Research Paper Volume 13, Issue 18 pp 22375—22389

A new mechanism of POCD caused by sevoflurane in mice: cognitive impairment induced by cross-dysfunction of iron and glucose metabolism

Xing Ge1, *, , Yong Zuo1, *, , Jinhong Xie1, , Xincheng Li1, , Yan Li1, , Anand Thirupathi2, , Peng Yu1, , Guofen Gao1, , Changhao Zhou3, &, , Yanzhong Chang1, , Zhenhua Shi1, ,

  • 1 Laboratory of Molecular Iron Metabolism, College of Life Science, Hebei Normal University, Shijiazhuang 050024, Hebei Province, China
  • 2 Faculty of Sports Science, Ningbo University, Ningbo 315211, Zhejiang Province, China
  • 3 The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
* Equal contribution

Received: May 12, 2021       Accepted: July 13, 2021       Published: September 21, 2021
How to Cite

Copyright: © 2021 Ge et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Sevoflurane (Sev) is a commonly used anesthetic in hospitals that can cause neurotoxicity. Postoperative cognitive dysfunction (POCD) is a common clinical problem induced by some anesthetics. However, the exact mechanism of neurotoxicity induced by Sev is unclear. Here we studied a new mechanism of POCD induced by Sev. We treated 15-month-old mice with 2% Sev for 6 hours, and we had found that Sev causes POCD. Using isobaric tags for relative and absolute quantitation (iTRAQ), we found that the transporter and the metabolism of carbohydrates and inorganic ions were involved in the cognitive impairment induced by Sev. Using synchrotron radiation micro-X-ray fluorescence (μ-XRF), we showed that Sev caused the iron overload in the brain of 15-month-old mice. Subsequently, excessive iron led to oxidative stress and impaired mitochondrial function that further led to glucose metabolism disorder and reduced ATP production by regulating the expression of key enzyme genes or proteins including G6Pase, Pck1, and Cs. Meanwhile, Sev also inhibited the oxygen consumption rate and glucose absorption by downregulating the expression of glucose transporter 1 in cerebral vascular endothelial cells. The cross-dysfunction of iron and glucose metabolism caused the apoptosis in the cortex and hippocampus through Bcl2/Bax pathway. In conclusion, the data here showed a new mechanism that Sev caused apoptosis by cross-dysregulation of iron and glucose metabolism and induced energy stress in mice. Maintaining iron and glucose metabolism homeostasis may play an important role in cognitive impairment induced by Sev.


Sev: sevoflurane; POCD: postoperative cognitive dysfunction; iTRAQs: isobaric tags for relative and absolute quantitation; μ-XRF: synchrotron radiation micro-X-ray fluorescence; TfR1: transferrin receptor 1; G6Pase: Glucose-6-phosphatase; HK1: hexokinase 1; PKM1: pyruvate kinase M1; Cs: citrate synthase; Pdha1: pyruvate dehydrogenase 1; Idh2: isocitrate dehydrogenase 2; OCR: oxygen consumption rate; MWM: Morris water maze; Glut: glucose transporter; FtH: heavy ferritin; FtL: light ferritin; ROS: reactive oxygen species; MMP: mitochondrial membrane potential.