urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2021-20-2-95-100urmj-783Research ArticleОБЗОР ЛИТЕРАТУРЫБиологические маркеры как предикторы развития послеоперационных нейрокогнитивных расстройствBiological markers as predictors of postoperative neurocognitive disordershttps://orcid.org/0000-0002-4024-7820БасенкоО. М.BasenkoО. М.

Басенко Ольга Михайловна

 г. Челябинск

Olga M. BasenkoChelyabinsk

basenkoolga@mail.ruhttps://orcid.org/0000-0001-6502-1513АстаховА. А.AstakhovА. А.

Астахов Алексей Арнольдович, д.м.н

 г. Челябинск

Alexey A. Astakhov

 Chelyabinsk

aaastakhov@gmail.comСиницкийА. И.SinitzkyА. I.

Синицкий Антон Иванович, д.м.н

 г. Челябинск

Anton I. Sinitzky

 Chelyabinsk

sinitskiyai@ya.ruhttps://orcid.org/0000-0001-8482-6392ВорошинД. Г.VoroshinD. G.

Ворошин Дмитрий Геннадьевич, к.м.н

 г. Челябинск

Dmitriy G. Voroshin

Chelyabinsk

d.voroshin@gmail.comГБУЗ «Челябинский областной клинический центр онкологии и ядерной медицины»; ФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияChelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine; South Ural State Medical UniversityRussian FederationФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияSouth Ural State Medical UniversityRussian FederationГБУЗ «Челябинский областной клинический центр онкологии и ядерной медицины»РоссияChelyabinsk Regional Clinical Center of Oncology and Nuclear MedicineRussian Federation20211907202120295100Copyright © Басенко О.М., Астахов А.А., Синицкий А.И., Ворошин Д.Г., 20212021Басенко О.М., Астахов А.А., Синицкий А.И., Ворошин Д.Г.Basenko О.М., Astakhov А.А., Sinitzky А.I., Voroshin D.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/783Введение

Введение. В литературном обзоре представлены новые определения понятий послеоперационных когнитивных дисфункций с учетом новой номенклатуры в соответствии с DSM-5 (Diagnostic and Statistical Manual of mental disorders, fifth edition – Диагностическое и статистическое руководство о психических расстройствах, 5-е издание) и временем их манифестации, в зависимости от давности выполненного хирургического вмешательства. Обозначены основные обсуждаемые тактические моменты ведения анестезиологом пациентов, относящихся к группе риска по снижению когнитивного потенциала в послеоперационном периоде. Сделан акцент на основных биологических маркерах, предикторах развития когнитивных послеоперационных расстройств.

Цель исследования — выделить основные обсуждаемые тактические моменты ведения анестезиологом пациентов, обозначить более перспективные аспекты биохимической лабораторной диагностики послеоперационных нейрокогнитивных расстройств.

Материалы и методы

Материалы и методы. Анализ и систематизация данных произведены на основе научных публикаций в общей базе данных PubMed за период 2016-2020 гг.

Результаты и обсуждение

Результаты и обсуждение. Приведены достижения новых исследований в области поиска биологических мишеней, маркеров и предикторов развития послеоперационных нейрокогнитивных расстройств на молекулярном уровне, позволяющих более точно воздействовать на патогенетические механизмы развития нейронального воспаления и оценивать потенциальный ущерб, нанесенный когнитивному статусу пациента. В работе обозначены более перспективные аспекты биохимической лабораторной диагностики с помощью маркеров ответа врожденного иммунитета на хирургическую травму и развивающегося вследствие этого системного воспаления.

Заключение

Заключение. Выявлены проблемы, требующие последующего изучения для поиска патогенетической терапии послеоперационных нейрокогнитивных расстройств.

Introduction

Introduction. The literature review presents new definitions of the concepts of postoperative cognitive dysfunctions, taking into account the new nomenclature according to DSM-5 (Diagnostic and Statistical Manual of mental disorders, fifth edition — Diagnostic and statistical manual of mental disorders, 5th edition) and time of their manifestations, depending on the age of the surgical intervention performed. The main discussed tactical aspects of the anesthesiologist's management of patients at risk of cognitive impairment in the postoperative period are outlined. The main biological markers, predictors of the development of cognitive postoperative disorders, are emphasized.

Aim of the study

Aim of the study: to highlight the main discussed tactical points of anesthesiologist's management of patients, to outline more promising aspects of biochemical laboratory diagnosis of postoperative neurocognitive disorders.

Materials and methods

Materials and methods. The data were analyzed and systematized based on scientific publications in the general PubMed database for the period 2016-2020.

