Toxicity of two lipid emulsions on human lymphocytes and neutrophils

Cury-Boaventura, Maria Fernanda; Gorjão, Renata; Lima, Thaís Martins de; Soriano, Francisco Garcia; Curi, R.

doi:10.1186/cc5568

Cited by 4 publications

(2 citation statements)

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“…Based on our results, propofol infusion may lead to iatrogenic T-cell dysfunction. Because lipid emulsion itself can decrease lymphocyte proliferation,53 propofol emulsion infusion may be harmful to patients with impaired T-cell function. Its clinical significance remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

Sedative Drug Modulates T-Cell and Lymphocyte Function-Associated Antigen-1 Function

Yuki

Soriano

Shimaoka

2011

Anesthesia &Amp; Analgesia

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Background Sedative drugs modify immune cell functions via several mechanisms. However, the effects of sedatives on immune function have been primarily investigated in neutrophils and macrophages, and to the lesser extent lymphocytes. Lymphocyte function-associated antigen-1 (LFA-1) is an adhesion molecule that plays a central role in regulating immune function of lymphocytes including interleukin-2 (IL-2) production and lymphocyte proliferation. Previous clinical studies reported that propofol and isoflurane reduced IL-2 level in patients, but midazolam did not. We previously demonstrated that isoflurane inhibited LFA-1 binding to its counter ligand, intercellular adhesion molecule-1 (ICAM-1), which might contribute to the reduction of IL-2 levels. Here, we examined the effect of propofol, midazolam and dexmedetomidine on LFA-1/ICAM-1 binding, and the subsequent biological effects. Methods The effect of sedative drugs on T-cell proliferation and IL-2 production was measured by calorimetric assays on human peripheral blood mononuclear cells. Because LFA-1/ ICAM-1 binding plays an important role in T-cell proliferation and IL-2 production, we measured the effect of sedative drugs on ICAM-1 binding to LFA-1 protein (cell-free assay). This analysis was followed by flow cytometric analysis of LFA-1 expressing T-cell binding to ICAM-1 (cell-based assay). To determine if the drug/LFA-1 interaction is due to competitive or allosteric inhibition, we analyzed the sedative drug effect on wild-type and high affinity LFA-1 and a panel of monoclonal antibodies that bind to different regions of LFA-1. Results Propofol at 10–100 µM inhibited ICAM-1 binding to LFA-1 in cell-free assays and cell-based assays (p < 0.05). However, dexmedetomidine and midazolam did not affect LFA-1/ICAM-1 binding. Propofol directly inhibits LFA-1 binding to ICAM-1 by binding near the ICAM-1-contact area in a competitive manner. At clinically relevant concentrations, propofol, but not dexmedetomidine or midazolam, inhibited IL-2 production (p < 0.05). Additionally, propofol inhibited lymphocyte proliferation (p < 0.05). Conclusions Our study suggests that propofol competitively inhibits LFA-1 binding to ICAM-1 on T-cells and suppresses T-cell proliferation and IL-2 production, while dexmedetomidine and midazolam do not significantly influence these immunological assays.

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Section: Discussionmentioning

confidence: 99%

Sedative Drug Modulates T-Cell and Lymphocyte Function-Associated Antigen-1 Function

Yuki

Soriano

Shimaoka

2011

Anesthesia &Amp; Analgesia

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“…The use of PN in Brazil is associated with a significant delay in the start of infusion and high mortality rates. The most used lipid emulsion (long-chain triglycerides/medium-chain triglycerides) has been associated with more apoptosis [ 2 ] and compromised lymphocyte proliferation [ 3 ]. The overall findings of these study indicate that strategies to reduce the delay in start of PN and the use of better lipid sources must be adopted to provide better assistance for patients in need of PN in Brazil.…”

Section: Discussionmentioning

confidence: 99%