Sevoflurane exerts a more marked influence compared with propofol on gene expression in patients undergoing coronary artery bypass graft surgery

Li,Hua; Cang,Jing; Zhang,Xiaoguang

doi:10.3892/etm.2015.2936

Sevoflurane exerts a more marked influence compared with propofol on gene expression in patients undergoing coronary artery bypass graft surgery

Authors:
- Hua Li
- Jing Cang
- Xiaoguang Zhang
View Affiliations

Affiliations: Department of Anesthesia, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
Published online on: December 14, 2015 https://doi.org/10.3892/etm.2015.2936
Pages: 448-454
Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to elucidate the influence of the anesthetics propofol and sevoflurane on gene expression in patients undergoing coronary artery bypass graft surgery (CABG) and to provide a basis for the selection of the appropriate anesthetic. The gene expression profiles of patients receiving one of the two anesthetics were analyzed prior to and following the induction of anesthesia. GSE4386 microarray data obtained from the Gene Expression Omnibus database was used to identify the differentially expressed genes (DEGs) by significance analysis of the microarray. The data set contained data regarding atrial tissue samples from 40 patients that underwent CABG, and that received either propofol (n=10) or sevoflurane (n=10) or were control subjects (n=20). The 20 control samples comprised the same patients prior to undergoing CABG. The Kyoto Encyclopedia of Genes and Genomes and Gene Ontology (GO) Enrichment Analysis was applied to the DEGs using the Database for Annotation, Visualization and Integration Discovery functional annotation bioinformatics microarray tool. A total of 242 and 560 DEGs were identified in the human atrial samples treated with propofol and sevoflurane, respectively. Among these, 116 upregulated DEGs and no downregulated DEGs were found to be unique to sevoflurane, while 10 upregulated and 212 downregulated DEGs were unique to propofol. The majority of the pathways that were significantly over‑represented among the upregulated DEGs were associated with the immune response, such as Toll‑ and NOD‑like receptors and Jak‑STAT signaling pathways. GO enrichment analysis revealed that the downregulated DEGs unique to sevoflurane treatment were involved in the immune response and glucose metabolism, while the upregulated DEGs were associated with cellular ion homeostasis and epithelial cell development. Compared with propofol, sevoflurane appeared to exert a more marked effect on biological pathways, such as drug metabolism, glycolysis, cellular ion homeostasis and epithelial cell development.