Results and discussion

Results and discussion. New research advances in the search for biological targets, markers and predictors of postoperative neurocognitive disorders at the molecular level are presented, allowing a more precise impact on the pathogenetic mechanisms of neuronal inflammation and assessment of the potential damage to the cognitive status of the patient. The paper outlines more promising aspects of biochemical laboratory diagnosis using markers of innate immunity response to surgical trauma and the resulting systemic inflammation.

Conclusion

Conclusion. Problems requiring further study to find pathogenetic therapy for postoperative neurocognitive disorders have been identified.

послеоперационные нейрокогнитивные расстройстваноменклатурабиологиче ские маркерыинфламмасомыцитокинpostoperative neurocognitive disordersnomenclaturebiological markersinflammasomescytokinesReferencesOh And The Nomenclature Consensus Working Group Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery-20181 / L. Evered, B. Silbert, DS Knopman [et al.] // J Alzheimers Dis JAD. – 2018. – Vol. 129. – Р. 872–9 (303258006).Oh And The Nomenclature Consensus Working Group Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery-20181 / L. Evered, B. Silbert, DS Knopman [et al.] // J Alzheimers Dis JAD. – 2018. – Vol. 129. – Р. 872–9 (303258006).The potential mechanism of postoperative cognitive dysfunction in older people / X. Lin, Y. Chen, P. Zhang [et al.] // Exp Gerontol. – 2020. – Vol. 130. – Р. 110791.The potential mechanism of postoperative cognitive dysfunction in older people / X. Lin, Y. Chen, P. Zhang [et al.] // Exp Gerontol. – 2020. – Vol. 130. – Р. 110791.Leslie, M. The post-op brain // Science. – 2017. – Vol. 356. – Р. 898–900.Leslie, M. The post-op brain // Science. – 2017. – Vol. 356. – Р. 898–900.Bedford, P. D. Adverse cerebral effects of anaesthesia on old people // Lancet Lond Engl. – 1955. – Vol. 269. – Р. 259–63.Bedford, P. D. Adverse cerebral effects of anaesthesia on old people // Lancet Lond Engl. – 1955. – Vol. 269. – Р. 259–63.ISPOCD2 (International Study of Postoperative Cognitive Dysfunction) Investigators. Does anesthesia cause postoperative cognitive dysfunction? A randomized study of regional versus general anesthesia in 438 elderly patients / L. S. Rasmussen, T. Johnson, H. M. Kuipers [et al.] // Acta Anaesthesiologica Scandinavica. – 2003. – Vol. 47 (3). – Р. 260-266.ISPOCD2 (International Study of Postoperative Cognitive Dysfunction) Investigators. Does anesthesia cause postoperative cognitive dysfunction? A randomized study of regional versus general anesthesia in 438 elderly patients / L. S. Rasmussen, T. Johnson, H. M. Kuipers [et al.] // Acta Anaesthesiologica Scandinavica. – 2003. – Vol. 47 (3). – Р. 260-266.The Nomenclature Consensus Working Group. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018 / L. Evered, B. Silbert, D. S. Knopman [et al.] // British Journal of Anaesthesia. – 2018. – Vol. 121 (5). – Р. e1005-e1012. – Doi: 10.1016/j.bja.2017.11.087The Nomenclature Consensus Working Group. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018 / L. Evered, B. Silbert, D. S. Knopman [et al.] // British Journal of An- aesthesia. – 2018. – Vol. 121 (5). – Р. e1005-e1012. – Doi: 10.1016/j.bja.2017.11.087Best practices for postoperative brain health: recommendations from the fifth international perioperative neurotoxicity working group / M. Berger, K. J. Schenning, C. H. Brown [et al.] // Anesth Analg. – 2018. – Vol. 127. – Р. 1406–13.Best practices for postoperative brain health: recommendations from the fifth international perioperative neurotoxicity working group / M. Berger, K. J. Schenning, C. H. Brown [et al.] // Anesth Analg. – 2018. – Vol. 127. – Р. 1406–13.Alzheimer’s disease facts and figures / Alzheimer’s Association // Alzheimers Dement J. – 2020. – Vol. 16. – Р. 391–440.Alzheimer’s disease facts and figures / Alzheimer’s Association // Alzheimers Dement J. – 2020. – Vol. 16. – Р. 391–440.Length of hospital stay and dementia: a systematic review of observational studies / T. Möllers, H. Stocker, W. Wei [et al.] // Int J Geriatr Psychiatry. – 2018. – Vol. 34. – Р. 8–21.Length of hospital stay and dementia: a systematic review of observational studies / T. Möllers, H. Stocker, W. Wei [et al.] // Int J Geriatr Psychiatry. – 2018. – Vol. 34. – Р. 8–21.Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery / D. Miller, S. R. Lewis, M. W. Pritchard [et al.] // Cochrane Database Syst Rev. – 2018. – Vol. 8. – Р. CD012317.Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery / D. Miller, S. R. Lewis, M. W. Pritchard [et al.] // Cochrane Database Syst Rev. – 2018. – Vol. 8. – Р. CD012317.Jillian, C. Anesthesiology and cognitive impairment: a narrative review of current clinical literature / C. Jillian, R. Belrose, R. Noppens // BMC Anesthesiology. – 2019. – Vol. 19 – Р. 241.Jillian, C. Anesthesiology and cognitive impairment: a narrative review of current clinical literature / C. Jillian, R. Belrose, R. Noppens // BMC Anesthesiology. – 2019. – Vol. 19 – Р. 241.General anesthesia exposure and risk of dementia: a meta-analysis of epidemiological studies / J. Jiang, Y. Dong, W. Huang, M. Bao // Oncotarget. – 2017. – Vol. 8. – Р. 59628–37.General anesthesia exposure and risk of dementia: a meta-analysis of epidemiological studies / J. Jiang, Y. Dong, W. Huang, M. Bao // Oncotarget. – 2017. – Vol. 8. – Р. 59628–37.Exposure to general anesthesia and risk of dementia: a Nationwide population-based cohort study / C. T. Kim, W. Myung, M. Lewis [et al.] // J Alzheimers Dis JAD. – 2018. – Vol. 63. – Р. 395–405.Exposure to general anesthesia and risk of dementia: a Nationwide population-based cohort study / C. T. Kim, W. Myung, M. Lewis [et al.] // J Alzheimers Dis JAD. – 2018. – Vol. 63. – Р. 395–405.Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology: A Systematic Review and Meta analysis / C. Bridel, N. Wessel van Wieringen, H. Zetterberg [et al.] // JAMA Neurol. – 2019. – Vol. 76 (9). – Р. 1035-1048EE.Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology: A Systematic Review and Meta analysis / C. Bridel, N. Wessel van Wieringen, H. Zetterberg [et al.] // JAMA Neurol. – 2019. – Vol. 76 (9). – Р. 1035-1048EE.Cognitive decline in the elderly after surgery and anaesthesia: results from the Oxford project to investigate memory and ageing (OPTIMA) cohort / D. Patel, A. D. Lunn, A. D. Smith [et al.] // Anaesthesia. – 2016. – Vol. 71. – Р. 1144–52.Cognitive decline in the elderly after surgery and anaesthesia: results from the Oxford project to investigate memory and ageing (OPTIMA) cohort / D. Patel, A. D. Lunn, A. D. Smith [et al.] // Anaesthesia. – 2016. – Vol. 71. – Р. 1144–52.Cerebrospinal fluid biomarker for Alzheimer disease predicts postoperative cognitive dysfunction / L. Evered, B. Silbert, DA Scott [et al.] // Anesthesiology. – 2016. – Vol. 124 – Р. 353–361.Cerebrospinal fluid biomarker for Alzheimer disease predicts postoperative cognitive dysfunction / L. Evered, B. Silbert, DA Scott [et al.] // Anesthesiology. – 2016. – Vol. 124 – Р. 353–361.Association of changes in plasma neurofilament light and tau levels with anesthesia and surgery: results from the CAPACITY and ARCADIAN studies / L. Evered, D. Scott, H. Zetterberg, K. Blennow // JAMA Neurol. – 2018. – Vol. 75. – Р. 542–547.Association of changes in plasma neurofilament light and tau levels with anesthesia and surgery: results from the CAPACITY and ARCADIAN studies / L. Evered, D. Scott, H. Zetterberg, K. Blennow // JAMA Neurol. – 2018. – Vol. 75. – Р. 542–547.Saxon, S. Restoring order to postooperative neurocognitive disorders / S. Saxon, M. Maze // JAMA Neurol. – 2018. – Vol. 75. – Р. 535–536.Saxon, S. Restoring order to postooperative neurocognitive disorders / S. Saxon, M. Maze // JAMA Neurol. – 2018. – Vol. 75. – Р. 535–536.Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology: A Systematic Review and Meta analysis / C. Bridel, N. Wessel van Wieringen, H. Zetterberg [et al.] // JAMA Neurol. – 2019. – Vol. 76 (9). – Р. 1035-1048EE.Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology: A Systematic Review and Meta analysis / C. Bridel, N. Wessel van Wieringen, H. Zetterberg [et al.] // JAMA Neurol. – 2019. – Vol. 76 (9). – Р. 1035-1048EE.Zetterberg Neurofilament light chain as a biomarker in neurological disorders / L. Gaetani, K. Blennow, P. Calabresi [et al.] // Neurol Neurosurg Psychiatry. – 2019. – Vol. 90 (8). – Р. 870-881.Zetterberg Neurofilament light chain as a biomarker in neurological disorders / L. Gaetani, K. Blennow, P. Calabresi [et al.] // Neurol Neurosurg Psychiatry. – 2019. – Vol. 90 (8). – Р. 870-881.Serum neurofilament light protein predicts clinical outcome in traumatic brain injury / P. Shahim, M. Gren, V. Liman [et al.] // Sci Rep. – 2016. – Vol. 6. – Р. 36791.Serum neurofilament light protein predicts clinical outcome in traumatic brain injury / P. Shahim, M. Gren, V. Liman [et al.] // Sci Rep. – 2016. – Vol. 6. – Р. 36791.Serum neurofilament light as a biomarker for mild traumatic brain injury in contact sports / P. Shahim, H. Zetterberg, Y. Tegner, K. Blennow // Neurology. – 2017. – Vol. 88 (19). – Р. 1788-1794.Serum neurofilament light as a biomarker for mild traumatic brain injury in contact sports / P. Shahim, H. Zetterberg, Y. Tegner, K. Blennow // Neurology. – 2017. – Vol. 88 (19). – Р. 1788-1794.High-sensitivity assays for troponin in patients with cardiac disease / D. Westermann, J. T. Neumann, N. A. Sörensen, S. Blankenberg // Nat Rev Cardiol. – 2017. – Vol. 14 (8). – Р. 472-483.High-sensitivity assays for troponin in patients with cardiac disease / D. Westermann, J. T. Neumann, N. A. Sörensen, S. Blankenberg // Nat Rev Cardiol. – 2017. – Vol. 14 (8). – Р. 472-483.The Potential Role of the NLRP3 Inflammasome Activation as a Link Between Mitochondria ROS Generation and Neuroinflammation in Postoperative Cognitive Dysfunction / P. Wei, F. Yang, Q. Zheng, [et al.] // Front Cell Neurosci. – 2019. – Vol. 13. – Р. 73.The Potential Role of the NLRP3 Inflammasome Activation as a Link Between Mitochondria ROS Generation and Neuroinflammation in Postoperative Cognitive Dysfunction / P. Wei, F. Yang, Q. Zheng, [et al.] // Front Cell Neurosci. – 2019. – Vol. 13. – Р. 73.Evavold, C. L. How inflammasomes inform adaptive Immunity / C. L. Evavold, J. C. Kagan // J. Mol. Biol. – 2018. – Vol. 430, № 2. – P. 217–237.Evavold, C. L. How inflammasomes inform adaptive Immunity / C. L. Evavold, J. C. Kagan // J. Mol. Bi- ol. – 2018. – Vol. 430, № 2. – P. 217–237.Shuai Optimal pathways for the assembly of the Apaf-1 cytochrome c complex into apoptosome / H. Qi, Y. Jiang, Z. Yin, [et al.] // Phys. Chem. Chem. Phys. – 2018. – Vol. 20, № 3. – P. 1964–1973.Shuai Optimal pathways for the assembly of the Apaf-1 cytochrome c complex into apoptosome / H. Qi, Y. Jiang, Z. Yin, [et al.] // Phys. Chem. Chem. Phys. – 2018. – Vol. 20, № 3. – P. 1964–1973.Bratton The Apaf-1 apoptosome induces formation of caspase-9 homoand heterodimers with distinct activities / Ch.Ch. Wu, S. Lee, S. Malladi [et al.] // Nat. Commun. – 2016. – Vol. 7. – P. 1–14.Bratton The Apaf-1 apoptosome induces formation of caspase-9 homo- and heterodimers with distinct activities / Ch.