Effects of nitrous oxide on the production of cytokines and chemokines by the airway epithelium during anesthesia with sevoflurane and propofol

Kumakura,Seiichiro; Yamaguchi,Keisuke; Sugasawa,Yusuke; Murakami,Taisuke; Kikuchi,Toshihiro; Inada,Eiichi; Nagaoka,Isao

doi:10.3892/mmr.2013.1745

Effects of nitrous oxide on the production of cytokines and chemokines by the airway epithelium during anesthesia with sevoflurane and propofol

Authors:
- Seiichiro Kumakura
- Keisuke Yamaguchi
- Yusuke Sugasawa
- Taisuke Murakami
- Toshihiro Kikuchi
- Eiichi Inada
- Isao Nagaoka
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Affiliations: Department of Anesthesiology and Pain Medicine, Juntendo University Nerima Hospital, Tokyo 177‑8521, Japan, Department of Host Defense and Biochemical Research, Juntendo University Graduate School of Medicine, Tokyo 113‑8431, Japan, Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113‑8431, Japan
Published online on: October 21, 2013 https://doi.org/10.3892/mmr.2013.1745
Pages: 1643-1648

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Abstract

The aim of this study was to evaluate the effects of nitrous oxide (a gaseous anesthetic) on the in vivo production of inflammatory cytokines and chemokines by the airway epithelium, when combined with sevoflurane or propofol. Subjects undergoing simple or segmental mastectomy were randomly assigned to the sevoflurane and nitrous oxide, sevoflurane and air, propofol and nitrous oxide, or propofol and air group (all n=13). Epithelial lining fluid (ELF) was obtained using the bronchoscopic microsampling method prior to and following the mastectomy to enable measurement of the pre‑ and post‑operative levels of certain inflammatory cytokines and chemokines using a cytometric bead array system. Notably, the levels of interleukin (IL)‑1β, IL‑8 and monocyte chemotactic protein‑1 (MCP‑1) in the ELF were significantly increased following the operations which involved the inhalation of sevoflurane and nitrous oxide, although the levels of these molecules were not significantly changed by the inhalation of sevoflurane and air. Furthermore, the IL‑12p70 levels were significantly reduced in the ELF following the operations that involved the inhalation of sevoflurane and air, although the IL‑12p70 levels were not significantly changed by the inhalation of nitrous oxide and sevoflurane. These observations suggest that the combination of sevoflurane and nitrous oxide induces an inflammatory response (increased production of IL‑1β, IL‑8 and MCP‑1) and suppresses the anti‑inflammatory response (reduced production of IL‑12p70) in the local milieu of the airway. Thus, the combination of these compounds should be carefully administered for anesthesia.

