Gut microbiota and perioperative neurocognitive disorder_West China Medical Journal

Authors：

DENG Qianyao ,  LIANG Peng ,  CHEN Chan

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIANG Peng, Email: liangpeng@wchscu.cn; CHEN Chan, Email: xychenchan@gmail.com

Keywords：

Perioperative; Neurocognitive disorder; Gut microbiota

DOI：

10.7507/1002-0179.201912016

Video：

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Perioperative neurocognitive disorder (PND) is one of the common perioperative complications in surgical patients, which has been concerned by most researchers. With the gradual increase of the elderly population in China, the complexity of individual diseases and the risk of PND is more and more severe. In recent years, a large number of studies have confirmed the close relationship between intestinal flora and neurological diseases and various studies have also proved that gut microbiota may contribute to the occurrence and development of PND. Based on the current studies, this article summarizes the effects of gut microbiota on PND, including possible mechanisms and intervention measures, providing some ideas for researchers and treatment of PND.

Citation： DENG Qianyao, LIANG Peng, CHEN Chan. Gut microbiota and perioperative neurocognitive disorder. West China Medical Journal, 2020, 35(12): 1540-1544. doi: 10.7507/1002-0179.201912016 Copy

1.	Johnson T, T Monk, Rasmussen LS, et al. Postoperative cognitive dysfunction in middle-aged patients. Anesthesiology, 2002, 96(6): 1351-1357.
2.	Monk TG, Weldon BC, Garvan CW, et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology, 2008, 108(1): 18-30.
3.	Meybohm P, Renner J, Broch O, et al. Postoperative neurocognitive dysfunction in patients undergoing cardiac surgery after remote ischemic preconditioning: a double-blind randomized controlled pilot study. PloS one, 2013, 8(5): e64743.
4.	都义日. 术后认知功能障碍的研究进展. 重庆医学, 2019, 48(6): 1021-1024.
5.	Le Y, S Liu, Peng M, et al. Aging differentially affects the loss of neuronal dendritic spine, neuroinflammation and memory impairment at rats after surgery. PloS one, 2014, 9(9): e106837.
6.	Scheperjans F, Aho V, Pereira PA, et al. Gut microbiota are related to Parkinson’s disease and clinical phenotype. Mov Disord, 2015, 30(3): 350-358.
7.	Sampson TR, Mazmanian SK. Control of brain development, function, and behavior by the microbiome. Cell Host Microbe, 2015, 17(5): 565-576.
8.	Gareau MG, Wine E, Rodrigues DM, et al. Bacterial infection causes stress-induced memory dysfunction in mice. Gut, 2011, 60(3): 307-317.
9.	Luczynski P, Whelan SO, O’Sullivan C, et al. Adult microbiota-deficient mice have distinct dendritic morphological changes: differential effects in the amygdala and hippocampus. EurJ Neurosci, 2016, 44(9): 2654-2666.
10.	Jiang XL, Gu XY, Zhou XX, et al. Intestinal dysbacteriosis mediates the reference memory deficit induced by anaesthesia/surgery in aged mice. Brain Behav Immun, 2019, 80: 605-615.
11.	Cheng D, Li H, Zhou J, et al. Chlorogenic acid relieves lead-induced cognitive impairments and hepato-renal damage via regulating the dysbiosis of the gut microbiota in mice. Food Funct, 2019, 10(2): 681-690.
12.	Heyck M, Ibarra A. Microbiota and memory: a symbiotic therapy to counter cognitive decline?. Brain Circ, 2019, 5(3): 124-129.
13.	Braniste V, Al-Asmakh M, Kowal C, et al. The gut microbiota influences blood-brain barrier permeability in mice. Sci Transl Med, 2014, 6(263): 263ra158.
14.	Marungruang N, Arévalo Sureda E, Lefrançoise A, et al. Impact of dietary induced precocious gut maturation on cecal microbiota and its relation to the blood-brain barrier during the postnatal period in rats. Neurogastroenterol Motil, 2018, 30(6): e13285.
15.	Mayer EA. Gut feelings: the emerging biology of gut-brain communication. Nat Rev Neurosci, 2011, 12(8): 453-466.
