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Cognitive decline following surgery in older individuals is a major clinical problem of uncertain mechanism; a similar cognitive decline also follows severe infection, chemotherapy, or trauma and is currently without effective therapy. A variety of mechanisms have been proposed, and exploring the role of inflammation, we recently reported the role of IL-1β in the hippocampus after surgery in mice with postoperative cognitive dysfunction. Here, we show that TNF-α is upstream of IL-1 and provokes its production in the brain. Peripheral blockade of TNF-α is able to limit the release of IL-1 and prevent neuroinflammation and cognitive decline in a mouse model of surgery-induced cognitive decline. TNF-α appears to synergize with MyD88, the IL-1/TLR superfamily common signaling pathway, to sustain postoperative cognitive decline. Taken together, our results suggest a unique therapeutic potential for preemptive treatment with anti-TNF antibody to prevent surgery-induced cognitive decline.

Original publication

DOI

10.1073/pnas.1014557107

Type

Journal article

Journal

Proc Natl Acad Sci U S A

Publication Date

23/11/2010

Volume

107

Pages

20518 - 20522

Keywords

Animals, Cognition Disorders, Cytokines, Enzyme-Linked Immunosorbent Assay, HMGB1 Protein, Inflammation, Interleukin-1, Mice, Mice, Knockout, Myeloid Differentiation Factor 88, Postoperative Complications, Signal Transduction, Toll-Like Receptor 4, Tumor Necrosis Factor-alpha