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      Xenon improves long-term cognitive function, reduces neuronal loss and chronic neuroinflammation, and improves survival after traumatic brain injury in mice

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          Abstract

          Background

          Xenon is a noble gas with neuroprotective properties that can improve short and long-term outcomes in young adult mice after controlled cortical impact. This follow-up study investigates the effects of xenon on very long-term outcomes and survival.

          Methods

          C57BL/6N young adult male mice ( n=72) received single controlled cortical impact or sham surgery and were treated with either xenon (75% Xe:25% O 2) or control gas (75% N 2:25% O 2). Outcomes measured were: (i) 24 h lesion volume and neurological outcome score; (ii) contextual fear conditioning at 2 weeks and 20 months; (iii) corpus callosum white matter quantification; (iv) immunohistological assessment of neuroinflammation and neuronal loss; and (v) long-term survival.

          Results

          Xenon treatment significantly reduced secondary injury ( P<0.05), improved short-term vestibulomotor function ( P<0.01), and prevented development of very late-onset traumatic brain injury (TBI)-related memory deficits. Xenon treatment reduced white matter loss in the contralateral corpus callosum and neuronal loss in the contralateral hippocampal CA1 and dentate gyrus areas at 20 months. Xenon's long-term neuroprotective effects were associated with a significant ( P<0.05) reduction in neuroinflammation in multiple brain areas involved in associative memory, including reduction in reactive astrogliosis and microglial cell proliferation. Survival was improved significantly ( P<0.05) in xenon-treated animals compared with untreated animals up to 12 months after injury.

          Conclusions

          Xenon treatment after TBI results in very long-term improvements in clinically relevant outcomes and survival. Our findings support the idea that xenon treatment shortly after TBI may have long-term benefits in the treatment of brain trauma patients.

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          Most cited references38

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          Chronic neuropathologies of single and repetitive TBI: substrates of dementia?

          Traumatic brain injury (TBI) has long been recognized to be a risk factor for dementia. This association has, however, only recently gained widespread attention through the increased awareness of 'chronic traumatic encephalopathy' (CTE) in athletes exposed to repetitive head injury. Originally termed 'dementia pugilistica' and linked to a career in boxing, descriptions of the neuropathological features of CTE include brain atrophy, cavum septum pellucidum, and amyloid-β, tau and TDP-43 pathologies, many of which might contribute to clinical syndromes of cognitive impairment. Similar chronic pathologies are also commonly found years after just a single moderate to severe TBI. However, little consensus currently exists on specific features of these post-TBI syndromes that might permit their confident clinical and/or pathological diagnosis. Moreover, the mechanisms contributing to neurodegeneration following TBI largely remain unknown. Here, we review the current literature and controversies in the study of chronic neuropathological changes after TBI.
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            How does xenon produce anaesthesia?

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              Two-pore-domain K+ channels are a novel target for the anesthetic gases xenon, nitrous oxide, and cyclopropane.

              Nitrous oxide, xenon, and cyclopropane are anesthetic gases that have a distinct pharmacological profile. Whereas the molecular basis for their anesthetic actions remains unclear, they behave very differently to most other general anesthetics in that they have little or no effect on GABAA receptors, yet strongly inhibit the N-methyl-d-aspartate subtype of glutamate receptors. Here we show that certain members of the two-pore-domain K+ channel superfamily may represent an important new target for these gaseous anesthetics. TREK-1 is markedly activated by clinically relevant concentrations of nitrous oxide, xenon, and cyclopropane. In contrast, TASK-3, a member of this family that is very sensitive to volatile anesthetics, such as halothane, is insensitive to the anesthetic gases. We demonstrate that the C-terminal cytoplasmic domain is not an absolute requirement for the actions of the gases, although it clearly plays an important modulatory role. Finally, we show that Glu306, an amino acid that has previously been found to be important in the modulation of TREK-1 by arachidonic acid, membrane stretch and internal pH, is critical for the activating effects of the anesthetic gases.
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                Author and article information

                Contributors
                Journal
                Br J Anaesth
                Br J Anaesth
                BJA: British Journal of Anaesthesia
                Elsevier
                0007-0912
                1471-6771
                21 May 2019
                July 2019
                21 May 2019
                : 123
                : 1
                : 60-73
                Affiliations
                [1 ]Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, UK
                [2 ]Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, UK
                [3 ]Charing Cross Hospital Intensive Care Unit, Critical Care Directorate, Imperial College Healthcare NHS Trust, London, UK
                [4 ]Department of Anaesthesiology, Medical Centre of Johannes Gutenberg University, Mainz, Germany
                [5 ]Mouse Behavioural Outcome Unit, Focus Program Translational Neurosciences, Johannes Gutenberg University, Mainz, Germany
                [6 ]Department of Life Sciences, Imperial College London, UK
                [7 ]Department of Anaesthetics, Royal Berkshire Hospital NHS Foundation Trust, Reading, UK
                Author notes
                Article
                S0007-0912(19)30232-6
                10.1016/j.bja.2019.02.032
                6676773
                31122738
                d8a19fec-068a-4784-a78c-bfa042ace097
                © 2019 The Author(s)

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 23 February 2019
                Categories
                Neurosciences and Neuroanaesthesia

                Anesthesiology & Pain management
                hippocampus,general anaesthesia,memory disorders,nerve degeneration,neuroinflammation,neuroprotection,traumatic brain injury

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