外周血T淋巴细胞在围术期锻炼防治术后认知功能障碍中的作用及其机制

With the support of National Natural Science Foundation of China for young scholars (title: The effects and mechanism of perioperative training on the postoperative cognitive dysfunction of aged patients, No.81400896), we formed a perioperative training program for elderly patients, and tested it in elderly orthopedic patients. The Data showed that our perioperative training program alleviated postoperative cognitive dysfunction and inhibited the peripheral inflammation in elderly patients. We also found that limiting peripheral blood T cells in lymph nodes blocked the improvement of training on cognitive function in mice. In the study, we will further investigate 1) the effects of peripheral blood T cells on brain neuroinflammation, neurogenesis and synaptic plasticity in mediating the protection of training on brains, and2) whether age affects the effects of T cells. Our data will refresh the protective mechanism of training on brain, and improve the existing perioperative training program.

在前一个国家自然科学基金青年基金(题目：围术期锻炼对老年病人术后认知功能障碍的影响及机制研究，编号：81400896）的支持下我们创建了“老年病人围术期锻炼方案”，并在骨科老年患者中证实了其对术后认知功能障碍的防治作用和对外周炎症的抑制作用； 而且在小鼠中发现把外周血T淋巴细胞局限于淋巴结可消除锻炼对脑功能的保护作用。本课题在此基础上将进一步探索：外周血T淋巴细胞在锻炼保护脑功能中对脑内炎症、神经元新生及其突触可塑的影响，及影响的年龄效应。这些研究结果有望刷新锻炼的脑保护机制，完善已有的围术期锻炼方案，使其真正服务于临床。

本研究计划从外周血 T 淋巴细胞的角度探讨锻炼-脑保护中的作用和机制。结果发现：①锻炼增强了小鼠的认知能力，②锻炼诱导了外周血T细胞在脑膜的聚集，③抑制T细胞在脑膜聚集减弱了的锻炼的脑保护作用，④成年小鼠锻炼后脑膜趋化因子的表达。 此外，我们还发现：①在大样本中锻炼可以改善全髋关节置换的老年患者的术后认知功能，②由高龄、术前认知储备、术前脑储备、每日活动量、术前基础疾病构建的术前脑脆性分层评估量表能较好的预测术后脑损伤的发生， ③慢性应激诱导外周血 T 淋巴细胞向脑膜聚集，促进了该病理条件下的脑损伤。