Imperial College London

Professor Daqing Ma, MD, PhD

Faculty of MedicineDepartment of Surgery & Cancer

Professor of Anaesthesia
 
 
 
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Contact

 

+44 (0)20 3315 8495d.ma Website

 
 
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Assistant

 

Miss Steffi Klier +44 (0)20 3315 8816

 
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Location

 

G3.44Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Publication Type
Year
to

377 results found

Huang H, Liu P, Ma D, Zhang H, Xu H, Zhou J, Zhao H, Zhao T, Li Cet al., 2022, Triiodothyronine attenuates neurocognitive dysfunction induced by sevoflurane in the developing brain of neonatal rats., J Affect Disord, Vol: 297, Pages: 455-462

BACKGROUND: Whilst concerns have been raised about the detrimental effects of general anaesthetics on the brain's development and function in the young, reports have indicated that thyroid hormones are able to promote neurogenesis in the developing brain. This present study aimed to investigate the effects of triiodothyronine (T3) on the neonatal rat brain, following sevoflurane exposure. METHODS: Postnatal day 7 (P7) ratpups were treated with Triiodothyronine (T3) (1 µg/100 g body weight, i.p. injection, once/day for 3 days) after 2% sevoflurane exposure for 6 h. They were sacrificed at either P7 (immediately), P15 or P30 and their brains were harvested to assess cell death, proliferation in the hippocampus, N-methyl-D-aspartate (NMDA) receptor subunit A and B, and a post-synaptic protein (PSD-95 in the hippocampus,). Neuro-behavioral changes in other cohorts between P27 and P30 were evaluated with Morris water maze and open field tests. RESULTS: Sevoflurane exposure caused cell death and suppressed the proliferation of astrocytes and neurons, as well as the dendritic growth of neurons in the hippocampus which were all reversed by the administration of T3. Moreover, cognitive function, including learning, memory, and adaptability to a new environment, were impaired by sevoflurane exposure, which was also negated by T3 treatment. Furthermore, sevoflurane decreased the expression of NMDA receptor subunits NR2A and NR2B, as well as PSD-95 in the hippocampus at P15 and those effects of sevoflurane were abolished by T3 administration. CONCLUSIONS: A potential therapeutic role of T3 in protecting general anesthetic induced neuronal injury in the developing brain is likely to occur through enhancing expression of PSD-95 and the NMDA NR2A and NR2B expression.

Journal article

Alam A, Ma D, 2021, Is it time to Assess Neurological Status before Surgery to Improve Postoperative Outcomes?, Annals of Surgery, Vol: Publish Ahead of Print, ISSN: 0003-4932

Journal article

Gao W, Li W, Yan Y, Yang R, Zhang Y, Jin M, Luo Z, Xie L, Ma Y, Xu X, Wang G, Kong Z, Gao Y, Li Y, Ruan Z, Zheng J, Ma D, Wang Qet al., 2021, Transcutaneous electrical acupoint stimulation applied in lower limbs decreases the incidence of paralytic ileus after colorectal surgery: A multicenter randomized controlled trial., Surgery

BACKGROUND: Postoperative paralytic ileus prolongs hospitalization duration, increases medical expenses, and is even associated with postoperative mortality; however, effective prevention of postoperative paralytic ileus is not yet available. This trial aimed to assess the preventative effectiveness of transcutaneous electrical acupoint stimulation applied in the lower limbs on postoperative paralytic ileus incidence after colorectal surgery. METHODS: After ethics approval and written informed consent, 610 patients from 10 hospitals who were scheduled for colorectal surgery between May 2018 and September 2019 were enrolled. Patients were randomly allocated into the transcutaneous electrical acupoint stimulation (stimulated on bilateral Zusanli, Shangjuxu, and Sanyinjiao acupoints in lower limbs for 30 minutes each time, total 4 times) or sham (without currents delivered) group with 1:1 ratio. The primary outcome was postoperative paralytic ileus incidence, defined as no flatus for >72 hours after surgery. RESULTS: Compared to the sham treatment, transcutaneous electrical acupoint stimulation lowered the postoperative paralytic ileus incidence by 8.7% (32.3% vs 41.0%, P = .026) and decreased the risk of postoperative paralytic ileus by 32% (OR, 0.68; P = .029). Transcutaneous electrical acupoint stimulation also shortened the recovery time to flatus, defecation, normal diet, and bowel sounds. Transcutaneous electrical acupoint stimulation treatment significantly increased median serum acetylcholine by 55% (P = .007) and interleukin-10 by 88% (P < .001), but decreased interleukin-6 by 47% (P < .001) and inducible nitric oxide synthase by 42% (P = .002) at 72 hours postoperatively. CONCLUSION: Transcutaneous electrical acupoint stimulation attenuated the postoperative paralytic ileus incidence and enhanced gastrointestinal functional recovery, which may be associated with increasing parasympathetic nerve tone and its anti-inflamma

