Elucidation of pathogenic mechanism of postoperative cognitive dysfunction in cancer patients and establishment of prevention method

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K11091
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Nagoya City University
• Principal Investigator: Sano Fumiaki 名古屋市立大学, 医薬学総合研究院(医学), 助教 (10752826)
• Co-Investigator(Kenkyū-buntansha): 大澤 匡弘 名古屋市立大学, 医薬学総合研究院(薬学), 准教授 (80369173) ; 祖父江 和哉 名古屋市立大学, 医薬学総合研究院(医学), 教授 (90264738)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 術後認知機能障害 / がん / 麻酔

Outline of Final Research Achievements

With the increase in the number of anesthesia cases for elderly cancer patients, elucidation of the cause of postoperative cognitive dysfunction (POCD) and establishment of preventive measures are urgent issues. The purpose of this study was to elucidate the pathogenesis of POCD by inhalational anesthetics in cancer using an animal model and to establish a preventive method in humans.
When C57BL / 6J mice were inoculated with melanoma cells and confirmed by novel object recognition tests, cognitive dysfunction was recognized 6 days after the inoculation. Since cognitive dysfunction developed only by inoculation of cancer cells, we used this model as a model of cognitive dysfunction in cancer, and examined inflammatory cytokines, but no clear increase was observed. Then, POCD was examined in diabetic model mice (TSOD mice), and POCD that developed on the second day after anesthesia was confirmed on the seventh day after anesthesia.

Free Research Field

麻酔科学、集中治療医学

Academic Significance and Societal Importance of the Research Achievements

これまでの研究では、POCDの発症を基礎疾患ではなく手術侵襲の程度や麻酔深度などで解析しており、がんとPOCDの相関は不明であった。高齢のがん患者の増加が予想されるため、がん患者におけるPOCDについては今後重要性を増してくると考えられる。
本研究ではマウスががんの接種のみで認知機能障害を認めたため、ヒトでもがん患者での認知機能障害を評価・対応する必要があると思われる。また、糖尿病モデルマウスではPOCDが持続することも確認できたため、同じく高齢者に多い糖尿病でもPOCDについての検討が急務である。