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Publication : Mechanisms underlying neonate-specific metabolic effects of volatile anesthetics.

First Author  Stokes J Year  2021
Journal  Elife Volume  10
PubMed ID  34254587 Mgi Jnum  J:308505
Mgi Id  MGI:6728709 Doi  10.7554/eLife.65400
Citation  Stokes J, et al. (2021) Mechanisms underlying neonate-specific metabolic effects of volatile anesthetics. Elife 10:e65400
abstractText  Volatile anesthetics (VAs) are widely used in medicine, but the mechanisms underlying their effects remain ill-defined. Though routine anesthesia is safe in healthy individuals, instances of sensitivity are well documented, and there has been significant concern regarding the impact of VAs on neonatal brain development. Evidence indicates that VAs have multiple targets, with anesthetic and non-anesthetic effects mediated by neuroreceptors, ion channels, and the mitochondrial electron transport chain. Here, we characterize an unexpected metabolic effect of VAs in neonatal mice. Neonatal blood beta-hydroxybutarate (beta-HB) is rapidly depleted by VAs at concentrations well below those necessary for anesthesia. beta-HB in adults, including animals in dietary ketosis, is unaffected. Depletion of beta-HB is mediated by citrate accumulation, malonyl-CoA production by acetyl-CoA carboxylase, and inhibition of fatty acid oxidation. Adults show similar significant changes to citrate and malonyl-CoA, but are insensitive to malonyl-CoA, displaying reduced metabolic flexibility compared to younger animals.
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