16.	Wang Y, Chen S, Xu Z, et al. GLP-1 receptor agonists downregulate aberrant GnT-Ⅲ expression in Alzheimer’s disease models through the Akt/GSK-3β/β-catenin signaling. Neuropharmacology, 2018, 131: 190-199.
17.	Meng F, Li N, Li D, et al. The presence of elevated circulating trimethylamine N-oxide exaggerates postoperative cognitive dysfunction in aged rats. Behav Brain Res, 2019, 368: 111902.
18.	Sharon G, Garg N, Debelius J, et al. Specialized metabolites from the microbiome in health and disease. Cell Metab, 2014, 20(5): 719-730.
19.	Bonaz B, Picq C, Sinniger V, et al. Vagus nerve stimulation: from epilepsy to the cholinergic anti-inflammatory pathway. Neurogastroenterol Motil, 2013, 25(3): 208-221.
20.	Wang Y, Kasper LH. The role of microbiome in central nervous system disorders. Brain Behav Immun, 2014, 38: 1-12.
21.	Hooper LV, Littman DR, Macpherson AJ. Interactions between the microbiota and the immune system. Science, 2012, 336(6086): 1268-1273.
22.	Bengmark S. Gut microbiota, immune development and function. Pharmacol Res, 2013, 69(1): 87-113.
23.	Ivanov II, Atarashi K, Manel N, et al. Induction of intestinal Th17 cells by segmented filamentous bacteria. Cell, 2009, 139(3): 485-498.
24.	Erny D, Hrabě de Angelis AL, Prinz M. Communicating systems in the body: how microbiota and microglia cooperate. Immunology, 2017, 150(1): 7-15.
25.	吴巧凤, 尹海燕, 徐广银, 等. 肠道菌群与脑科学. 世界华人消化杂志, 2017, 25(20): 1832-1839.
26.	Akbari E, Asemi Z, Daneshvar Kakhaki R, et al. Effect of probiotic supplementation on cognitive function and metabolic status in Alzheimer’s Disease: a randomized, double-blind and controlled trial. Front Aging Neurosci, 2016, 8: 256.
27.	Romo-Araiza A, Ibarra A. Prebiotics and probiotics as potential therapy for cognitive impairment. Med Hypotheses, 2019, 134: 109410.
28.	Zmora N, Zilberman-Schapira G, Suez J, et al. Personalized gut mucosal colonization resistance to empiric probiotics is associated with unique host and microbiome features. Cell, 2018, 174(6): 1388-1405.
29.	Belizário JE, Napolitano M. Human microbiomes and their roles in dysbiosis, common diseases, and novel therapeutic approaches. Front Microbiol, 2015, 6: 1050.
30.	Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis, 2015, 60(Suppl 2): S129-S134.
31.	Dani C, Coviello CC, Corsini II, et al. Lactobacillus sepsis and probiotic therapy in newborns: two new cases and literature review. AJP Rep, 2016, 6(1): e25-e29.
32.	Suez J, Zmora N, Zilberman-Schapira G, et al. Post-antibiotic gut mucosal microbiome reconstitution is impaired by probiotics and improved by autologous FMT. Cell, 2018, 174(6): 1406-1423.e16.
33.	Sun J, Xu J, Ling Y, et al. Fecal microbiota transplantation alleviated Alzheimer’s disease-like pathogenesis in APP/PS1 transgenic mice. Transl Psychiatry, 2019, 9(1): 189.
34.	Zhan G, Hua D, Huang N, et al. Anesthesia and surgery induce cognitive dysfunction in elderly male mice: the role of gut microbiota. Aging (Albany NY), 2019, 11(6): 1778-1790.
35.	Barrientos RM, Thompson VM, Arnold TH, et al. The role of hepatic and splenic macrophages in E.coli-induced memory impairments in aged rats. Brain Behav Immun, 2015, 43: 60-67.
36.	Liang P, Shan W, Zuo Z. Perioperative use of cefazolin ameliorates postoperative cognitive dysfunction but induces gut inflammation in mice. J Neuroinflammation, 2018, 15(1): 235.
37.	Hovens IB, van Leeuwen BL, Nyakas C, et al. Prior infection exacerbates postoperative cognitive dysfunction in aged rats. AmJ Physiol Regul Integr Comp Physiol, 2015, 309(2): R148-R159.
38.	Kammer J, Ziesing S, Davila LA, et al. Neurological manifestations of mycoplasma pneumoniae infection in hospitalized children and their long-term follow-up. Neuropediatrics, 2016, 47(5): 308-317.
39.	Severyn CJ, Bhatt AS. With probiotics, resistance is not always futile. Cell Host Microbe, 2018, 24(3): 334-336.

