Isoflurane can lead to the death of brain cells

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The commonly used anesthetic isoflurane can lead to the death of brain cells and the production of amyloid-beta plaque, a hallmark of Alzheimer's disease, Harvard researchers report. Their study appears in the January issue of the Journal of Gerontology, which is devoted to the problems of dementia and delirium.

The Harvard study raises questions about the safety of isoflurane, which has been used for years for all ages of patients. "Many people, especially the elderly, who have anesthesia suffer from postoperative cognitive dysfunction, scrambling and delirium that can last six hours or two weeks or months," said lead researcher Rudolph Tanzi, a professor of neurology at the Genetics and Aging Research Unit of the Massachusetts General Institute for Neurodegenerative Disease. "To me, a big dose of isoflurane mimics a stroke or a bang to the head, and you don't want that as a risk factor for Alzheimer's disease at any age," Tanzi said.

In experiments with cells that had an amyloid-beta protein, Tanzi's team exposed them to isoflurane for six hours. The researchers found that isoflurane caused these cells to die. "It also caused the cell to overproduce the toxic molecule responsible for the pathology of Alzheimer's disease, particularly amyloid-beta," Tanzi said.

This is a warning, Tanzi said. "Isoflurane may be one reason why the elderly are more prone to cognitive dysfunction following anesthesia," he said. "Any trauma to the brain induces cell death. Isoflurane now joins that list of insults to the brain that can cause cell death and excessive production of this key molecule in Alzheimer's pathology," Tanzi. "This does increase the risk for Alzheimer's disease."