The Crosstalk between the Blood–Brain Barrier Dysfunction and Neuroinflammation after General Anaesthesia
Round 1
Reviewer 1 Report
to this sentence
At this point, many studies have also observed that clinically used anesthetics can disrupt the integrity of the BBB
Page 10 plebe more accurrate for this paragraph and provide specific reference otherwise use conditional such as may or possible etc
These studies have allowed us to understand that propofol application has a long-term and profound effect on neuroinflammation and BBB disruption, but the exact mechanisms and connections are still unclear to us, and we expect that more studies will follow to focus on and investigate this issue to promote perioperative brain function homeostasis.
Page 10
Taken together, we found a significant association between inhaled anesthetics with BBB destruction and neuroinflammation, but the deeper mechanisms involved need to be further explored.
Pleas explain "we found" in the above sentence , what do you exactly mean , do you have your own research ?
Given some patients have multiple consecutive general anesthesia and recover adequately there must some reversibility on this crossover or this cross over phenomenon is infraclinic please add some discussion I guess we are still far from this affirmation
The authors need to be more cautious on all thier conclusion since most of them are based on in vitro or animal studies
Author Response
Please see the attachment.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Authors describe ina a good narrative review a very interesting topic. The relationship between Blood Brain Barrier Dysfunction and neuroinflammation after General Anesthesia.
Please just consider in further studies the possibility of the influence of genetic factors in brain mechanism (PMID: 27874938).
Thanks
Author Response
Dear Professor, thank you very much for your kind comments on this review. I have also noticed the role played by genetic factors in brain homeostasis recently and would explore it with pleasure in my future studies. Thank you again, and I wish you all the best.
Author Response File: Author Response.docx
Reviewer 3 Report
This paper reviewed the blood-brain barrier (BBB) dysfunction and neuroinflammation after general anesthesia. I have several comments.
1. The authors described in detail the components of BBB and their roles in the development of neuroinflammation. In my opinion, the focus of this review is the effect of general anesthetics on BBB dysfunction and neuroinflammation. The authors may consider adding more discussion in the 5th section.
2. Please consider adding some details about the cited studies (cell culture experiment? animal experiment? what model did they use? clinical studies?) instead of describing their conclusions.
3. Is there clinical studies the authors found in their search that aim to investigate the relationship between general anesthetics, BBB dysfunction, neuroinflammation, underlying mechanisms, and strategies to treat potential cognitive impairment after general anesthetics? Please add more discussion.
Others
1. Page 1. “… proposed that anesthetic drugs may induce long-t-erm morphological ….” Please fix the typo.
2. Page 2. “At this point, many studies have also observed that clinically used anesthetics can disrupt the integrity of the BBB.” Please add references.
3. Page 5. “Occludin was the first TJ protein identified, and they form tight TJs through extracellular loop interactions, while the intracellular loop interacts with the band of ZO protein [23]。” Please fix the typo.
4. Several upper cases in the manuscript are not necessary. Please check and correct them.
5. The English requires improvement. Carefully checking to eliminate grammatical errors is needed.
Author Response
Please see the attachment.
Author Response File: Author Response.docx
Round 2
Reviewer 3 Report
I appreciate the authors' response. No further comments.
