The aim of the study was to evaluate the effect of anesthetics as operating room contaminants on tetrahydrobiopterin pathway in 40 operating room personnel and 30 healthy controls by measuring biopterin, dihydrobiopterin reductase, tryptophan, kynurenine and serotonin. Biopterin concentrations were 124 ± 12.3 µmol/mol creatinine in workers and 88 ± 5.7 µmol/mol creatinine in controls whereas kynurenine concentrations were 1.75 ± 0.09 µM and 1.95 ± 0.06 µM, respectively (both, p < 0.05). It can be claimed that enhanced biopterin and diminished kynurenine levels may play a triggering role in disruption of metabolic events in operating room personnel.
Today it is known that neopterin is mainly produced by activated macrophages and a marker of immune activation and macrophage activity. Increased neopterin concentrations are observed in diseases related to cellular immunity including occupational pathologies.The major goal of the present study was to evaluate the possible alteration of neopterin levels in operating room personnel, and also to show whether screening of neopterin may be useful to monitor the effect of occupational anesthetic exposure on the cellular immune system.Therefore, urinary neopterin to creatinine levels in both, exposed workers (n = 40) and healthy volunteers (n = 30), were measured by using high-performance liquid chromatography. At the same time, the correlation among urinary neopterin levels and working years, age, and smoking status were evaluated.Compared to controls, urinary neopterin levels in the exposed group were increased (controls: 85 ± 16 μmol/mol creatinine, workers: 151 ± 39 μmol/mol creatinine; p <0.05).The findings suggest that the follow up of neopterin levels may have diagnostic value in possible occupational exposure-related immune system disorders. Moreover, its biological monitoring should be performed in workplaces for clinical diagnosis and prognosis.
It has been claimed that inhalational anesthetics affect many phases of immune response. Although, there are a lot of studies on the effects of widely used anaesthetic agents and methods on the immune system, there are only a few studies to show the effects by evaluation of neopterin concentrations as an important marker of cellular immunity. This study was done to evaluate possible effects of inhalation anesthetics, such as desflurane, isoflurane, and sevoflurane on the immune system by measuring urinary neopterin concentrations in patients who underwent laparoscopic cholecystectomy. The study is randomized, prospective and double blind. Urinary neopterin was measured in patients submitted to general anesthesia with either desflurane (n = 20) or isoflurane (n = 11), or sevoflurane (n = 13) in laparoscopic cholecystectomy. Urine samples were collected preoperatively, at 2nd and 24th hours post-operatively and the neopterin per creatinine concentrations were measured by using high-performance liquid chromatography.The preoperative neopterin levels were similar across the study groups. Variance analysis of repeated measures showed an effect of time (p <0.05): Neopterin concentrations increased over time, but the effect of different anesthetics on neopterin was similar. The mean increases in neopterin concentrations were similar among all the applied anesthetics. In conclusion, this report shows changes of immune response by investigation of neopterin in urine samples during 24 hours in patients exposed to three different inhalational anesthetic agents sevoflurane, desflurane and isoflurane in laparoscopic cholecystectomy.
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