AIM Post-operative fatigue syndrome (POFS) is a common complication that prolongs the recovery to normal function and activity after surgery. The aim of the present study was to explore the mechanism of central fatigue in POFS and the anti-fatigue effect of ginsenoside Rb1. METHOD We investigated the association between inflammation, indoleamine 2,3-dioxygenase (IDO) enzyme, and tryptophan metabolism in the hippocampus of POFS rats. A POFS rat model was induced by major small intestinal resection. Rats with major small intestinal resection were administered ginsenoside Rb1 (15 mg/kg) once a day from 3 days before surgery to the day of sacrifice, or with saline as corresponding controls. Fatigue was assessed with the open field test (OFT) and sucrose preference test (SPT). ELISA, RT-PCR, Western blot, immunofluorescence, and high-performance liquid chromatography (HPLC) were used to test the inflammatory cytokines; p38MAPK, NF-κB/p65, and IDO enzyme expressions; and the concentrations of tryptophan, kynurenine, and serotonin, respectively. RESULT Our results showed that POFS was associated with increased expressions of inflammatory cytokines and p38MAPK and higher concentrations of kynurenine and tryptophan on post-operative days 1 and 3; a lower serotonin level on post-operative day 1; and an enhanced translocation of NF-κB/p65 and the IDO enzyme on post-operative days 1, 3, and 5. Ginsenoside Rb1 had an improvement effect on these. CONCLUSION Inflammatory cytokines induced by large abdominal surgery disturb tryptophan metabolism to cause POFS through the activation of the p38MAPK-NF-κB/p65-IDO pathway in the hippocampus. Ginsenoside Rb1 had an anti-fatigue effect on POFS by reducing inflammation and IDO enzyme.

中文翻译：

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炎症通过吲哚胺2,3-双氧合酶干扰术后疲劳综合征大鼠海马色氨酸代谢产物及人参皂甙Rb1的改善作用。

AIM 术后疲劳综合征 (POFS) 是一种常见的并发症，会延长术后恢复到正常功能和活动的时间。本研究旨在探讨 POFS 中枢疲劳机制及人参皂甙 Rb1 的抗疲劳作用。方法 我们研究了 POFS 大鼠海马中炎症、吲哚胺 2,3-双加氧酶 (IDO) 酶和色氨酸代谢之间的关系。POFS大鼠模型由大肠小肠切除诱导。从手术前3天到处死当天，每天一次给大肠切除术的大鼠施用人参皂苷Rb1（15mg / kg），或用盐水作为相应的对照。疲劳通过旷场试验 (OFT) 和蔗糖偏好试验 (SPT) 进行评估。ELISA，RT-PCR，蛋白质印迹，免疫荧光，并采用高效液相色谱法（HPLC）检测炎性细胞因子；p38MAPK、NF-κB/p65 和 IDO 酶的表达；以及色氨酸、犬尿氨酸和血清素的浓度，分别。结果 我们的研究结果表明，POFS 与术后第 1 天和第 3 天炎性细胞因子和 p38MAPK 表达增加以及犬尿氨酸和色氨酸浓度升高有关；术后第 1 天血清素水平降低；NF-κB/p65 和 IDO 酶在术后第 1、3 和 5 天的易位增强。人参皂甙 Rb1 对这些有改善作用。结论腹部大手术诱导的炎性细胞因子通过激活海马p38MAPK-NF-κB/p65-IDO通路干扰色氨酸代谢导致POFS。