Effects of anesthetic method on inflammatory response in patients with Parkinson’s disease: a randomized controlled study

Abstract

Background: The pathogenesis of Parkinson's disease (PD) involves degeneration of dopaminergic neurons, which is influenced by innate and adaptive immunity. IL-17 is a characteristic cytokine secreted by Th17 cells, which acts as a powerful stimulator of neutrophil migration and infiltration and promotes the secretion of inflammatory cytokines. General anesthesia and surgical stress induce immune and inflammatory responses that activate the immunosuppressive mechanism in the perioperative period. The present study investigated changes in levels of inflammatory cytokines, such as IL-17, IL-1β, and TNF-α, in patients with PD undergoing general anesthesia with inhalational anesthetics or TIVA. Methods: Adult patients, aged 40-75 years, scheduled for cerebral stimulator implantation were enrolled. Upon arrival at the operating theater, patients were allocated to the inhalational (I) or TIVA (T) group using block randomization. In group I, anesthesia was induced by tracheal intubation 1-2 min after intravenous administration of propofol (1-2 mg/kg) and rocuronium (0.6-1 mg/kg). Thereafter, anesthesia was maintained with 1-2 vol% sevoflurane, 0.01-0.2 μg/kg/min remifentanil, and O 2 /air (FiO 2 0.4). In group T, propofol (3-6 μg/mL), remifentanil (2-6 ng/mL), and rocuronium (0.6-1 mg/kg) were administered using target controlled infusion (TCI) for induction of anesthesia. Blood samples were obtained preoperatively (T0), 2 h after induction of anesthesia (T1), and 24 h after surgery (T2). IL-17, IL-1β, and TNF-α levels were evaluated by ELISA. Results: Serum levels of IL-17 were elevated at T2 in group I compared to group T but the difference was not statistically significant. IL-1β tended to be greater in group I compared to group T, but the differences were not significant. TNF-α was slightly higher at all time points in group T and showed a tendency to increase at T2 in both groups, but this was not statistically significant. Conclusions: TIVA may be useful for inhibiting neuroinflammation by inhibiting the increase in serum levels of IL-17 24 h after implantation surgery. Serum IL-17 level may be used as a biomarker for PD progression.

Short-term inhalation of isoflurane improves the outcomes of intraportal hepatocyte transplantation

“…On the other hand, the serum levels of IL-2, IL-5, IL-17, and IL-12p70 were upregulated in the ISO group in comparison to the AW group. Although IL-2 and IL-17 were previously reported to be induced by isoflurane 31,35 and sevoflurane (a similar type of volatile inhalation anesthetic to isoflurane) 36 , in the present study, all values of abovementioned mediators were well controlled to below the pre-values (before catheter insertion) throughout the study period, irrespective of the study group. Therefore, the exact reason why the levels of the abovementioned mediators were higher in the ISO group remains unknown; however, it is most likely based on individual differences among recipient animals.…”