View Figures

View References

1	Møller C, Penninga L, Wetterslev J, Steinbrüchel D and Gluud C: Off-pump versus on-pump coronary artery by-pass grafting for ischaemic heart disease. Cochrane Database Syst Rev. 3:CD0072242012.PubMed/NCBI
2	Wang J, Zheng H, Chen CL, Lu W and Zhang YQ: Sevoflurane at 1 MAC provides optimal myocardial protection during off-pump CABG. Scand Cardiovasc J. 47:175–184. 2013. View Article : Google Scholar : PubMed/NCBI
3	Hellström J, Öwall A, Bergström J and Sackey P: Cardiac outcome after sevoflurane versus propofol sedation following coronary bypass surgery, A pilot study. Acta Anaesthesiol Scand. 55:460–467. 2011. View Article : Google Scholar : PubMed/NCBI
4	Gülçin I, Alici HA and Cesur M: Determination of in vitro antioxidant and radical scavenging activities of propofol. Chem Pharm Bull (Tokyo). 53:281–285. 2005. View Article : Google Scholar : PubMed/NCBI
5	Marik PE: Propofol: Therapeutic indications and side-effects. Curr Pharm Des. 10:3639–3649. 2004. View Article : Google Scholar : PubMed/NCBI
6	Vakkuri A, Yli-Hankala A, Talja P, Mustola S, Tolvanen-Laakso H, Sampson T and Viertiö-Oja H: Time-frequency balanced spectral entropy as a measure of anesthetic drug effect in central nervous system during sevoflurane, propofol and thiopental anesthesia. Acta Anaesthesiol Scand. 48:145–153. 2004. View Article : Google Scholar : PubMed/NCBI
7	Sayin MM, Özatamer O, Taşöz R, Kilinc K and Ünal N: Propofol attenuates myocardial lipid peroxidation during coronary artery bypass grafting surgery. Br J Anaesth. 89:242–246. 2002. View Article : Google Scholar : PubMed/NCBI
8	Corcoran TB, Engel A, Sakamoto H, O'Shea A, O'Callaghan-Enright S and Shorten G: The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function. Br J Anaesth. 97:825–831. 2006. View Article : Google Scholar : PubMed/NCBI
9	Garcia C, Julier K, Bestmann L, Zollinger A, von Segesser LK, Pasch T, Spahn DR and Zaugg M: Preconditioning with sevoflurane decreases PECAM-1 expression and improves one-year cardiovascular outcome in coronary artery bypass graft surgery. Br J Anaesth. 94:159–165. 2005. View Article : Google Scholar : PubMed/NCBI
10	Lucchinetti E, da Silva R, Pasch T, Schaub MC and Zaugg M: Anaesthetic preconditioning but not postconditioning prevents early activation of the deleterious cardiac remodelling programme, Evidence of opposing genomic responses in cardioprotection by pre-and postconditioning. Br J Anaesth. 95:140–152. 2005. View Article : Google Scholar : PubMed/NCBI
11	Yao YT and Li LH: Sevoflurane versus propofol for myocardial protection in patients undergoing coronary artery bypass grafting surgery, A meta-analysis of randomized controlled trials. Chin Med Sci J. 24:133–141. 2009. View Article : Google Scholar : PubMed/NCBI
12	Landoni G, Biondi-Zoccai GG, Zangrillo A, Bignami E, D'Avolio S, Marchetti C, Calabrò MG, Fochi O, Guarracino F, Tritapepe L, et al: Desflurane and sevoflurane in cardiac surgery: A meta-analysis of randomized clinical trials. J Cardiothorac Vasc Anesth. 21:502–511. 2007. View Article : Google Scholar : PubMed/NCBI
13	Yu CH and Beattie WS: The effects of volatile anesthetics on cardiac ischemic complications and mortality in CABG, A meta-analysis. Can J Anaesth. 53:906–918. 2006. View Article : Google Scholar : PubMed/NCBI
14	Yao YT and Li LH: Sevoflurane versus propofol for myocardial protection in patients undergoing coronary artery bypass grafting surgery, A meta-analysis of randomized controlled trials. Chin Med Sci J. 24:133–141. 2009. View Article : Google Scholar : PubMed/NCBI
15	Jakobsen CJ, Berg H, Hindsholm KB, Faddy N and Sloth E: The influence of propofol versus sevoflurane anesthesia on outcome in 10,535 cardiac surgical procedures. J Cardiothorac Vasc Anesth. 21:664–671. 2007. View Article : Google Scholar : PubMed/NCBI
16	Jakobsen CJ, Berg H, Hindsholm KB, Faddy N and Sloth E: The influence of propofol versus sevoflurane anesthesia on outcome in 10,535 cardiac surgical procedures. J Cardiothorac Vasc Anesth. 21:664–671. 2007. View Article : Google Scholar : PubMed/NCBI
17	Ballester M, Llorens J, Garcia-de-la-Asuncion J, Perez-Griera J, Tebar E, Martinez-Leon J, Belda J and Juez M: Myocardial oxidative stress protection by sevoflurane vs. propofol, A randomised controlled study in patients undergoing off-pump coronary artery bypass graft surgery. Eur J Anaesthesiol. 28:874–881. 2011. View Article : Google Scholar : PubMed/NCBI
18	Yao YT and Li LH: Sevoflurane versus propofol for myocardial protection in patients undergoing coronary artery bypass grafting surgery, A meta-analysis of randomized controlled trials. Chin Med Sci J. 24:133–141. 2009. View Article : Google Scholar : PubMed/NCBI
