General anesthetics suppress CNS activity by modulating the function of membrane ion channels, in particular, by enhancing activity of GABA receptors. In contrast, several volatile (isoflurane, desflurane) and i.v. (propofol) general anesthetics excite peripheral sensory nerves to cause pain and irritation upon administration. These noxious anesthetics activate transient receptor potential ankyrin repeat 1 (TRPA1), a major nociceptive ion channel, but the underlying mechanisms and site of action are unknown. Here we exploit the observation that pungent anesthetics activate mammalian but not TRPA1. Analysis of chimeric and mouse TRPA1 channels reveal a critical role for the fifth transmembrane domain (S5) in sensing anesthetics. Interestingly, we show that anesthetics share with the antagonist A-967079 a potential binding pocket lined by residues in the S5, S6, and the first pore helix; isoflurane competitively disrupts A-967079 antagonism, and introducing these mammalian TRPA1 residues into dTRPA1 recapitulates anesthetic agonism. Furthermore, molecular modeling predicts that isoflurane and propofol bind to this pocket by forming H-bond and halogen-bond interactions with Ser-876, Met-915, and Met-956. Mutagenizing Met-915 or Met-956 selectively abolishes activation by isoflurane and propofol without affecting actions of A-967079 or the agonist, menthol. Thus, our combined experimental and computational results reveal the potential binding mode of noxious general anesthetics at TRPA1. These data may provide a structural basis for designing drugs to counter the noxious and vasorelaxant properties of general anesthetics and may prove useful in understanding effects of anesthetics on related ion channels.
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http://dx.doi.org/10.1073/pnas.1618144114 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Anesthesia and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750001, China.
Objective: This study aims to compare the effects of sevoflurane (SEV) and propofol (PRO) on postoperative cognitive dysfunction (POCD) in patients undergoing cardiac surgery (CS) under cardiopulmonary bypass (CPB), with a focus on evaluating the efficacy of these anesthetic agents in preventing POCD.
Methods: A total of 113 patients undergoing CS with CPB were grouped into two: PRO group (n = 58) and SEV group (n = 55). Baseline data, anesthesia effects (CPB duration, anesthesia time, respiratory recovery time, and anesthesia recovery time), Montreal Cognitive Assessment (MoCA) scores, POCD incidence, neurological function markers (NSE, S-100β, MMP9), and serum inflammatory markers (IL-6, IL-8, TNF-α) were analyzed.
BMC Anesthesiol
January 2025
Department of Neurosurgery, Xijing Hospital, No. 127, Changle West Road, Xi'an, 710032, China.
Background: Anesthesia can lead to functional cognitive impairment, which can seriously affect postoperative recovery. To investigate the effect and mechanism of quercetin (Que) in anesthetized rats, the study provided a new therapeutic idea for the prevention of cognitive dysfunction caused by anesthesia.
Methods: Cognitively impaired rats were constructed using Isoflurane (ISO) anesthesia and treated with Que.
A A Pract
January 2025
From the Department of Anesthesiology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY.
Malignant hyperthermia (MH) is a rare genetic disorder triggered by inhalational anesthetics or depolarizing neuromuscular blocking agents that carries significant mortality if not promptly treated. The following case presents a healthy 39-year-old man who developed MH several hours into an anesthetic exposure. Rapid intraoperative stabilization tactics that paralleled intensive care unit (ICU) level care allowed for continuation of operative management as opposed to case termination given the patient was at high risk for permanent nerve palsy if the case were to be aborted during dissection.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
As one of the most commonly used general anesthetics (GAs) in surgery, numerous studies have demonstrated the detrimental effects of sevoflurane exposure on myelination in the developing and elderly brain. However, the impact of sevoflurane exposure on intact myelin structure in the adult brain is barely discovered. Here, we show that repeated sevoflurane exposure, but not single exposure, causes hypomyelination and abnormal ultrastructure of myelin sheath in the prefrontal cortex (PFC) of adult male mice, which is considered as a critical brain region for general anesthesia mediated consciousness change.
View Article and Find Full Text PDFPharmacol Res
January 2025
Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Anesthesiology and Resuscitation (Huazhong University of Science and Technology), Ministry of Education, Wuhan, China. Electronic address:
General anesthesia is administered to millions of individuals each year, however, the precise mechanism by which it induces unconsciousness remains unclear. While some theories suggest that anesthesia shares similarities with natural sleep, targeting sleep-promoting areas and inhibiting arousal nuclei, recent research indicates a more complex process. Emerging evidence highlights the critical role of corticothalamocortical circuits, which are involved in higher cognitive functions, in controlling arousal states and modulating transitions between different conscious states during anesthesia.
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