Document Detail

Human Alzheimer and inflammation biomarkers after anesthesia and surgery.
MedLine Citation:
PMID:  21857497     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The prevalence of postoperative cognitive disturbance, coupled with growing in vitro, cell, and animal evidence suggesting anesthetic effects on neurodegeneration, calls for additional study of the interaction between surgical care and Alzheimer neuropathology. The authors studied human cerebrospinal fluid (CSF) biomarkers during surgery.
METHODS: Eleven patients undergoing idiopathic nasal CSF leak correction were admitted to this Institutional Review Board-approved study. Lumbar subarachnoid catheters were placed before the procedure. Anesthesia was total intravenous propofol or remifentanil or inhalational sevoflurane, depending on provider choice. CSF samples were taken after catheter placement (base), at procedure end (0 h), and then at 6, 24, and 48 h. CSF was analyzed using xMAP Luminex immunoassay (Luminex, Austin, TX).
RESULTS: Of the 11 patients (age range, 53 ± 6 yr), 8 were women; 4 received intravenous anesthesia, 6 sevoflurane, and 1 mixed. Procedures lasted 6.4 ± 2 h. Mean CSF amyloid-β(1-42) remained unchanged, but total-tau and phosphorylated-tau181P increased progressively until at least 48 h. Total-tau, phosphorylated-tau, or amyloid-β(1-42) concentrations were not different between anesthetic groups. CSF interleukin-10, S100Beta, and tumor necrosis factor α were increased similarly in both anesthetic groups at 24 h, but interleukin-6 was increased more in the inhalational group.
CONCLUSION: These data indicate a robust neuroinflammatory response, including not only the usual markers (interleukin-6, tumor necrosis factor α, interleukin-10), but also S100Beta and tau, markers of injury. The total-tau/amyloid-β(1-42) ratio increased in a pattern consistent with Alzheimer disease, largely because of an increase in total-tau rather than a decline in amyloid-β(1-42). The differences in CSF interleukin-6 concentrations suggest that anesthetic management may make a difference in neuroinflammatory response.
Junxia X Tang; Dimitry Baranov; Mary Hammond; Leslie M Shaw; Maryellen F Eckenhoff; Roderic G Eckenhoff
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  115     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-22     Completed Date:  2011-11-15     Revised Date:  2014-09-10    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  727-32     Citation Subset:  AIM; IM    
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MeSH Terms
Alzheimer Disease / cerebrospinal fluid,  metabolism*
Amyloid beta-Peptides / cerebrospinal fluid
Anesthesia, Inhalation
Anesthesia, Intravenous
Antibodies / analysis
Biological Markers / analysis*,  cerebrospinal fluid
Enzyme-Linked Immunosorbent Assay
Inflammation / cerebrospinal fluid,  metabolism*
Interleukin-10 / cerebrospinal fluid
Interleukin-6 / cerebrospinal fluid
Middle Aged
Peptide Fragments / cerebrospinal fluid
Postoperative Period*
S100 Proteins / cerebrospinal fluid
Tumor Necrosis Factor-alpha / cerebrospinal fluid
tau Proteins / cerebrospinal fluid
Grant Support
R01 AG031742/AG/NIA NIH HHS; R01 AG031742-04/AG/NIA NIH HHS
Reg. No./Substance:
0/Amyloid beta-Peptides; 0/Antibodies; 0/Biological Markers; 0/Interleukin-6; 0/Peptide Fragments; 0/S100 Proteins; 0/Tumor Necrosis Factor-alpha; 0/amyloid beta-protein (40-1); 0/tau Proteins; 130068-27-8/Interleukin-10

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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