The In Vivo Effects of General and Epidural Anesthesia on Human Immune Function

Procopio, Marcia A.; Rassias, Athos J.; DeLeo, Joyce A.; Pahl, Janice; Hildebrandt, Laurie; Yeager, Mark P.

doi:10.1097/00000539-200108000-00044

Cited by 24 publications

(17 citation statements)

References 23 publications

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“…Although the type of anesthetic drugs is often the scope of interest, consideration should be also given how long and how much they are used. A brief and small anesthetic exposure may not have a significant impact on immune function (Procopio, Rassias et al 2001). These results suggest that multiple factors may be taken into consideration when we study the impact of anesthetics in tumor immunology.…”

Section: Discussionmentioning

confidence: 99%

The effect of different anesthetics on tumor cytotoxicity by natural killer cells

et al. 2017

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A number of retrospective studies have suggested that choice of anesthetic drugs during surgical tumor resection might affect tumor recurrence/ metastasis, or outcome of patients. The recent study showed that volatile anesthetics-based general anesthesia was associated with the worse outcomes than intravenous anesthetics-based general anesthesia. However, the underlying mechanism is yet to be determined. Because natural killer (NK) cells are implicated as important immune cells for tumor recurrence/ metastasis in the perioperative period, we examined the effect of different anesthetics on NK cell-mediated tumor cytotoxicity. Because adhesion molecule leukocyte function-associated antigen-1 (LFA-1) is functionally important in NK cells and is inhibited by commonly used volatile anesthetics isoflurane and sevoflurane, we hypothesized that these anesthetics would attenuate NK cell-mediated cytotoxicity. Using human NK cell line NK92-MI cells and tumor cell line K562 cells as a model system, we performed cytotoxicity, proliferation, conjugation and degranulation assays. Lytic granule polarization was also assessed. We showed that isoflurane, sevoflurane and LFA-1 inhibitor BIRT377 attenuated cytotoxicity, and reduced conjugation and polarization, but not degranulation of NK cells. Our data suggest that isoflurane and sevoflurane attenuated NK cell-mediated cytotoxicity at least partly by their LFA-1 inhibition in vitro. Whether or not isoflurane and sevoflurane attenuate NK cell-mediated tumor cytotoxicity in patients needs to be determined in the future.

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Section: Discussionmentioning

confidence: 99%

The effect of different anesthetics on tumor cytotoxicity by natural killer cells

et al. 2017

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“…One central limitation may revolve around the possible confounding role of anesthesia in our analyses. Prior analyses have suggested that anesthesia may affect inflammatory and related physiological responses [72], [73], [74], [75], [76], [77], [78].…”

Section: Discussionmentioning

confidence: 99%

A Dynamic View of Trauma/Hemorrhage-Induced Inflammation in Mice: Principal Drivers and Networks

et al. 2011

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BackgroundComplex biological processes such as acute inflammation induced by trauma/hemorrhagic shock/ (T/HS) are dynamic and multi-dimensional. We utilized multiplexing cytokine analysis coupled with data-driven modeling to gain a systems perspective into T/HS.Methodology/Principal FindingsMice were subjected to surgical cannulation trauma (ST) ± hemorrhagic shock (HS; 25 mmHg), and followed for 1, 2, 3, or 4 h in each case. Serum was assayed for 20 cytokines and NO2 −/NO3 −. These data were analyzed using four data-driven methods (Hierarchical Clustering Analysis [HCA], multivariate analysis [MA], Principal Component Analysis [PCA], and Dynamic Network Analysis [DyNA]). Using HCA, animals subjected to ST vs. ST + HS could be partially segregated based on inflammatory mediator profiles, despite a large overlap. Based on MA, interleukin [IL]-12p40/p70 (IL-12.total), monokine induced by interferon-γ (CXCL-9) [MIG], and IP-10 were the best discriminators between ST and ST/HS. PCA suggested that the inflammatory mediators found in the three main principal components in animals subjected to ST were IL-6, IL-10, and IL-13, while the three principal components in ST + HS included a large number of cytokines including IL-6, IL-10, keratinocyte-derived cytokine (CXCL-1) [KC], and tumor necrosis factor-α [TNF-α]. DyNA suggested that the circulating mediators produced in response to ST were characterized by a high degree of interconnection/complexity at all time points; the response to ST + HS consisted of different central nodes, and exhibited zero network density over the first 2 h with lesser connectivity vs. ST at all time points. DyNA also helped link the conclusions from MA and PCA, in that central nodes consisting of IP-10 and IL-12 were seen in ST, while MIG and IL-6 were central nodes in ST + HS.Conclusions/SignificanceThese studies help elucidate the dynamics of T/HS-induced inflammation, complementing other forms of dynamic mechanistic modeling. These methods should be applicable to the analysis of other complex biological processes.

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“…7 However, recent results suggest that anaesthesia exposure alone does not signi cantly affect human immune responsiveness. 8 A study on rats revealed that immune changes following surgery do not recover for four to eight days. 9 Another study showed that an anaesthetised group of puppies that were vaccinated with rabies vaccine had signi cantly lower antibody titres compared with an unanaesthetised control group.…”

Section: Discussionmentioning

confidence: 99%

Rabies vaccine and neuraxial anaesthesia

Rewari

Garg

Trikha

2010

Southern African Journal of Anaesthesia and Analgesia

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This case report of neuraxial anaesthesia for emergency orthopaedic surgery serves to highlight the dilemma faced by anaesthetists when surgical intervention becomes necessary in a patient on anti-rabies vaccine. The two issues of importance are the possible reduction in the ef cacy of vaccination by an immunosuppressive effect of anaesthesia and surgery, and the possible need to avoid local anaesthetics for the provision of postoperative analgesia to assist in the early detection of any neurological de cit.Peer reviewed.

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The In Vivo Effects of General and Epidural Anesthesia on Human Immune Function

Abstract: General or epidural anesthesia alone, in the absence of surgery, seems to have only transient and minor effects on human immune function.

Cited by 24 publications

References 23 publications

The effect of different anesthetics on tumor cytotoxicity by natural killer cells

The effect of different anesthetics on tumor cytotoxicity by natural killer cells

A Dynamic View of Trauma/Hemorrhage-Induced Inflammation in Mice: Principal Drivers and Networks

Rabies vaccine and neuraxial anaesthesia

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