1. Johnson T, T Monk, Rasmussen LS, et al. Postoperative cognitive dysfunction in middle-aged patients. Anesthesiology, 2002, 96(6): 1351-1357.
2. Monk TG, Weldon BC, Garvan CW, et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology, 2008, 108(1): 18-30.
3. Meybohm P, Renner J, Broch O, et al. Postoperative neurocognitive dysfunction in patients undergoing cardiac surgery after remote ischemic preconditioning: a double-blind randomized controlled pilot study. PloS one, 2013, 8(5): e64743.
4. 都义日. 术后认知功能障碍的研究进展. 重庆医学, 2019, 48(6): 1021-1024.
5. Le Y, S Liu, Peng M, et al. Aging differentially affects the loss of neuronal dendritic spine, neuroinflammation and memory impairment at rats after surgery. PloS one, 2014, 9(9): e106837.
6. Scheperjans F, Aho V, Pereira PA, et al. Gut microbiota are related to Parkinson’s disease and clinical phenotype. Mov Disord, 2015, 30(3): 350-358.
7. Sampson TR, Mazmanian SK. Control of brain development, function, and behavior by the microbiome. Cell Host Microbe, 2015, 17(5): 565-576.
8. Gareau MG, Wine E, Rodrigues DM, et al. Bacterial infection causes stress-induced memory dysfunction in mice. Gut, 2011, 60(3): 307-317.
9. Luczynski P, Whelan SO, O’Sullivan C, et al. Adult microbiota-deficient mice have distinct dendritic morphological changes: differential effects in the amygdala and hippocampus. EurJ Neurosci, 2016, 44(9): 2654-2666.
10. Jiang XL, Gu XY, Zhou XX, et al. Intestinal dysbacteriosis mediates the reference memory deficit induced by anaesthesia/surgery in aged mice. Brain Behav Immun, 2019, 80: 605-615.
11. Cheng D, Li H, Zhou J, et al. Chlorogenic acid relieves lead-induced cognitive impairments and hepato-renal damage via regulating the dysbiosis of the gut microbiota in mice. Food Funct, 2019, 10(2): 681-690.
12. Heyck M, Ibarra A. Microbiota and memory: a symbiotic therapy to counter cognitive decline?. Brain Circ, 2019, 5(3): 124-129.
13. Braniste V, Al-Asmakh M, Kowal C, et al. The gut microbiota influences blood-brain barrier permeability in mice. Sci Transl Med, 2014, 6(263): 263ra158.
14. Marungruang N, Arévalo Sureda E, Lefrançoise A, et al. Impact of dietary induced precocious gut maturation on cecal microbiota and its relation to the blood-brain barrier during the postnatal period in rats. Neurogastroenterol Motil, 2018, 30(6): e13285.
15. Mayer EA. Gut feelings: the emerging biology of gut-brain communication. Nat Rev Neurosci, 2011, 12(8): 453-466.
16. Wang Y, Chen S, Xu Z, et al. GLP-1 receptor agonists downregulate aberrant GnT-Ⅲ expression in Alzheimer’s disease models through the Akt/GSK-3β/β-catenin signaling. Neuropharmacology, 2018, 131: 190-199.
17. Meng F, Li N, Li D, et al. The presence of elevated circulating trimethylamine N-oxide exaggerates postoperative cognitive dysfunction in aged rats. Behav Brain Res, 2019, 368: 111902.
18. Sharon G, Garg N, Debelius J, et al. Specialized metabolites from the microbiome in health and disease. Cell Metab, 2014, 20(5): 719-730.
19. Bonaz B, Picq C, Sinniger V, et al. Vagus nerve stimulation: from epilepsy to the cholinergic anti-inflammatory pathway. Neurogastroenterol Motil, 2013, 25(3): 208-221.