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1	Weiser TG, Regenbogen SE, Thompson KD, et al: An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 372:139–144. 2008.PubMed/NCBI
2	Fisher DM and Zwass MS: MAC of desflurane in 60% nitrous oxide in infants and children. Anesthesiology. 76:354–356. 1992.
3	Gupta K, Vohra V and Sood J: The role of magnesium as an adjuvant during general anaesthesia. Anaesthesia. 61:1058–1063. 2006. View Article : Google Scholar : PubMed/NCBI
4	Myles PS, Leslie K, Chan MT, et al; ENIGMA Trial Group. Avoidance of nitrous oxide for patients undergoing major surgery: a randomized controlled trial. Anesthesiology. 107:221–231. 2007. View Article : Google Scholar : PubMed/NCBI
5	Myles PS, Leslie K, Peyton P, et al; ANZCA Trials Group. Nitrous oxide and perioperative cardiac morbidity (ENIGMA-II) Trial: rationale and design. Am Heart J. 157:488–494. 2009. View Article : Google Scholar : PubMed/NCBI
6	Urman RD and Desai SP: History of anesthesia for ambulatory surgery. Curr Opin Anaesthesiol. 25:641–647. 2012.PubMed/NCBI
7	Nunn JF: Clinical aspects of the interaction between nitrous oxide and vitamin B12. Br J Anaesth. 59:3–13. 1987. View Article : Google Scholar : PubMed/NCBI
8	Myles PS, Leslie K, Silbert B, Paech M and Peyton P: A review of the risks and benefits of nitrous oxide in current anaesthetic practice. Anaesth Intensive Care. 32:165–172. 2004.PubMed/NCBI
9	Akca O, Lenhardt R, Fleischmann E, et al: Nitrous oxide increases the incidence of bowel distension in patients undergoing elective colon resection. Acta Anaesthesiol Scand. 48:894–898. 2004. View Article : Google Scholar : PubMed/NCBI
10	Kaisti KK, Langsjo JW, Aalto S, et al: Effects of sevoflurane, propofol, and adjunct nitrous oxide on regional cerebral blood flow, oxygen consumption, and blood volume in humans. Anesthesiology. 99:603–613. 2003.PubMed/NCBI
11	Marie RM, Le Biez E, Busson P, et al: Nitrous oxide anesthesia-associated myelopathy. Arch Neurol. 57:380–382. 2000. View Article : Google Scholar : PubMed/NCBI
12	Schilling RF: Is nitrous oxide a dangerous anesthetic for vitamin B12-deficient subjects. JAMA. 255:1605–1606. 1986. View Article : Google Scholar : PubMed/NCBI
13	Parbrook GD: Leucopenic effects of prolonged nitrous oxide treatment. Br J Anaesth. 39:119–127. 1967. View Article : Google Scholar : PubMed/NCBI
14	Mazze RI, Wilson AI, Rice SA and Baden JM: Reproduction and fetal development in rats exposed to nitrous oxide. Teratology. 30:259–265. 1984. View Article : Google Scholar : PubMed/NCBI
15	Badner NH, Beattie WS, Freeman D and Spence JD: Nitrous oxide-induced increased homocysteine concentrations are associated with increased postoperative myocardial ischemia in patients undergoing carotid endarterectomy. Anesth Analg. 91:1073–1079. 2000.
16	Badner NH, Drader K, Freeman D and Spence JD: The use of intraoperative nitrous oxide leads to postoperative increases in plasma homocysteine. Anesth Analg. 87:711–713. 1998.PubMed/NCBI
17	Tramer M, Moore A and McQuay H: Meta-analytic comparison of prophylactic antiemetic efficacy for postoperative nausea and vomiting: Propofol anaesthesia versus omitting nitrous oxide versus total i.v. anaesthesia with propofol. Br J Anaesth. 78:256–259. 1997. View Article : Google Scholar
18	Apfel CC, Korttila K, Abdalla M, et al: A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 350:2441–2451. 2004. View Article : Google Scholar : PubMed/NCBI
19	Macario A, Weinger M, Carney S and Kim A: Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 89:652–658. 1999.PubMed/NCBI
20	Greif R, Akca O, Horn EP, Kurz A and Sessler DI: Supplemental perioperative oxygen to reduce the incidence of surgical wound infection. N Engl J Med. 342:161–167. 2000. View Article : Google Scholar
21	Belda FJ, Aguilera L, Garcia de la Asunción J, et al: Supplemental perioperative oxygen and the risk of surgical wound infection. JAMA. 294:2035–2042. 2005. View Article : Google Scholar : PubMed/NCBI
22	Grief R, Laciny S, Rapf B, Hickle RS and Sessler DI: Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology. 91:1246–1252. 1999. View Article : Google Scholar : PubMed/NCBI
23	Henderson KA, Raj N and Hall JE: The use of nitrous oxide in anaesthetic practice: a questionnaire survey. Anaesthesia. 57:1155–1158. 2002. View Article : Google Scholar : PubMed/NCBI
24	Schneemilch CE, Hachenberg T, Ansorge S, Ittenson A and Bank U: Effects of different anaesthetic agents on immune cell function in vitro. Eur J Anaesthesiol. 22:616–623. 2005. View Article : Google Scholar : PubMed/NCBI
