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Inhibition of the neutrophil oxidative response by propofol: preserved in vivo function despite in vitro inhibition

Published online by Cambridge University Press:  19 June 2006

D. Fröhlich ,
B. Trabold ,
G. Rothe ,
K. Hoerauf  and
S. Wittmann
D. Fröhlich
Affiliation:
University of Regensburg, Department of Anaesthesiology, Regensburg, Germany
B. Trabold
Affiliation:
University of Regensburg, Department of Anaesthesiology, Regensburg, Germany
G. Rothe
Affiliation:
Bremer Zentrum für Laboratoriumsmedizin, Germany
K. Hoerauf
Affiliation:
University of Vienna, Department of Anaesthesiology, Vienna, Austria
S. Wittmann
Affiliation:
University of Regensburg, Department of Anaesthesiology, Regensburg, Germany
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Abstract

Summary

Background and objective: Propofol has been shown to inhibit a variety of functions of neutrophils in vitro, but there is a lack of in vivo data. To analyse the effects of propofol on neutrophil function in vivo we chose to investigate cataract surgery since it represents a small surgical procedure with minimal immunomodulatory effects induced by surgery. We sought to analyse any immunosuppressive effects of propofol after short-term administration in vivo in comparison to local anaesthesia as well as to in vitro effects of propofol. Methods: The study was designed as an open randomized trial enrolling 20 patients undergoing general or local anaesthesia. The neutrophil oxidative response and propofol plasma concentration were assessed prior, during and after anaesthesia. Neutrophil function was determined flow cytometrically based on dihydrorhodamine 123 oxidation. Results: Propofol concentrations which yielded a marked suppression in vitro did not alter the neutrophil oxidative response during cataract surgery in vivo. However, after local anaesthesia the neutrophil oxidative response declined to 37%, compared to the control response prior to anaesthesia. Conclusions: Although we could detect the well established suppression of neutrophil function by propofol in vitro it was not evident in vivo. This may be due to compensating effects on neutrophil function during surgery in vivo. The decline in the neutrophil oxidative response in the local anaesthesia group might be due to increased stress and catecholamine concentrations or a direct interaction of local anaesthetics with neutrophil intracellular signalling.

Keywords

ANAESTHETICS INTRAVENOUS, propofolNEUTROPHILS, function, oxidative responseANAESTHESIA, CONDUCTION, peribulbar block
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 11 , November 2006 , pp. 948 - 953
Copyright
2006 European Society of Anaesthesiology

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References

Heine J, Jaeger K, Weingaertner Net al. Effects of different preparations of propofol, diazepam, and etomidate on human neutrophils in vitro. Acta Anaesthesiol Scand 2001; 45: 213–220.Google Scholar
Mikawa K, Akamatsu H, Nishina Ket al. Propofol inhibits human neutrophil functions. Anesth Analg 1998; 87: 695–700.Google Scholar
Fröhlich D, Rothe G, Schwall Bet al. Thiopentone and propofol, but not methohexitone nor midazolam, inhibit neutrophil oxidative response to the bacterial peptide FMLP. Eur J Anaesthesiol 1996; 13: 582–588.Google Scholar
Inada T, Taniuchi S, Shingu Ket al. Propofol depressed neutrophil hydrogen peroxide production more than midazolam, whereas adhesion molecule expression was minimally affected by both anesthetics in rats with abdominal sepsis. Anesth Analg 2001; 92: 437–441.Google Scholar
Heine J, Jaeger K, Osthaus Aet al. Anaesthesia with propofol decreases FMLP-induced neutrophil respiratory burst but not phagocytosis compared with isoflurane. Br J Anaesth 2000; 85: 424–430.Google Scholar
Zhao J, Juettner B, Scheinichen Det al. Respiratory burst activity of polymorphonuclear cells is dependent on the cell preparation technique. Acta Anaesthesiol Scand 2003; 47: 702–706.Google Scholar
Jaeger K, Scheinichen D, Heine Jet al. Remifentanil, fentanyl, and alfentanil have no influence on the respiratory burst of human neutrophils in vitro. Acta Anaesthesiol Scand 1998; 42: 1110–1113.Google Scholar
Schwall B, Jakob W, Sessler DI, Taeger K, Fröhlich D. Less adrenergic activation during cataract surgery with total intravenous than with local anesthesia. Acta Anaesthesiol Scand 2000; 44: 343–347.Google Scholar
O'Dowd YM, El-Benna J, Perianin A, Newsholme P. Inhibition of formyl-methionyl-leucyl-phenylalanine-stimulated respiratory burst in human neutrophils by adrenaline: inhibition of phospholipase A2 activity but not p47phox phosphorylation and translocation. Biochem Pharmacol 2004; 67: 183–190.Google Scholar
Inada T, Yamanouchi Y, Jomura Set al. Effect of propofol and isoflurane anaesthesia on the immune response to surgery. Anaesthesia 2004; 59: 954–959.Google Scholar
Heine G, Gabriel H, Weindler J, Ruprecht KW, Kindermann W. Painful regional anaesthesia induces an immunological stress reaction: the model of retrobulbar anaesthesia. Eur J Anaesthesiol 2001; 18: 505–510.Google Scholar
Horn NA, Anastase DM, Hecker KEet al. Epinephrine enhances platelet-neutrophil adhesion in whole blood in vitro. Anesth Analg 2005; 100: 520–526.Google Scholar
Wittmann S, Rothe G, Schmitz G, Fröhlich D. Cytokine upregulation of surface antigens correlates to the priming of the neutrophil oxidative burst response. Cytometry 2004; 57A: 53–62.Google Scholar
Hollmann MW, Herroeder S, Kurz KSet al. Time-dependent inhibition of G protein-coupled receptor signaling by local anesthetics. Anesthesiology 2004; 100: 852–860.Google Scholar
Hattori M, Dohi S, Nozaki M, Niwa M, Shimonaka H. The inhibitory effects of local anesthetics on superoxide generation of neutrophils correlate with their partition coefficients. Anesth Analg 1997; 84: 405–412.Google Scholar
Hollmann MW, Gross A, Jelacin N, Durieux ME. Local anesthetic effects on priming and activation of human neutrophils. Anesthesiology 2001; 95: 113–122.Google Scholar
Sakuragi T, Ishino H, Dan K. Bactericidal activity of clinically used local anesthetics on Staphylococcus aureus. Reg Anesth 1996; 21: 239–242.Google Scholar