Panax Notoginseng Saponins attenuates sevoflurane-induced nerve cell injury by modulating AKT signaling pathway

General anesthesia in patients with or at risk for neuronal injury remains challenging due to the neurotoxic effects of volatile anesthetics. One inhalation anesthetic, sevoflurane, induces neuronal damage, including neuroapoptosis, and learning and memory impairment. Panax Notoginseng Saponins (PNS) is the active ingredient of Sanqui and has been reported to exert neuroprotective effects. In the current study, the protective effect of PNS on sevoflurane-induced nerve cell injury was explored. Cell proliferation was significantly reduced in a dose-dependent manner following stimulation with sevoflurane. Furthermore, cell apoptosis and the protein expression of caspase-3, caspase-9 and Bax were significantly increased, while the expression of Bcl-2 was decreased in the sevoflurane group compared with normal control. Furthermore, the protein level of Bace-1, APP and Aβ were elevated in the sevoflurane group compared with the control group. By contrast, PNS treatment significantly reduced the neurotoxicity induced by sevoflurane. Additionally, sevoflurane reduced activation of the AKT signaling pathway, which was activated by PNS treatment. In conclusion, the results suggested that PNS attenuates sevoflurane-induced neurotoxicity through by stimulating cell proliferation and inhibiting cell apoptosis. These effects were mediated, at least in part, by activating the AKT signaling pathway.