Metabolic Interventions for Sleep, Anesthesia-related Neurocognitive Disorders and Alzheimer's Disease

针对睡眠、麻醉相关神经认知障碍和阿尔茨海默病的代谢干预

• 批准号: 10419578
• 负责人: Christa Joy Nehs
• 金额: $ 55.58万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10419578
• 关键词: Acetoacetates; Acetylcholine; Address; Adenosine; Age; Aging; Alzheimer' s Disease; Alzheimer’s disease biomarker; Anesthesia procedures; Anesthetics; Animals; Antiinflammatory Effect; Anxiety; Biosensor; Blood; Brain; Brain Diseases; Carbohydrates; Clinical; Dementia; Diet; Eating; Elderly; Electroencephalography; Epilepsy; Exercise; Fatty Acids; Fatty acid glycerol esters; General Anesthesia; General anesthetic drugs; Glioblastoma; Glucose; Glutamates; Immune; Impaired cognition; Inflammation; Inflammatory; Inflammatory Response; Insulin Resistance; Interleukin-1; Interleukin-10; Interleukin-17; Interleukin-6; Intervention; Ketone Bodies; Ketones; Lead; Link; Measures; Mental Depression; Metabolic; Methods; Microdialysis; Mitochondria; NF-kappa B; Neurodegenerative Disorders; Neuromodulator; Neurons; Norepinephrine; Parkinson Disease; Pathway interactions; Prefrontal Cortex; Propofol; Purinergic P1 Receptors; Pyruvate; REM Sleep; Rattus; Reactive Oxygen Species; Research; Rodent; Safety; Seizures; Signal Transduction; Sleep; Sleep Fragmentations; Sleep disturbances; Source; Starvation; Testing; Time; Weight; aged; aging brain; aging population; antagonist; autism spectrum disorder; beta-Hydroxybutyrate; brain health; brain metabolism; early detection biomarkers; experimental study; gamma-Aminobutyric Acid; improved; inflammatory marker; innovation; ketogenic diet; liquid chromatography mass spectrometry; metabolomics; mitochondrial dysfunction; neurocognitive disorder; neuronal metabolism; neurotransmitter release; new therapeutic target; non rapid eye movement; normal aging; novel strategies; poor sleep; post-operative cognitive dysfunction; postoperative delirium; sevoflurane; sleep quality

ABSTRACT This objective of this research is to develop metabolic interventions to improve sleep quality and anesthesia safety in the elderly and eventually to treat neurodegenerative diseases like Alzheimer's disease. The aging brain has many changes including mitochondrial dysfunction, insulin resistance and decreased neurotransmitter release leading to poor sleep quality and more complications with general anesthesia. The ability of the brain to use glucose declines with age but the brain's ability to use ketones as fuel remains. Ketone bodies are produced naturally from the breakdown of fatty acids and become a major fuel source for the brain during times of starvation, exercise and high-fat, low-carbohydrate diets. The ketone bodies acetoacetate and beta-hydroxybutyrate not only provide energy to the brain but also have potent signaling and anti-inflammatory effects. The activation of inflammatory pathways, such as nuclear factor kappa B, are thought to be one mechanism through which sleep disturbance and dementia are linked as well as post-operative delirium and post-operative cognitive dysfunction. The inflammatory response is also tightly correlated with the onset and clinical course of Alzheimer's disease and disruptions in sleep are an early biomarker of Alzheimer's disease. Sleep quality declines with normal age as well, losing restorative slow and delta power and becoming more fragmented. Therefore, targeting brain energy usage by providing ketones could be one strategy for improving sleep quality in aged animals. In addition, the aged population is more susceptible to general anesthesia. Less anesthesia is needed to anesthetize older people and they are more likely to develop post-operative cognitive dysfunction. The energy substrate and anti-inflammatory effects of ketones could be neuroprotective during anesthesia in the aged brain. Taken together, these ideas give rise to novel strategies that address the dysfunctional neuronal metabolic-immune interactions in the aged brain by increasing ketones that could lead to improved sleep quality (AIM 1) and safer delivery of general anesthesia (AIM 2) to the elderly. These innovative strategies to improve brain health in the aged population have the potential for broad impact as many brain diseases have components of metabolic dysregulation including epilepsy, Alzheimer's disease, Parkinson's disease, autism, anxiety, depression and glioblastoma.

抽象的 本研究的目的是开发代谢干预措施以改善睡眠质量和 老年人的麻醉安全，并最终治疗阿尔茨海默病等神经退行性疾病。 衰老的大脑会出现许多变化，包括线粒体功能障碍、胰岛素抵抗和功能下降。 神经递质释放导致睡眠质量差和全身麻醉出现更多并发症。这 大脑使用葡萄糖的能力随着年龄的增长而下降，但大脑使用酮作为燃料的能力仍然存在。酮 身体由脂肪酸分解自然产生，并成为大脑的主要燃料来源 在饥饿、运动和高脂肪、低碳水化合物饮食期间。酮体乙酰乙酸和 β-羟基丁酸不仅为大脑提供能量，还具有有效的信号传导和抗炎作用 影响。炎症途径的激活，例如核因子 kappa B，被认为是其中之一 睡眠障碍与痴呆以及术后谵妄之间的联系机制 术后认知功能障碍。炎症反应也与发病和发生密切相关。 阿尔茨海默病的临床病程和睡眠中断是阿尔茨海默病的早期生物标志物。 睡眠质量也会随着正常年龄的增长而下降，失去恢复性的慢速能量和增量能量，并且变得更加严重。 支离破碎。因此，通过提供酮来瞄准大脑能量的使用可能是改善大脑能量使用的一种策略。 老年动物的睡眠质量。此外，老年人更容易受到全身麻醉的影响。较少的 老年人需要麻醉，他们更有可能出现术后认知能力 功能障碍。酮的能量底物和抗炎作用可能在神经保护过程中发挥作用 老年大脑的麻醉。总而言之，这些想法产生了解决以下问题的新颖策略： 通过增加酮体，老年大脑中功能失调的神经元代谢-免疫相互作用可能导致 改善老年人的睡眠质量 (AIM 1) 并更安全地实施全身麻醉 (AIM 2)。这些创新的 改善老年人脑健康的策略有可能产生广泛影响，因为许多大脑 具有代谢失调成分的疾病包括癫痫、阿尔茨海默病、帕金森病 疾病、自闭症、焦虑、抑郁和胶质母细胞瘤。