General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells. Oligodendrocytes perform essential roles in the central nervous system, including myelin sheath formation, axonal metabolism, and neuroplasticity regulation. They are particularly vulnerable to the effects of general anesthetic agents resulting in impaired proliferation, differentiation, and apoptosis. Neurologists are increasingly interested in the effects of general anesthetic agents on oligodendrocytes. These agents not only act on the surface receptors of oligodendrocytes to elicit neuroinflammation through modulation of signaling pathways, but also disrupt metabolic processes and alter the expression of genes involved in oligodendrocyte development and function. In this review, we summarize the effects of general anesthetic agents on oligodendrocytes. We anticipate that future research will continue to explore these effects and develop strategies to decrease the incidence of adverse reactions associated with the use of general anesthetic agents.
全身麻醉药通过作用于神经胶质细胞，并与神经元相互作用，从而影响大脑功能。其中，少突胶质细胞占人脑全部胶质细胞的45%-75%，在神经系统中主要与髓鞘形成和轴突支持作用密切相关。相关研究表明，全身麻醉药可以通过参与多个重要分子机制引起少突胶质细胞增殖、分化障碍甚至凋亡。目前关于全身麻醉药对少突胶质细胞的影响的研究日益受到神经学家的关注。全身麻醉药通过作用于少突胶质祖细胞表面受体如GABA受体，可引起细胞内的钙稳态失衡，进而导致少突胶质祖细胞的异常增殖分化，并影响髓鞘的形成。同时，全身麻醉药诱导的线粒体外膜通透性转变（MOMP）可导致细胞色素c的外漏并最终激活caspase-3，这一级联反应也是引起少突胶质细胞凋亡的关键机制之一。多个信号通路包括mTOR通路、Raf-MAPK-Eek1/2通路、Wnt通路等，均可作为全身麻醉药的重要靶点。这些靶点受到影响会引起少突胶质细胞的功能异常，进而诱发围手术期神经认知障碍。此外，全身麻醉药引起的促炎细胞因子释放增加，叶酸代谢紊乱，基因水平表达变化均会抑制少突胶质细胞的发育成熟。但也有部分药物表现出一定的神经保护特性，如右美托咪啶和氙气等。该文总结了全身麻醉药对少突胶质细胞的作用及可能机制，并为防治其诱导的神经毒性提供了一定的解决方案，以期为减少与全身麻醉药使用相关的不良反应及未来进一步研究作出贡献。.
Keywords: Central nervous system; General anesthetic agents; Neurotoxicity; Oligodendrocytes; Perioperative neurocognitive disorders.