Ritiu, S.A.; Rogobete, A.F.; Sandesc, D.; Bedreag, O.H.; Papurica, M.; Popovici, S.E.; Toma, D.; Ivascu, R.I.; Velovan, R.; Garofil, D.N.; Corneci, D.; Bratu, L.M.; Pahontu, E.M.; Pistol, A. The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways: Crosstalk on Perioperative Antioxidant Therapy. Cells2022, 11, 1880.
Ritiu, S.A.; Rogobete, A.F.; Sandesc, D.; Bedreag, O.H.; Papurica, M.; Popovici, S.E.; Toma, D.; Ivascu, R.I.; Velovan, R.; Garofil, D.N.; Corneci, D.; Bratu, L.M.; Pahontu, E.M.; Pistol, A. The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways: Crosstalk on Perioperative Antioxidant Therapy. Cells 2022, 11, 1880.
Worldwide, the prevalence of surgery under general anaesthesia has increased significantly, on one hand because of modern anaesthetic and pain control techniques, and on the other hand because of better diagnosis and increased complexity of surgical technique. Together with the development of new concepts in the surgical field, the attention of researchers and clinicians turned to minimizing the impact of surgical trauma and offering minimal invasive procedures. This fact is due to the recent discoveries in the field of cellular and molecular mechanisms, that have revealed a systemic inflammatory and pro-oxidative impact that not only lasts in the perioperative period, but also impacts the long term, contributing to more difficult recovery, increased morbidity, and mortality, and finally a negative financial impact. Detailed molecular and cellular analysis have shown an overproduction of inflammatory and pro-oxidative species, that are responsible for an augmentation of the systemic inflammatory status and more difficult postoperative recovery. Moreover, it was shown that there are a series of changes in certain epigenetic structures, the most important being the microRNAs. Based on these findings, a series of modern, targeted therapeutic approaches have been proposed, with the final goal of blocking these mechanisms and reducing the redox state. Recent studies carried out had a positive clinical impact regarding antioxidant therapy and have shown that it can be used in the perioperative period with beneficial clinical impact. This review describes and details the most important molecular and cellular mechanisms that impact the surgical patient undergoing general anaesthesia, and it presents a series of antioxidant therapies that can reduce systemic inflammation.
general anesthesia; redox; inflammation; antioxidants; hypermetabolism; microRNAs; biomarkers; oxidative stress; Vitamin C
MEDICINE & PHARMACOLOGY, Other
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