- Ch. Wu, S. Lee, S. Malladi [et al.] // Nat. Commun. – 2016. – Vol. 7. – P. 1–14.Molecular basis of caspase-1 polymerization and its inhibition by a new capping mechanism / A. Lu, Y. Li, F. I. Schmidt [et al.] // Nat. Struct. Mol. Biol. – 2016. – Vol. 23, № 5. – P. 416–425. – Doi: 10.1038/nsmb.3199.Molecular basis of caspase-1 polymerization and its inhibition by a new capping mechanism / A. Lu, Y. Li, F. I. Schmidt [et al.] // Nat. Struct. Mol. Biol. – 2016. – Vol. 23, № 5. – P. 416–425. – Doi: 10.1038/nsmb.3199.Whole blood assay as a model for in vitro evaluation of inflammasome activation and subsequent caspase-mediated interleukin-1 beta release / T. A. T. Tran, H. W. Grievink, K. Lipinska [et al.] // PLoS ONE. – 2019. – Vol. 14, № 4. – P. 1–16.Whole blood assay as a model for in vitro evaluation of inflammasome ac- tivation and subsequent caspase-mediated interleukin-1 beta release / T. A. T. Tran, H. W. Grievink, K. Lipinska [et al.] // PLoS ONE. – 2019. – Vol. 14, № 4. – P. 1–16.NLRP6: A multifaceted innate immune sensor / M. Levy, H. Shapiro, C. A. Thaiss, E. Elinav // Trends Immunol. – 2017. – Vol. 38, № 4. – P. 248–260.NLRP6: A multifaceted innate immune sensor / M. Levy, H. Shapiro, C. A. Thaiss, E. Elinav // Trends Immunol. – 2017. – Vol. 38, № 4. – P. 248–260.Man, S. M. Converging roles of caspases in inflammasome activation, cell death and innate immunity / S. M. Man, T. D. Kanneganti // Nat. Rev. Immune. – 2016. – Vol. 16, № 1. – P. 7–21.Man, S. M. Converging roles of caspases in inflammasome activation, cell death and innate immunity / S. M. Man, T. D. Kanneganti // Nat. Rev. Immune. – 2016. – Vol. 16, № 1. – P. 7–21.Sharma, D. The cell biology of inflammasomes: Mechanisms of inflammasome activation and regulation / D. Sharma, T. D. Kanneganti // J. Cell Biol. – 2016. – Vol. 213, № 6. – P. 617–629.Sharma, D. The cell biology of inflammasomes: Mechanisms of inflam- masome activation and regulation / D. Sharma, T. D. Kanneganti // J. Cell Biol. – 2016. – Vol. 213, № 6. – P. 617–629.The emerging role of inflammasomes as central mediators in inflammatory bladder pathology / B. M. Inouye, F. M. Hughes, S. J. Sexton, J. T. Purves // Curr. Urol. – 2018. – Vol. 11, № 2. – P. 57–72.The emerging role of inflam- masomes as central mediators in inflammatory bladder pathology / B. M. Inouye, F. M. Hughes, S. J. Sexton, J. T. Purves // Curr. Urol. – 2018. – Vol. 11, № 2. – P. 57–72.Inflammasome-activated gasdermin D causes pyroptosis by forming membrane pores / X. Liu, Z. Zhang, J. Ruan [et al.] // Nature. – 2016. – Vol. 535, № 7610. – P. 153–158.Inflammasome- activated gasdermin D causes pyroptosis by forming membrane pores / X. Liu, Z. Zhang, J. Ruan [et al.] // Nature. – 2016. – Vol. 535, № 7610. – P. 153–158.Peri-operative inflammatory cytokines in plasma of the elderly correlate in prospective study with postoperative changes in cognitive test scores / R. Kline, E. Wong, M. Haile [et al.] // Int J Anesthesiol Res. – 2016. – Vol. 4. – Р. 313–21.Peri-operative inflammatory cytokines in plasma of the elderly correlate in prospective study with postoperative changes in cognitive test scores / R. Kline, E. Wong, M. Haile [et al.] // Int J Anesthesiol Res. – 2016. – Vol. 4. – Р. 313–21.Liu, X. Inflammatory markers in postoperative delirium (POD) and cognitive dysfunction (POCD): a meta-analysis of observational studies / X. Liu, Y. Yu, S. Zhu // PLoS One. – 2018. – Vol. 13. – Р. e0195659.Liu, X. Inflammatory markers in postoperative delirium (POD) and cognitive dysfunction (POCD): a meta-analysis of observational studies / X. Liu, Y. Yu, S. Zhu // PLoS One. – 2018. – Vol. 13. – Р. e0195659.Preexisting cognitive impairment is associated with postoperative cognitive dysfunction after hip joint replacement surgery / B. Silbert, L. Evered, D. A. Scott [et al.] // Anesthesiology. – 2015. – Vol. 122 (6). – Р.1224–1234.Preexisting cognitive impairment is associated with postoperative cognitive dys-function after hip joint replacement surgery / B. Silbert, L. Evered, D. A. Scott [et al.] // Anesthesiology. – 2015. – Vol. 122 (6). – Р.1224–1234.

The authors declare that there are no conflicts of interest present.