New advances in clinical application of neostigmine: no longer focusing solely on increasing skeletal muscle strength

Shangkun Si; Xiaohu Zhao; Fan Su; Hongxiu Lu; Dongbin Zhang; Li Sun; Fulei Wang; Li Xu

doi:10.3389/fphar.2023.1227496

New advances in clinical application of neostigmine: no longer focusing solely on increasing skeletal muscle strength

Front Pharmacol. 2023 Aug 4:14:1227496. doi: 10.3389/fphar.2023.1227496. eCollection 2023.

Authors

Shangkun Si¹, Xiaohu Zhao¹, Fan Su², Hongxiu Lu², Dongbin Zhang², Li Sun², Fulei Wang¹, Li Xu¹

Affiliations

¹ Shandong University of Traditional Chinese Medicine, Jinan, China.
² Department of Anesthesiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.

Abstract

Neostigmine is a clinical cholinesterase inhibitor, that is, commonly used to enhance the function of the cholinergic neuromuscular junction. Recent studies have shown that neostigmine regulates the immune-inflammatory response through the cholinergic anti-inflammatory pathway, affecting perioperative neurocognitive function. This article reviews the relevant research evidence over the past 20 years, intending to provide new perspectives and strategies for the clinical application of neostigmine.

Keywords: cholinergic anti-inflammatory pathway; cholinesterase inhibitors; inflammation; neostigmine; perioperative cognitive function; α7nAChR.

Publication types

Review

Grants and funding

This study was supported by the Ji’nan Science and Technology Innovation Development Plan (202134068) and Ji’nan “20 New universities” scientific research leader studio project (202228124).