Journal article

Hu C, Huang Y, Wu L, Zhao H, Pac Soo C, Lian Q, Ma Det al., 2021, Apoptosis and necroptosis occur in the different brain regions of hippocampus in a rat model of hypoxia asphyxia., Int J Neurosci, Vol: 131, Pages: 843-853

AIM OF THE STUDY: Hypoxic-ischemic encephalopathy (HIE) is a major cause of newborn brain injury. Apoptosis and necroptosis are two forms of cell death which may occur in HIE but reported data are yet limited. This study investigates the expression of receptor interacting protein kinase (RIPK) 1 and 3, and caspase3, the key modulators of necroptosis and apoptosis, respectively, in a model of HIE to determine whether both forms of cell death occur in the corresponding brain regions. MATERIALS AND METHODS: Postneonatal day 7 Sprague-Dawley rats were subjected to right carotid artery ligation followed by hypoxia or subjected to skin incision under surgical anesthesia without ligation and hypoxia. Neuroglioma (H4) cell was cultured and subjected to 24 h hypoxic insults. Necrostatin-1, a RIPK1 inhibitor, was administered in both in vivo and in vitro settings before insult. RESULTS: After hypoxic-ischemic insults, both RIPK1 and RIPK3 expression were significantly increased in the region of hippocampal dentate gyrus in the injurious hemisphere. However, cleaved caspase3 was significantly increased in the hippocampal cornu ammonis 1 region in the injurious hemisphere. After hypoxic insults, RIPK1 and RIPK3 expression was also found in H4 cells. In addition, it was identified that the increased RIPK1 and RIPK3 can be inhibited by necrostatin-1 in both in vivo and in vitro. CONCLUSIONS: These data indicated that apoptosis and necroptosis occur in different brain regions of hippocampus in a model of HIE which may suggest that strategies to prevent each form of neuronal death is valuable to be developed.

Journal article

Liu Y, Yang H, Fu Y, Pan Z, Qiu F, Xu Y, Yang X, Chen Q, Ma D, Liu Zet al., 2021, TRPV1 Antagonist Prevents Neonatal Sevoflurane-Induced Synaptic Abnormality and Cognitive Impairment in Mice Through Regulating the Src/Cofilin Signaling Pathway, FRONTIERS IN CELL AND DEVELOPMENTAL BIOLOGY, Vol: 9, ISSN: 2296-634X

Journal article

Zhu Y, Zhou M, Jia X, Zhang W, Shi Y, Bai S, Rampes S, Vizcaychipi MP, Wu C, Wang K, Ma D, Yang Q, Wang Let al., 2021, Inflammation Disrupts the Brain Network of Executive Function After Cardiac Surgery., Ann Surg

