Pachyman alleviates cognitive impairment after sevoflurane anesthesia in gastric cancer surgery

Cancer cell metastasis has already taken place in most of the gastric cancer (GC) patients when diagnosed. Despite that surgery effectively delays the development of GC, sevoflurane anesthetic during surgery tends to cause cognitive impairment. Previous studies have depicted anti-tumor and neuroprotective effects of pachyman. Therefore, this study aimed at investigating a potential mechanism whereby pachyman alleviates cognitive impairment after sevoflurane anesthesia in GC surgery. A rat model of GC was constructed and received treatment with pachyman at different concentrations and caspase-3 inhibitor and agonist. After treatment, the level of inflammatory factors was detected by ELISA. Flow cytometer and Morris water maze were conducted to assess cell death and cognitive function, followed by HE gastric histopathological staining. In addition, RT-qPCR and Western blot detected GSH-PX and caspase-3 expression. Pachyman positively induced the apoptosis of GC cells and strengthened the cognitive function of rats with downregulated caspase-3. Moreover, caspase-3 inhibitor also accelerated apoptosis and improved rat cognitive function. When caspase-3 was inhibited, the level of GSH-PX was elevated. Combination of pachyman and caspase-3 inhibitor more significantly induced GC cell apoptosis and alleviated cognitive impairment. Pachyman alleviates the cognitive impairment caused by sevoflurane anesthesia in GC rats and induces tumor cell apoptosis through down-regulation of caspase-3 and up-regulation of GSH-PX.