NLRP3 inflammasomes are involved in the progression of postoperative cognitive dysfunction: from mechanism to treatment

Neurosurg Rev. 2021 Aug;44(4):1815-1831. doi: 10.1007/s10143-020-01387-z. Epub 2020 Sep 12.

Abstract

Postoperative cognitive dysfunction (POCD) involves patient memory and learning decline after surgery. POCD not only presents challenges for postoperative nursing and recovery but may also cause permanent brain damage for patients, including children and the aged, with vulnerable central nervous systems. Its occurrence is mainly influenced by surgical trauma, anesthetics, and the health condition of the patient. There is a lack of imaging and experimental diagnosis; therefore, patients can only be diagnosed by clinical observation, which may underestimate the morbidity, resulting in decreased treatment efficacy. Except for symptomatic support therapy, there is a relative lack of effective drugs specific for the treatment of POCD, because the precise mechanism of POCD remains to be determined. One current hypothesis is that postoperative inflammation promotes the progression of POCD. Accumulating research has indicated that overactivation of NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasomes contribute to the POCD progression, suggesting that targeting NLRP3 inflammasomes may be an effective therapy to treat POCD. In this review, we summarize recent studies and systematically describe the pathogenesis, treatment progression, and potential treatment options of targeting NLRP3 inflammasomes in POCD patients.

Keywords: NLRP3 inflammasomes; POCD treatment; Postoperative cognitive dysfunction.

Publication types

  • Review

MeSH terms

  • Central Nervous System
  • Humans
  • Inflammasomes*
  • Inflammation
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • Postoperative Cognitive Complications*

Substances

  • Inflammasomes
  • NLR Family, Pyrin Domain-Containing 3 Protein