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ABSTRACT: Objective
The aim was to determine preoperative gut microbiota metabolites that may be associated with postoperative delirium (POD) development in patients and further study in rodents.Summary background data
POD occurs in 9% to 50% of older patients undergoing anesthesia/surgery but lacks effective treatments or prevention. High-throughput metabolomics using liquid chromatography with tandem mass spectrometry has accelerated disease-related biomarkers discovery. We performed metabolomic studies in humans to identify potential metabolite biomarkers linked to POD and examined potential mechanisms in rodents.Methods
We performed a prospective observational cohort study to examine the metabolomic changes that were associated with the development of POD. Then the gut microbiota-related metabolomic changes were recapitulated by gut microbiota perturbation in rodents. POD was assessed in mice using a battery of behavioral tests including novel objective test, Y-maze test, open-field test, and buried food test. The mechanisms through which gut microbiota-related metabolomic changes influenced POD were examined using chemogenetics.Results
Indole-3-propionic acid (IPA) is a gut microbiota metabolite that belongs to the indole family. Baseline plasma levels of IPA were significantly inversely correlated with the onset of POD in 103 (17 cases) human individuals. This relationship was validated in preclinical mouse models for POD: reducing IPA levels through gut microbiota perturbation promoted POD-like behavior. More importantly, IPA administration deterred POD-like behavior. Colonization of germ-free mice with mutant Clostridium sporogenes that did not produce IPA-promoted POD-like behavior. Chemogenetic studies revealed that the protective effect of IPA in mice was mediated, in part, by peroxisome proliferator-activated receptor gamma coactivator 1-alpha in hippocampal interneurons.Conclusions
Gut microbiota-derived IPA is an important molecule implicated in the pathogenesis of POD, which could potentially be harnessed for POD prevention.
SUBMITTER: Zhou X
PROVIDER: S-EPMC10603211 | biostudies-literature | 2023 Dec
REPOSITORIES: biostudies-literature
Zhou Xue X Wu Xinbo X Wu Yan Y Yang Liuyue L Shi Eleanor E Ding Weihua W Chen Liang L Shi Xu X Feng Xia X Su Chienwen C You Zerong Z Xia Jianguo J Chen Cynthia C Yeliseyev Vladimir V Bry Lynn L Xia Suyun S Huang Peigen P Meng Jiawei J Houle Timothy T Akeju Oluwaseun O Mao Jianren J Gerszten Robert R Chen Qian Q Xie Zhongcong Z Shen Shiqian S
Annals of surgery 20230427 6
<h4>Objective</h4>The aim was to determine preoperative gut microbiota metabolites that may be associated with postoperative delirium (POD) development in patients and further study in rodents.<h4>Summary background data</h4>POD occurs in 9% to 50% of older patients undergoing anesthesia/surgery but lacks effective treatments or prevention. High-throughput metabolomics using liquid chromatography with tandem mass spectrometry has accelerated disease-related biomarkers discovery. We performed met ...[more]