20. Wang Y, Kasper LH. The role of microbiome in central nervous system disorders. Brain Behav Immun, 2014, 38: 1-12.
21. Hooper LV, Littman DR, Macpherson AJ. Interactions between the microbiota and the immune system. Science, 2012, 336(6086): 1268-1273.
22. Bengmark S. Gut microbiota, immune development and function. Pharmacol Res, 2013, 69(1): 87-113.
23. Ivanov II, Atarashi K, Manel N, et al. Induction of intestinal Th17 cells by segmented filamentous bacteria. Cell, 2009, 139(3): 485-498.
24. Erny D, Hrabě de Angelis AL, Prinz M. Communicating systems in the body: how microbiota and microglia cooperate. Immunology, 2017, 150(1): 7-15.
25. 吴巧凤, 尹海燕, 徐广银, 等. 肠道菌群与脑科学. 世界华人消化杂志, 2017, 25(20): 1832-1839.
26. Akbari E, Asemi Z, Daneshvar Kakhaki R, et al. Effect of probiotic supplementation on cognitive function and metabolic status in Alzheimer’s Disease: a randomized, double-blind and controlled trial. Front Aging Neurosci, 2016, 8: 256.
27. Romo-Araiza A, Ibarra A. Prebiotics and probiotics as potential therapy for cognitive impairment. Med Hypotheses, 2019, 134: 109410.
28. Zmora N, Zilberman-Schapira G, Suez J, et al. Personalized gut mucosal colonization resistance to empiric probiotics is associated with unique host and microbiome features. Cell, 2018, 174(6): 1388-1405.
29. Belizário JE, Napolitano M. Human microbiomes and their roles in dysbiosis, common diseases, and novel therapeutic approaches. Front Microbiol, 2015, 6: 1050.
30. Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis, 2015, 60(Suppl 2): S129-S134.
31. Dani C, Coviello CC, Corsini II, et al. Lactobacillus sepsis and probiotic therapy in newborns: two new cases and literature review. AJP Rep, 2016, 6(1): e25-e29.
32. Suez J, Zmora N, Zilberman-Schapira G, et al. Post-antibiotic gut mucosal microbiome reconstitution is impaired by probiotics and improved by autologous FMT. Cell, 2018, 174(6): 1406-1423.e16.
33. Sun J, Xu J, Ling Y, et al. Fecal microbiota transplantation alleviated Alzheimer’s disease-like pathogenesis in APP/PS1 transgenic mice. Transl Psychiatry, 2019, 9(1): 189.
34. Zhan G, Hua D, Huang N, et al. Anesthesia and surgery induce cognitive dysfunction in elderly male mice: the role of gut microbiota. Aging (Albany NY), 2019, 11(6): 1778-1790.
35. Barrientos RM, Thompson VM, Arnold TH, et al. The role of hepatic and splenic macrophages in E.coli-induced memory impairments in aged rats. Brain Behav Immun, 2015, 43: 60-67.
36. Liang P, Shan W, Zuo Z. Perioperative use of cefazolin ameliorates postoperative cognitive dysfunction but induces gut inflammation in mice. J Neuroinflammation, 2018, 15(1): 235.
37. Hovens IB, van Leeuwen BL, Nyakas C, et al. Prior infection exacerbates postoperative cognitive dysfunction in aged rats. AmJ Physiol Regul Integr Comp Physiol, 2015, 309(2): R148-R159.
38. Kammer J, Ziesing S, Davila LA, et al. Neurological manifestations of mycoplasma pneumoniae infection in hospitalized children and their long-term follow-up. Neuropediatrics, 2016, 47(5): 308-317.
39. Severyn CJ, Bhatt AS. With probiotics, resistance is not always futile. Cell Host Microbe, 2018, 24(3): 334-336.

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