Jie Y, Lai ZW, Zhou W, Li YC, Zhong BL, Zeng XX, Jiang Q. Neuroimmune synapse and modulation by anesthetics: Inflammatory mechanisms and therapeutic perspectives for postoperative neurocognitive disorders. World J Psychiatry 2026; 16(4): 115567 [DOI: 10.5498/wjp.v16.i4.115567]
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Apr 19, 2026 (publication date) through Mar 30, 2026
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Publication Name
World Journal of Psychiatry
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2220-3206
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Jie Y, Lai ZW, Zhou W, Li YC, Zhong BL, Zeng XX, Jiang Q. Neuroimmune synapse and modulation by anesthetics: Inflammatory mechanisms and therapeutic perspectives for postoperative neurocognitive disorders. World J Psychiatry 2026; 16(4): 115567 [DOI: 10.5498/wjp.v16.i4.115567]
Yao Jie, Wen Zhou, You-Chun Li, Bao-Lin Zhong, Qiong Jiang, Department of Anesthesiology, Ganzhou People’s Hospital, Ganzhou 341000, Jiangxi Province, China
Zhi-Wei Lai, Department of Orthopedics, Ganzhou Hospital of Traditional Chinese Medicine, Ganzhou 341000, Jiangxi Province, China
Xin-Xing Zeng, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Jie Y, Lai ZW, Zhou W, Li YC, and Zhong BL drafted the manuscript and performed the major revisions; Lai ZW and Zhou W prepared and revised the figures; Jie Y, Li YC, Zhong BL, and Zeng XX conducted the literature search and data curation; Jiang Q and Jie Y conceived the study, supervised the project, and critically reviewed and edited the manuscript. All authors discussed the proposed scope and content of the article before drafting, and have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Received: October 20, 2025 Revised: November 13, 2025 Accepted: December 25, 2025 Published online: April 19, 2026 Processing time: 161 Days and 10.4 Hours
Core Tip
Core Tip: This review reinterprets postoperative neurocognitive disorders through the concept of the neuroimmune synapse (NIS), the microglia, astrocyte, and neuron interface coordinating immune and neuronal signaling. We synthesize evidence on NIS pathways (CX3C chemokine ligand 1/CX3CR1, CD200/CD200R, complement, triggering receptor expressed on myeloid cells 2/DNAX activation protein of 12 kDa), show how anesthesia combined with surgical stress perturbs NIS function, and link aberrant microglial activation, excessive synaptic pruning, and hippocampal and prefrontal dysfunction to postoperative neurocognitive disorders. We further outline how distinct anesthetic classes modulate NIS structure and signaling, and propose testable interventions: Agent selection, multimodal analgesia, and targeting CX3CR1, triggering receptor expressed on myeloid cells 2, and complement to restore synaptic homeostasis.