19	Lucchinetti E, Hofer C, Bestmann L, Hersberger M, Feng J, Zhu M, Furrer L, Schaub MC, Tavakoli R, Genoni M, et al: Gene regulatory control of myocardial energy metabolism predicts postoperative cardiac function in patients undergoing off-pump coronary artery bypass graft surgery: Inhalational versus intravenous anesthetics. Anesthesiology. 106:444–457. 2007. View Article : Google Scholar : PubMed/NCBI
20	Barrett T, Suzek TO, Troup DB, Wilhite SE, Ngau WC, Ledoux P, Rudnev D, Lash AE, Fujibuchi W and Edgar R: NCBI GEO, Mining millions of expression profiles-database and tools. Nucleic Acids Res. 33:(Database Issue). D562–D566. 2005. View Article : Google Scholar : PubMed/NCBI
21	Smyth GK: Linear models and empirical bayes methods for assessing differential expression in microarray experiments. Stat Appl Genet Mol Biol. 3:Article32004.PubMed/NCBI
22	Dennis G Jr, Sherman BT, Hosack DA, Yang J, Gao W, Lane HC and Lempicki RA: DAVID: Database for annotation, visualization and integrated discovery. Genome biol. 4:P32003. View Article : Google Scholar : PubMed/NCBI
23	Soro M, Gallego L, Silva V, Ballester MT, Lloréns J, Alvariño A, García-Perez ML, Pastor E, Aguilar G, Martí FJ, et al: Cardioprotective effect of sevoflurane and propofol during anaesthesia and the postoperative period in coronary bypass graft surgery: a double-blind randomised study. Eur J Anaesthesiol. 29:561–569. 2012. View Article : Google Scholar : PubMed/NCBI
24	Wang J, Lei B, Popp S, Meng F, Cottrell J and Kass I: Sevoflurane immediate preconditioning alters hypoxic membrane potential changes in rat hippocampal slices and improves recovery of CA1 pyramidal cells after hypoxia and global cerebral ischemia. Neuroscience. 145:1097–1107. 2007. View Article : Google Scholar : PubMed/NCBI
25	Kehl F, Krolikowski JG, Tessmer JP, Pagel PS, Warltier DC and Kersten JR: Increases in coronary collateral blood flow produced by sevoflurane are mediated by calcium-activated potassium (BKCa) channels in vivo. Anesthesiology. 97:725–731. 2002. View Article : Google Scholar : PubMed/NCBI
26	Lee HT, Kim M, Jan M and Emala CW: Anti-inflammatory and antinecrotic effects of the volatile anesthetic sevoflurane in kidney proximal tubule cells. Am J Physiol Renal Physiol. 291:F67–F78. 2006. View Article : Google Scholar : PubMed/NCBI
27	Sharma M, Ganguly NK, Chaturvedi G, Thingnam SK, Majumdar S and Suri RK: A possible role of HSP70 in mediating cardioprotection in patients undergoing CABG. Mol Cell Biochem. 247:31–36. 2003. View Article : Google Scholar : PubMed/NCBI
28	Saho S, Kadota Y, Sameshima T, Miyao J, Tsurumaru T and Yoshimura N: The effects of sevoflurane anesthesia on insulin secretion and glucose metabolism in pigs. Anesth Analg. 84:1359–1365. 1997. View Article : Google Scholar : PubMed/NCBI
29	Ai M, Otokozawa S, Asztalos BF, White CC, Cupples LA, Nakajima K, Lamon-Fava S, Wilson PW, Matsuzawa Y and Schaefer EJ: Adiponectin. An independent risk factor for coronary heart disease in men in the Framingham offspring study. Atherosclerosis. 217:543–548. 2011. View Article : Google Scholar : PubMed/NCBI
30	Dybdahl B, Wahba A, Lien E, Flo TH, Waage A, Qureshi N, Sellevold OF, Espevik T and Sundan A: Inflammatory response after open heart surgery, Release of heat-shock protein 70 and signaling through toll-like receptor-4. Circulation. 105:685–690. 2002. View Article : Google Scholar : PubMed/NCBI
31	Akira S and Takeda K: Toll-like receptor signalling. Nat Rev Immunol. 4:499–511. 2004. View Article : Google Scholar : PubMed/NCBI
32	Kanneganti TD, Lamkanfi M and Núñez G: Intracellular NOD-like receptors in host defense and disease. Immunity. 27:549–559. 2007. View Article : Google Scholar : PubMed/NCBI
33	Kaminska B: MAPK signalling pathways as molecular targets for anti-inflammatory therapy-from molecular mechanisms to therapeutic benefits. Biochim Biophys Acta. 1754:253–262. 2005. View Article : Google Scholar : PubMed/NCBI
34	Murray PJ: The JAK-STAT signaling pathway: Input and output integration. J Immunol. 178:2623–2629. 2007. View Article : Google Scholar : PubMed/NCBI
35	Appledorn DM, Patial S, McBride A, Godbehere S, Van Rooijen N, Parameswaran N and Amalfitano A: Adenovirus vector-induced innate inflammatory mediators, MAPK signaling, as well as adaptive immune responses are dependent upon both TLR2 and TLR9 in vivo. J Immunol. 181:2134–2144. 2008. View Article : Google Scholar : PubMed/NCBI
36	Huang G, Shi LZ and Chi H: Regulation of JNK and p38 MAPK in the immune system, Signal integration, propagation and termination. Cytokine. 48:161–169. 2009. View Article : Google Scholar : PubMed/NCBI
37	Samadikhah J, Golzari SE, Sabermarouf B, Karimzadeh I and Tizro P: MohammadK hanli H and Ghabili K: Efficacy of combination therapy of statin and vitamin C in comparison with statin in the prevention of post-CABG atrial fibrillation. Adv Pharm Bull. 4:97–100. 2014.PubMed/NCBI
38	Baeke F, Takiishi T, Korf H, Gysemans C and Mathieu C: Vitamin D, Modulator of the immune system. Curr Opin Pharmacol. 10:482–496. 2010. View Article : Google Scholar : PubMed/NCBI