 150 shows improved postoperative analgesia with better overall analgesia compared with other agents such as fentanyl. The surgical application and consequent effects of dexmedetomidine are summarized in Figure 3 .…”

Section: Key Surgical Applicationsmentioning

confidence: 99%

Recent Advances in the Clinical Value and Potential of Dexmedetomidine

Liu¹,

Li²,

Kang³

et al. 2021

JIR

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Dexmedetomidine, a highly selective α2-adrenoceptor agonist, has sedative, anxiolytic, analgesic, sympatholytic, and opioid-sparing properties and induces a unique sedative response which shows an easy transition from sleep to wakefulness, thus allowing a patient to be cooperative and communicative when stimulated. Recent studies indicate several emerging clinical applications via different routes. We review recent data on dexmedetomidine studies, particularly exploring the varying routes of administration, experimental implications, clinical effects, and comparative advantages over other drugs. A search was conducted on the PubMed and Web of Science libraries for recent studies using different combinations of the words “dexmedetomidine”, “route of administration”, and pharmacological effect. The current routes, pharmacological effects, and application categories of dexmedetomidine are presented. It functions by stimulating pre- and post-synaptic α2-adrenoreceptors within the central nervous system, leading to hyperpolarization of noradrenergic neurons, induction of an inhibitory feedback loop, and reduction of norepinephrine secretion, causing a sympatholytic effect, in addition to its anti-inflammation, sleep induction, bowel recovery, and sore throat reduction effects. Compared with similar α2-adrenoceptor agonists, dexmedetomidine has both pharmacodynamics advantage of a significantly greater α2:α1-adrenoceptor affinity ratio and a pharmacokinetic advantage of having a significantly shorter elimination half-life. In its clinical application, dexmedetomidine has been reported to present a significant number of benefits including safe sedation for various surgical interventions, improvement of intraoperative and postoperative analgesia, sedation for compromised airways without respiratory depression, nephroprotection and stability of hypotensive hemodynamics, reduction of postoperative nausea and vomiting and postoperative shivering incidence, and decrease of intraoperative blood loss. Although the clinical application of dexmedetomidine is promising, it is still limited and further research is required to enhance understanding of its pharmacological properties, patient selection, dosage, and adverse effects.

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Effect of dexmedetomidine on the cognitive function of patients undergoing gastric cancer surgery by regulating the PI3K/AKT signaling pathway

Cited by 14 publications

References 20 publications

Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Effect of dexmedetomidine on postoperative systemic inflammation and recovery in patients undergoing digest tract cancer surgery: A meta-analysis of randomized controlled trials

Recent Advances in the Clinical Value and Potential of Dexmedetomidine

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