Although numerous studies have raised public concerns regarding the safety of
anesthetics including
sevoflurane in children, the biochemical mechanisms leading to
anesthetics-induced neurotoxicity remain elusive. Moreover, potential
biomarker(s) for early detection of
general anesthetics-induced
brain injury are urgent for public health. We employed an enabling technology of shotgun lipidomics and analyzed nearly 20 classes and subclasses of
lipids present in the blood serum of postnatal day (PND) 5 or 6 rhesus monkeys temporally collected after exposure to
sevoflurane at a clinically relevant concentration or room-air as control. Lipidomics analysis revealed numerous significant
anesthetic-induced changes of serum
lipids and their metabolites as well as short chain acylcarnitines in the brain and cerebrospinal fluid after
anesthetic exposure. These include decreased
carnitine and acylcarnitines, unchanged
triacylglycerol mass but accumulation of 16:0 and 18:1 fatty acyl chains in the
triacylglycerol pool, losses of
polyunsaturated fatty acids in both non-
esterified fatty acid and
phospholipid pools, and increased
4-hydroxynonenal content as early as 2 h after
sevoflurane exposure. Importantly, the amounts of short chain acylcarnitines in the brain and cerebrospinal fluid were also significantly reduced after
anesthetic exposure. We propose that this serum lipidomic profile can serve as indicative of neuronal damage. Our results reveal that
sevoflurane exposure induces an energy deficient state in the brain evidenced by reduced free and acyl
carnitine contents, as well as the presence of a pro-inflammatory state in the exposed animals, providing deep insights into the underlying mechanisms responsible for
anesthetic-induced neurotoxicity.