Dexmedetomidine Can Reduce the Level of Oxidative Stress and Serum miR-10a in Patients with Lung Cancer after Surgery

Significance of contrast-enhanced computed tomography parameters and miR-10a and miR-21 expression in rectal cancer

BACKGROUND

The incidence of rectal cancer is still high in China and increases with age. The existing screening methods are not ideal for early detection of rectal cancer, and it is necessary to find an efficient and sensitive screening method to provide theoretical reference for early differential diagnosis of rectal cancer.

AIM

To evaluate the significance of contrast-enhanced compu-terized tomography (CT) parameters and microRNA-10a (miR-10a) and microRNA-21 (miR-21) expression in rectal cancer.

METHODS

A total of 100 patients with rectal cancer in Haishu District People's Hospital in Ningbo from June 2020 to June 2023 were selected as a study group, and another 100 patients with benign rectal tumors in the same period were selected as a control group. All patients underwent contrast-enhanced CT examinations as well as miR-10a and miR-21 expression detection. The △CT values and mir-10a and miR-21 expression of the two groups were statistically analyzed. Spearman analysis was used to analyze the correlation of △CT values and miR-10a and miR-21 expression with clinicopathological parameters. Receiver operating characteristic curve and area under the curve were used to analyze the diagnostic efficacy of △CT values and miR-10a and miR-21 expression for rectal cancer. Kaplan-Meier survival curve analysis was performed to explore the relationship of △CT values and miR-10a and miR-21 expression with the prognosis of rectal cancer.

RESULTS

The △CT values and the expression of miR-10a and miR-21 in the arterial phase, venous phase, and delayed phase of the study group were significantly higher than those of the control group (P < 0.05). Spearman correlation analysis showed that the △CT values and miR-10a and miR-21 expression in the arterial, venous, and delayed phases were positively correlated with tumor diameter, TNM stage, vascular invasion, and nerve invasion, and negatively correlated with differentiation degree in rectal cancer patients (P < 0.05). The diagnostic efficacy of △CT value + miR-10a + miR-21 in the arterial phase, venous phase, and delayed phase for rectal cancer was significantly higher than that of any one of them alone (0.914 vs 0.807, 0.821, 0.787, and 0.766). The survival rate of patients with high expression of miR-10a and miR-21 in the arterial phase, venous phase, and delayed phase was lower than that of patients with low expression, but the difference was not statistically significant (P > 0.05).

CONCLUSION

△CT value and miR-10a and miR-21 expression are associated with clinicopathological parameters and survival prognosis in rectal cancer. Combined detection can help improve the diagnostic efficacy for rectal cancer, guide clinical decision-making, and control disease progression.

Trial watch: dexmedetomidine in cancer therapy

Dexmedetomidine (DEX) is a highly selective α2-adrenoceptor agonist that is widely used in intensive and anesthetic care for its sedative and anxiolytic properties. DEX has the capacity to alleviate inflammatory pain while limiting immunosuppressive glucocorticoid stress during major surgery, thus harboring therapeutic benefits for oncological procedures. Recently, the molecular mechanisms of DEX-mediated anticancer effects have been partially deciphered. Together with additional preclinical data, these mechanistic insights support the hypothesis that DEX-induced therapeutic benefits are mediated via the stimulation of adaptive anti-tumor immune responses. Similarly, published clinical trials including ancillary studies described an immunostimulatory role of DEX during the perioperative period of cancer surgery. The impact of DEX on long-term patient survival remains elusive. Nevertheless, DEX-mediated immunostimulation offers an interesting therapeutic option for onco-anesthesia. Our present review comprehensively summarizes data from preclinical and clinical studies as well as from ongoing trials with a distinct focus on the role of DEX in overcoming (tumor microenvironment (TME)-imposed) cancer therapy resistance. The objective of this update is to guide clinicians in their choice toward immunostimulatory onco-anesthetic agents that have the capacity to improve disease outcome.

Dexmedetomidine Attenuates Methotrexate-Induced Neurotoxicity and Memory Deficits in Rats through Improving Hippocampal Neurogenesis: The Role of miR-15a/ROCK-1/ERK1/2/CREB/BDNF Pathway Modulation

Methotrexate (MTX) is a widely used neurotoxic drug with broad antineoplastic and immunosuppressant spectra. However, the exact molecular mechanisms by which MTX inhibits hippocampal neurogenesis are yet unclear. Dexmedetomidine (Dex), an α2-adrenergic receptor agonist, has recently shown neuroprotective effects; however, its full mechanism is unexplored. This study investigated the potential of Dex to mitigate MTX-induced neurotoxicity and memory impairment in rats and the possible role of the miR-15a/ROCK-1/ERK1/2/CREB/BDNF pathway. Notably, no former studies have linked this pathway to MTX-induced neurotoxicity. Male Sprague Dawley rats were placed into four groups. Group 1 received saline i.p. daily and i.v. on days 8 and 15. Group 2 received Dex at 10 μg/kg/day i.p. for 30 days. Group 3 received MTX at 75 mg/kg i.v. on days 8 and 15, followed by four i.p. doses of leucovorin at 6 mg/kg after 18 h and 3 mg/kg after 26, 42, and 50 h. Group 4 received MTX and leucovorin as in group 3 and Dex daily dosages as in group 2. Bioinformatic analysis identified the association of miR-15a with ROCK-1/ERK1/2/CREB/BDNF and neurogenesis. MTX lowered hippocampal doublecortin and Ki-67, two markers of neurogenesis. This was associated with the downregulation of miR-15a, upregulation of its target ROCK-1, and reduction in the downstream ERK1/2/CREB/BDNF pathway, along with disturbed hippocampal redox state. Novel object recognition and Morris water maze tests demonstrated the MTX-induced memory deficiencies. Dex co-treatment reversed the MTX-induced behavioral, biochemical, and histological alterations in the rats. These neuroprotective actions could be partly mediated through modulating the miR-15a/ROCK-1/ERK1/2/CREB/BDNF pathway, which enhances hippocampal neurogenesis.