OBJECTIVE: To investigate postoperative functional connectivity alterations across impaired cognitive domains and their causal relationships with systemic inflammation. BACKGROUND: Postoperative cognitive dysfunction commonly occurs after cardiac surgery, and both systemic and neuroinflammation may trigger its development. Whether functional connectivity alterations underlying deficits in specific cognitive domains after cardiac surgery are affected by inflammation remain unclear. METHODS: Seventeen patients, who underwent cardiac valve replacement, completed a neuropsychological test battery and brain MRI scan before surgery and on days 7 and 30 after surgery compared to age-matched healthy controls. Blood samples were taken for TNF-α and IL-6 measurements. Seed-to-voxel FC of the left dorsolateral prefrontal cortex (DLPFC) was examined. Bivariate correlation and linear regression models were used to determine the relationships among cognitive function, FC alterations and cytokines. RESULTS: Executive function was significantly impaired after cardiac surgery. At day 7 follow-up, the surgical patients, compared to the controls, demonstrated significantly decreased DLPFC functional connectivity with the superior parietal lobe and attenuated negative connectivity in the default mode network, including the angular gyrus and posterior cingulate cortex. The left DLPFC enhanced the connectivity in the right DLPFC and posterior cingulate cortex, all of which were related to the increased TNF-α and decreased executive function up to day 7 after cardiac surgery. CONCLUSIONS: The decreased functional connectivity of executive control network and its anticorrelation with the default mode network may contribute to executive function deficits following cardiac surgery. Systemic inflammation may trigger these transient FC changes and executive function impairments.

Journal article

Hu C, Iwasaki M, Liu Z, Wang B, Li X, Lin H, Li J, Li JV, Lian Q, Ma Det al., 2021, Lung but not brain cancer cell malignancy inhibited by commonly used anesthetic propofol during surgery: Implication of reducing cancer recurrence risk, Journal of Advanced Research, Vol: 31, Pages: 1-12, ISSN: 2090-1232

IntroductionIntravenous anesthesia with propofol was reported to improve cancer surgical outcomes when compared with inhalational anesthesia. However, the underlying molecular mechanisms largely remain unknown.ObjectivesThe anti-tumor effects of propofol and the possible underlying mechanism including altered metabolic and signaling pathways were studied in the current study.MethodsThe cell viability, proliferation, migration, and invasion of cancer cells were analyzed with CCK-8, Ki-67 staining, wound healing, and Transwell assay, respectively. The protein changes were analyzed with Western blot and immunofluorescent staining. The metabolomics alteration was studied with 1H-NMR spectroscopy. The gene expression regulations were analyzed with PCR gene array and qRT-PCR experiments.ResultsIn this study, we found that propofol reduced cell viability and inhibited cell proliferation, migration and invasion of lung cancer cells, but not neuroglioma cells. In lung cancer cells, propofol downregulated glucose transporter 1 (GLUT1), mitochondrial pyruvate carrier 1 (MPC1), p-Akt, p-Erk1/2, and hypoxia- inducible factor 1 alpha (HIF-1 α ) expressions and upregulated pigment epithelium-derived factor (PEDF) expression. Propofol increased intracellular glutamate and glycine but decreased acetate and formate whilst increased glucose, lactate, glutamine, succinate, pyruvate, arginine, valine, isoleucine, and leucine and glycerol, and decreased acetate, ethanol, isopropanol in the culture media of lung cancer cells. Furthermore, VEGFA, CTBP1, CST7, CTSK, CXCL12, and CXCR4 gene expressions were downregulated, while NR4A3, RB1, NME1, MTSS1, NME4, SYK, APC, and FAT1 were upregulated following the propofol treatment. Consistent with the phenotypical changes, these molecular and metabolic changes were not found in the neuroglioma cells.ConclusionOur findings indicated anti-tumor effects of propofol on the lung cancer but not brain cancer, through the regulation of tumor metasta

Journal article

Chen L, Alam A, Pac-Soo A, Chen Q, Shang Y, Zhao H, Yao S, Ma Det al., 2021, Pretreatment with valproic acid alleviates pulmonary fibrosis through epithelial-mesenchymal transition inhibition in vitro and in vivo, LABORATORY INVESTIGATION, Vol: 101, Pages: 1166-1175, ISSN: 0023-6837

Journal article

Alam A, Rampes S, Patel S, Hana Z, Ma Det al., 2021, Anesthetics or anesthetic techniques and cancer surgical outcomes: a possible link., Korean J Anesthesiol, Vol: 74, Pages: 191-203