25	Moudgil GC, Gordon J and Forrest JB: Comparative effects of volatile anaesthetic agents and nitrous oxide on human leucocyte chemotaxis in vitro. Can Anaesth Soc J. 31:631–637. 1984. View Article : Google Scholar : PubMed/NCBI
26	Ishizaka A, Watanabe M, Yamashita T, et al: New bronchoscopic microsample probe to measure the biochemical constituents in epithelial lining fluid of patients with acute respiratory distress syndrome. Crit Care Med. 29:896–898. 2001. View Article : Google Scholar
27	Simon RH and Paine R III: Participation of pulmonary alveolar epithelial cells in lung inflammation. J Lab Clin Med. 126:108–118. 1995.PubMed/NCBI
28	Takizawa H: Airway epithelial cells as regulators of airway inflammation. Int J Mol Med. 1:367–378. 1998.PubMed/NCBI
29	De Conno E, Steurer MP, Wittlinger M, et al: Anesthetic-induced improvement of the inflammatory response to one-lung ventilation. Anesthesiology. 110:1316–1326. 2009.PubMed/NCBI
30	Vozzelli MA, Mason SN, Whorton MH and Auten RL Jr: Antimacrophage chemokine treatment prevents neutrophil and macrophage influx in hyperoxia-exposed newborn rat lung. Am J Physiol Lung Cell Mol Physiol. 286:L488–L493. 2004. View Article : Google Scholar : PubMed/NCBI
31	Beck-Schimmer B, Schwendener R, Pasch T, Reyes L, Booy C and Schimmer RC: Alveolar macrophages regulate neutrophil recruitment in endotoxin-induced lung injury. Respir Res. 6:61–66. 2005. View Article : Google Scholar : PubMed/NCBI
32	Brunda MJ: Interleukin-12. J Leukoc Biol. 55:280–288. 1994.
33	Tanaka K, Ludwig LM, Kersten JR, Pagel PS and Warltier DC: Mechanisms of cardioprotection by volatile anesthetics. Anesthesiology. 100:707–721. 2004. View Article : Google Scholar : PubMed/NCBI
34	Reutershan J, Chang D, Hayes JK and Ley K: Protective effects of isoflurane pretreatment in endotoxin-induced lung injury. Anesthesiology. 104:511–517. 2006. View Article : Google Scholar : PubMed/NCBI
35	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. 291:67–78. 2006. View Article : Google Scholar : PubMed/NCBI
36	Suter D, Spahn DR, Blumenthal S, Reyes L, Booy C, Z’Graggen BR and Beck-Schimmer B: The immunomodulatory effect of sevoflurane in endotoxin-injured alveolar epithelial cells. Anesth Analg. 104:638–645. 2007. View Article : Google Scholar : PubMed/NCBI
37	Loop T, Scheiermann P, Doviakue D, et al: Sevoflurane inhibits phorbol-myristate-acetate-induced activator protein-1 activation in human T lymphocytes in vitro: potential role of the p38-stress kinase pathway. Anesthesiology. 101:710–721. 2004. View Article : Google Scholar
38	Frohlich D, Rothe G, Wittmann S, Schmitz G, Schmid P, Taeger K and Hobbhahn J: Nitrous oxide impairs the neutrophil oxidative response. Anesthesiology. 88:1281–1290. 1998. View Article : Google Scholar : PubMed/NCBI
39	Hill GE, English JB, Stanley TH, Kawamura R, Loeser EA and Hill HR: Nitrous oxide and neutrophil chemotaxis in man. Br J Anaesth. 50:555–558. 1978. View Article : Google Scholar : PubMed/NCBI
40	Kripke BJ, Kupferman A and Luu KC: Suppression of chemotaxis to corneal inflammation by nitrous oxide. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi. 20:302–310. 1987.PubMed/NCBI
41	Nunn JF and O’Morain C: Nitrous oxide decreases motility of human neutrophils in vitro. Anesthesiology. 56:45–48. 1982. View Article : Google Scholar : PubMed/NCBI
42	Welch WD: Effect of enflurane, isoflurane, and nitrous oxide on the microbicidal activity of human polymorphonuclear leukocytes. Anesthesiology. 61:188–192. 1984. View Article : Google Scholar : PubMed/NCBI
43	Welch WD and Zaccari J: Effect of halothane and N₂O on the oxidative activity of human neutrophils. Anesthesiology. 57:172–176. 1982.
44	Bardosi L, Bardosi A and Gabius HJ: Changes of expression of endogenous sugar receptors by polymorphonuclear leukocytes after prolonged anaesthesia and surgery. Can J Anaesth. 39:143–150. 1992. View Article : Google Scholar : PubMed/NCBI
45	Frohlich D, Rothe G, Schmitz G and Taeger K: Nitrous oxide impairs the signaling of neutrophils downstream of receptors. Toxicol Lett. 100–101:121–127. 1998.PubMed/NCBI
46	Lehmberg J, Waldner M, Baethmann A and Uhl E: Inflammatory response to nitrous oxide in the central nervous system. Brain Res. 30:1246:88–95. 2008. View Article : Google Scholar : PubMed/NCBI
47	Sugasawa Y, Yamaguchi K, Kumakura S, Murakami T, Suzuki K, Nagaoka I and Inada E: Effects of sevoflurane and propofol on pulmonary inflammatory responses during lung resection. J Anesth. 26:62–69. 2012. View Article : Google Scholar : PubMed/NCBI