Prevention of Postoperative Fatigue Syndrome in Rat Model by Ginsenoside Rb1 via Down-Regulation of Inflammation along the NMDA Receptor Pathway in the Hippocampus

  • Chen Wei-Zhe
    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University
  • Liu Shu
    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University
  • Chen Fan-Feng
    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University
  • Zhou Chong-Jun
    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University
  • Yu Jian
    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University
  • Zhuang Cheng-Le
    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University
  • Shen Xian
    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University
  • Chen Bi-Cheng
    Wenzhou Key Laboratory of Surgery, The First Affiliated Hospital of Wenzhou Medical University
  • Yu Zhen
    Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University Department of Surgery, Shanghai Tenth People’s Hospital Affiliated to TongJi University

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  • Prevention of Postoperative Fatigue Syndrome in Rat Model by Ginsenoside Rb1 <i>via</i> Down-Regulation of Inflammation along the NMDA Receptor Pathway in the Hippocampus

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Postoperative fatigue syndrome (POFS) is a common complication which decelerates recovery after surgery. The present study investigated the anti-fatigue effect of ginsenoside Rb1 (GRb1) through the inflammatory cytokine-mediated N-methyl-D-aspartate (NMDA) receptor pathway. A POFS rat model was created by major small intestinal resection and assessed with an open field test. Real-time quantitative polymerase chain reaction, western blot analysis, high performance liquid chromatography and a transmission electron microscopic analysis were used to determine typical biochemical parameters in the hippocampus. Our results showed that POFS rats exhibited fatigue associated with an increased expression of inflammatory cytokines and NMDA receptor 1, higher (kynurenine)/(tryptophan) and (kynurenine)/(kynurenic acid) on postoperative days 1 and 3, and an increased expression of indoleamine 2,3-dioxygenase (IDO) on postoperative day 1. Degenerated neurons were found in the hippocampus of POFS rats. The NMDA receptor antagonist MK801 had a significant effect on central fatigue on postoperative day 1. GRb1 had no effect on IDO or tryptophan metabolism, but exhibited a significant effect on POFS by inhibiting the expression of inflammatory cytokines and NMDA receptor 1. These data suggested that inflammatory cytokines could activate tryptophan metabolism to cause POFS through the NMDA receptor pathway. GRb1 had an anti-fatigue effect on POFS by reducing inflammatory cytokines and NMDA receptors.

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