As of 2018 cancer is responsible for almost 9.6 million deaths annually and, with an aging population, the incidence of cancer is expected to continue to rise. Surgery is an important treatment modality for patients with solid organ cancers. It has been postulated that, due to potentially overlapping processes underlying the development of malignancy and the therapeutic pathways of various anesthetic agents, the choice of anesthetic type and method of administration may affect post-operative outcomes in patients with cancer. This is a literature review of the most recent evidence extracted from various databases including PubMed, EMBASE, and the Cochrane, as well as journals and book reference lists. The review highlights the pathophysiological processes underpinning cancer development and the molecular actions of anesthetic agents, pre-clinical and retrospective studies investigating cancer and anesthetics, as well as ongoing clinical trials. Overall, there are conflicting results regarding the impact of regional vs. general anesthesia on cancer recurrence, whilst the majority of data suggest a benefit of the use of intravenous propofol over inhalational volatile anesthetics. The biological changes associated with the surgical inflammatory response offer a unique opportunity to intervene to counteract any potentially cancer-promoting effects.

Journal article

Ishikawa M, Iwasaki M, Zhao H, Saito J, Hu C, Sun Q, Sakamoto A, Ma Det al., 2021, Inhalational Anesthetics Inhibit Neuroglioma Cell Proliferation and Migration via miR-138, -210 and -335., Int J Mol Sci, Vol: 22

Inhalational anesthetics was previously reported to suppress glioma cell malignancy but underlying mechanisms remain unclear. The present study aims to investigate the effects of sevoflurane and desflurane on glioma cell malignancy changes via microRNA (miRNA) modulation. The cultured H4 cells were exposed to 3.6% sevoflurane or 10.3% desflurane for 2 h. The miR-138, -210 and -335 expression were determined with qRT-PCR. Cell proliferation and migration were assessed with wound healing assay, Ki67 staining and cell count kit 8 (CCK8) assay with/without miR-138/-210/-335 inhibitor transfections. The miRNA downstream proteins, hypoxia inducible factor-1α (HIF-1α) and matrix metalloproteinase 9 (MMP9), were also determined with immunofluorescent staining. Sevoflurane and desflurane exposure to glioma cells inhibited their proliferation and migration. Sevoflurane exposure increased miR-210 expression whereas desflurane exposure upregulated both miR-138 and miR-335 expressions. The administration of inhibitor of miR-138, -210 or -335 inhibited the suppressing effects of sevoflurane or desflurane on cell proliferation and migration, in line with the HIF-1α and MMP9 expression changes. These data indicated that inhalational anesthetics, sevoflurane and desflurane, inhibited glioma cell malignancy via miRNAs upregulation and their downstream effectors, HIF-1α and MMP9, downregulation. The implication of the current study warrants further study.

Journal article

Gao X, Xiong Y, Huang J, Zhang N, Li J, Zheng S, Lu K, Ma D, Yang B, Ning Jet al., 2021, The Effect of Mechanical Ventilation With Low Tidal Volume on Blood Loss During Laparoscopic Liver Resection: A Randomized Controlled Trial, ANESTHESIA AND ANALGESIA, Vol: 132, Pages: 1033-1041, ISSN: 0003-2999

Journal article

Wen J-L, Sun Q-Z, Cheng Z, Liao X-Z, Wang L-Q, Yuan Y, Li J-W, Hou L-S, Gao W-J, Wang W-J, Soh W-Y, Li B-F, Ma D-Qet al., 2021, Extracorporeal membrane oxygenation for coronavirus disease 2019-associated acute respiratory distress syndrome: Report of two cases and review of the literature, WORLD JOURNAL OF CLINICAL CASES, Vol: 9, Pages: 1953-1967, ISSN: 2307-8960

Journal article

Ishikawa M, Iwasaki M, Sakamoto A, Ma Det al., 2021, Anesthetics may modulate cancer surgical outcome: a possible role of miRNAs regulation., BMC Anesthesiol, Vol: 21

BACKGROUND: microRNAs (miRNAs) are single-stranded and noncoding RNA molecules that control post-transcriptional gene regulation. miRNAs can be tumor suppressors or oncogenes through various mechanism including cancer cell biology, cell-to-cell communication, and anti-cancer immunity. MAIN BODY: Anesthetics can affect cell biology through miRNA-mediated regulation of messenger RNA (mRNA). Indeed, sevoflurane was reported to upregulate miR-203 and suppresses breast cancer cell proliferation. Propofol reduces matrix metalloproteinase expression through its impact on miRNAs, leading to anti-cancer microenvironmental changes. Propofol also modifies miRNA expression profile in circulating extracellular vesicles with their subsequent anti-cancer effects via modulating cell-to-cell communication. CONCLUSION: Inhalational and intravenous anesthetics can alter cancer cell biology through various cellular signaling pathways induced by miRNAs' modification. However, this area of research is insufficient and further study is needed to figure out optimal anesthesia regimens for cancer patients.

