Putative Involvement of Cytokine Modulation in the Development of Perioperative Neurocognitive Disorders

Christopher Pereira,1 Melanie Dani,1 Simon D Taylor-Robinson,2 Michael Fertleman1 1Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, UK; 2Department of Surgery and Cancer, Imperial College London, London, UKCorrespondence: Michael Fertleman, Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, UK, Tel +44 203 312 1077, Email m.fertleman@imperial.ac.ukAbstract: Following surgery, local cytokine-driven inflammation occurs, as part of the normal healing process. Cytokines in the central nervous system such as IL-6 and IL-8 may also be elevated. These cytokine changes likely contribute to neuroinflammation, but the complex mechanisms through which this occurs are incompletely understood. It may be that perioperative changes in pro- and anti-inflammatory cytokines have a role in the development of perioperative neurocognitive disorders (PND), such as post-operative delirium (POD). This review considers the current evidence regarding perioperative cytokine changes in the blood and cerebrospinal fluid (CSF), as well as considering the potential for cytokine-altering therapies to prevent and treat PND.Keywords: neuroinflammation, interleukins, central nervous system, perioperative neurocognitive disorders, blood-brain barrier, delirium