Metformin Ameliorates Postoperative Cognitive Dysfunction through Regulation of the AMPK/SIRT1 Pathway. 2023

Peiyu Jia, and Ji Che, and Junfeng Zhang, and Haibing Li, and Quanhong Zhou, and Yong Guo
Department of Pain, Huadong Hospital, Shanghai Key Laboratory of Clinical Geriatric Medicine, Fudan University, 200040 Shanghai, China.

BACKGROUND Postoperative cognitive dysfunction (POCD) is a common postoperative complication in elderly patients. The purpose of this study was to investigate the mechanism through which metformin improves postoperative cognitive function. METHODS In the in vivo experiment, 18-month-old Sprague-Dawley (SD) rats were randomly divided into four groups (n = 12 in each group): the control, metformin, operation, and operation plus metformin groups. The animals were pretreated with metformin by gavage once daily for two weeks. The Morris water maze (MWM) was used to measure cognitive ability. In the in vitro experiment, BV2 cells were divided into five groups: the control, metformin, lipopolysaccharide (LPS), LPS plus metformin, and LPS plus metformin plus compound C groups. We stimulated microglia with LPS (500 ng/mL). Immunofluorescence and Western blotting were used to assess ROS (reactive oxygen species) levels, autophagy-associated protein levels and adenosine monophosphate-activated protein kinase (AMPK)/regulator factor 2-related enzyme 1 (SIRT1) signaling pathway activity in the rat cortex and microglial cells. RESULTS In the MWM test, the metformin-pretreated rats spent a higher proportion of time in the target quadrant. Immunofluorescence showed that the fluorescence intensity of LC3 in the cortex was increased in rats pretreated with metformin. Western blotting indicated that metformin upregulated the expression of autophagy-related and AMPK/SIRT1 signaling pathway-related proteins in the cortex after surgery. By activating the AMPK/SIRT1 signaling pathway in vitro, metformin reduced microglial activation and oxidative stress and promoted autophagy. CONCLUSIONS Through the AMPK/SIRT1 pathway, metformin can boost autophagy and reduce oxidative stress in cortical microglia in older rats, in turn improving postoperative cognitive function.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008070 Lipopolysaccharides Lipid-containing polysaccharides which are endotoxins and important group-specific antigens. They are often derived from the cell wall of gram-negative bacteria and induce immunoglobulin secretion. The lipopolysaccharide molecule consists of three parts: LIPID A, core polysaccharide, and O-specific chains (O ANTIGENS). When derived from Escherichia coli, lipopolysaccharides serve as polyclonal B-cell mitogens commonly used in laboratory immunology. (From Dorland, 28th ed) Lipopolysaccharide,Lipoglycans
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000079690 Postoperative Cognitive Complications COGNITIVE IMPAIRMENT or functional decline after a surgical procedure. Postoperative Cognitive Decline,Postoperative Cognitive Disorders,Postoperative Cognitive Dysfunction,Postoperative Dementia,Cognitive Complication, Postoperative,Cognitive Decline, Postoperative,Cognitive Disorder, Postoperative,Cognitive Dysfunction, Postoperative,Complication, Postoperative Cognitive,Decline, Postoperative Cognitive,Dementia, Postoperative,Dementias, Postoperative,Disorder, Postoperative Cognitive,Dysfunction, Postoperative Cognitive,Postoperative Cognitive Complication,Postoperative Cognitive Disorder,Postoperative Dementias
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D017207 Rats, Sprague-Dawley A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company. Holtzman Rat,Rats, Holtzman,Sprague-Dawley Rat,Rats, Sprague Dawley,Holtzman Rats,Rat, Holtzman,Rat, Sprague-Dawley,Sprague Dawley Rat,Sprague Dawley Rats,Sprague-Dawley Rats
D051381 Rats The common name for the genus Rattus. Rattus,Rats, Laboratory,Rats, Norway,Rattus norvegicus,Laboratory Rat,Laboratory Rats,Norway Rat,Norway Rats,Rat,Rat, Laboratory,Rat, Norway,norvegicus, Rattus
D055372 AMP-Activated Protein Kinases Intracellular signaling protein kinases that play a signaling role in the regulation of cellular energy metabolism. Their activity largely depends upon the concentration of cellular AMP which is increased under conditions of low energy or metabolic stress. AMP-activated protein kinases modify enzymes involved in LIPID METABOLISM, which in turn provide substrates needed to convert AMP into ATP. 5'-AMP-Activated Protein Kinase,AMP-Activated Kinase,AMP-Activated Protein Kinase,AMP-Activated Protein Kinase alpha Subunit,AMP-Activated Protein Kinase alpha Subunits,AMP-Activated Protein Kinase beta Subunit,AMP-Activated Protein Kinase beta Subunits,AMP-Activated Protein Kinase gamma Subunit,AMP-Activated Protein Kinase gamma Subunits,PRKAA,5' AMP Activated Protein Kinase,AMP Activated Kinase,AMP Activated Protein Kinase,AMP Activated Protein Kinase alpha Subunit,AMP Activated Protein Kinase alpha Subunits,AMP Activated Protein Kinase beta Subunit,AMP Activated Protein Kinase beta Subunits,AMP Activated Protein Kinase gamma Subunit,AMP Activated Protein Kinase gamma Subunits,AMP Activated Protein Kinases
D056564 Sirtuin 1 A sirtuin family member found primarily in the CELL NUCLEUS. It is an NAD-dependent deacetylase with specificity towards HISTONES and a variety of proteins involved in gene regulation. Silent Mating Type Information Regulation 2 Homolog 1,Sirt1

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