Journal article

Deng C-M, Ding T, Li S, Lei B, Xu M-J, Wang L, Xu S-C, Yang H-X, Sun X-Y, Li X-Y, Ma D, Wang D-Xet al., 2021, Neuraxial labor analgesia is associated with a reduced risk of postpartum depression: A multicenter prospective cohort study with propensity score matching, JOURNAL OF AFFECTIVE DISORDERS, Vol: 281, Pages: 342-350, ISSN: 0165-0327

Journal article

Ishikawa M, Iwasaki M, Zhao H, Saito J, Hu C, Sun Q, Sakamoto A, Ma Det al., 2021, Sevoflurane and Desflurane Exposure Enhanced Cell Proliferation and Migration in Ovarian Cancer Cells via miR-210 and miR-138 Downregulation, INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, Vol: 22

Journal article

Zhao H, Davies R, Ma D, 2021, Potential therapeutic value of dexmedetomidine in COVID-19 patients admitted to ICU., Br J Anaesth, Vol: 126, Pages: e33-e35

Journal article

Liu C, Yu M, Li Y, Wang H, Xu C, Zhang X, Li M, Guo H, Ma D, Guo Xet al., 2020, Lidocaine inhibits the metastatic potential of ovarian cancer by blocking Na(V)1.5-mediated EMT and FAK/Paxillin signaling pathway, CANCER MEDICINE, Vol: 10, Pages: 337-349, ISSN: 2045-7634

Journal article

Zhao T, Chen Y, Sun Z, Shi Z, Qin J, Lu J, Li C, Ma D, Zhou L, Song Xet al., 2020, Prenatal sevoflurane exposure causes neuronal excitatory/inhibitory imbalance in the prefrontal cortex and neurofunctional abnormality in rats, NEUROBIOLOGY OF DISEASE, Vol: 146, ISSN: 0969-9961

Journal article

Chen R, Yu Y-L, Li W, Liu Y, Lu J-X, Chen F, Zhou Q, Xia Z-Y, Gao L, Meng Q-T, Ma Det al., 2020, Gastrointestinal Symptoms Associated With Unfavorable Prognosis of COVID-19 Patients: A Retrospective Study, FRONTIERS IN MEDICINE, Vol: 7

Journal article

Iwasaki M, Saito J, Zhao H, Sakamoto A, Hirota K, Ma Det al., 2020, Inflammation Triggered by SARS-CoV-2 and ACE2 Augment Drives Multiple Organ Failure of Severe COVID-19: Molecular Mechanisms and Implications, INFLAMMATION, Vol: 44, Pages: 13-34, ISSN: 0360-3997

Journal article

Wang D, Huang Y, Wang X, Chen X, Li J, Zhang S, Wu J, Liu D, Ma D, Mei Wet al., 2020, Circadian differences in emergence from volatile anaesthesia in mice: involvement of the locus coeruleus noradrenergic system, BRITISH JOURNAL OF ANAESTHESIA, Vol: 125, Pages: 548-559, ISSN: 0007-0912

Journal article

Jin Z, Hu J, Ma D, 2020, Postoperative delirium: perioperative assessment, risk reduction, and management., Br J Anaesth, Vol: 125, Pages: 492-504

Postoperative delirium is a relatively common and serious complication. It increases hospital stay by 2-3 days and is associated with a 30-day mortality of 7-10%. It is most prevalent in older patients, those with existing neurocognitive disorders, and those undergoing complex or emergency procedures. Preclinical and clinical research in recent years has uncovered more about the pathophysiology of postoperative delirium and may yield more potential therapeutic options. Using the enhanced recovery pathway framework of risk stratification, risk reduction, and rescue treatment, we have reviewed the current clinical evidence on the validity of delirium prediction scores for the surgical population, the effectiveness of perioperative delirium risk reduction interventions, and management options for established delirium. Effective perioperative interventions include depth of anaesthesia monitoring, intraoperative dexmedetomidine infusion, and multimodal analgesia. Choice of general anaesthetic agent may not be associated with significant difference in delirium risk. Several other factors, such as preoperative fasting, temperature control, and blood pressure management have some association with the risk of postoperative delirium; these will require further studies. Because of the limited treatment options available for established delirium, we propose that risk assessment and perioperative risk reduction may be the most effective approaches in managing postoperative delirium.

