Corticosterone-linked microglial activity underpins sexually dimorphic neuroplasticity after ketamine anesthesia.

Venturino, Alessandro; Alamalhoda, MohammadAmin; Negrello, Thomas; Jin, Kelly; van Velthoven, Cindy T J; Cubero, Ryan John A; Yeung, Jake; Koppensteiner, Peter et al. · Sci Adv · 2026

basic_science · Level V

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Abstract

Anesthesia recovery is critical for resuming normal physiological and neuronal functions; however, the mechanisms involved remain elusive. Here, we identify a female-selective corticosterone-mediated microglia-neuron interaction during ketamine anesthesia recovery, absent in males. This microglia-neuron interaction induces plastic and functional neuronal changes, as evidenced by increased mEPSC frequency, which was occluded upon microglia depletion. We showed that this process is driven through up-regulation of the stress-responsive co-chaperone <i>Fkbp5</i> mRNA and its protein, Fkbp51, in female microglia. <i>Fkbp5</i>/Fkbp51 is a key intermediary in a corticosteroid-induced stress response, and its involvement points toward a critical interface between endocrine signaling and microglia. To counteract the observed ketamine anesthesia-mediated increase in blood corticosterone during recovery, we removed the primary source of corticosterone by adrenalectomy. Close microglia-neuron interaction was reduced and increased again following corticosterone injection. Our findings identify a sex-specific microglia-mediated mechanism of neuronal plasticity during anesthesia recovery, driven by corticosterone, thereby enhancing our understanding of sex differences in brain function.

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