Journal article

Lan F, Lin G, Cao G, Li Z, Ma D, Liu F, Duan M, Fu H, Xiao W, Qi Z, Wang Tet al., 2020, Altered Intrinsic Brain Activity and Functional Connectivity Before and After Knee Arthroplasty in the Elderly: A Resting-State fMRI Study, FRONTIERS IN NEUROLOGY, Vol: 11, ISSN: 1664-2295

Journal article

Zhen C, Zhao H, Wu L, Alam A, Eguchi S, Weng H, Ma Det al., 2020, The Role of Neutrophil NETosis in Organ Injury: Novel Inflammatory Cell Death Mechanisms, INFLAMMATION, Vol: 43, Pages: 2021-2032, ISSN: 0360-3997

Journal article

Ma DAQING, 2020, Propofol induced MiR-20b expression initiates endogenous cellular signal changes mitigating hypoxia/re-oxygenation-induced endothelial autophagy in vitro, Cell Death and Disease, ISSN: 2041-4889

Journal article

Ishikawa M, Sakamoto A, Ma D, 2020, Recurrence of breast cancer after anaesthesia., Lancet, Vol: 396, Pages: 375-376

Journal article

Yang S-R, Hua K-F, Chu LJ, Hwu Y-K, Yang S-M, Wu C-Y, Lin T-J, Weng J-C, Zhao H, Hsu W-H, Liu F-C, Liaw W-J, Ma D, Ka S-M, Chen Aet al., 2020, Xenon blunts NF-κB/NLRP3 inflammasome activation and improves acute onset of accelerated and severe lupus nephritis in mice., Kidney Int, Vol: 98, Pages: 378-390

Xenon, an inert anesthetic gas, is increasingly recognized to possess desirable properties including cytoprotective and anti-inflammatory effects. Here we evaluated the effects of xenon on the progression of lupus nephritis (LN) in a mouse model. A two hour exposure of either 70% xenon or 70% nitrogen balanced with oxygen was administered daily for five weeks to female NZB/W F1 mice that had been induced to develop accelerated and severe LN. Xenon treatment improved kidney function and renal histology, and decreased the renal expression of neutrophil chemoattractants, thereby attenuating glomerular neutrophil infiltration. The effects of xenon were mediated primarily by deceasing serum levels of anti-double stranded DNA autoantibody, inhibiting reactive oxygen species production, NF-κB/NLRP3 inflammasome activation, ICAM-1 expression, glomerular deposition of IgG and C3 and apoptosis, in the kidney; and enhancing renal hypoxia inducible factor 1-α expression. Proteomic analysis revealed that the treatment with xenon downregulated renal NLRP3 inflammasome-mediated cellular signaling. Similarly, xenon was effective in improving renal pathology and function in a spontaneous LN model in female NZB/W F1 mice. Thus, xenon may have a therapeutic role in treating LN but further studies are warranted to determine applicability to patients.

Journal article

Jin Z, Suen KC, Wang Z, Ma Det al., 2020, Review 2: Primary graft dysfunction after lung transplant-pathophysiology, clinical considerations and therapeutic targets, JOURNAL OF ANESTHESIA, Vol: 34, Pages: 729-740, ISSN: 0913-8668

Journal article

Huang W-W, Zhu W-Z, Mu D-L, Ji X-Q, Li X-Y, Ma D, Wang D-Xet al., 2020, Intraoperative hypotension is associated with shortened overall survival after lung cancer surgery, BMC ANESTHESIOLOGY, Vol: 20, ISSN: 1471-2253

Journal article

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