Effects of anesthesia with sevoflurane and propofol on the cytokine/chemokine production at the airway epithelium during esophagectomy

  • Authors:
    • Saiko Wakabayashi
    • Keisuke Yamaguchi
    • Seiichiro Kumakura
    • Taisuke Murakami
    • Akimasa Someya
    • Yoshiaki Kajiyama
    • Isao Nagaoka
    • Eiichi Inada
  • View Affiliations

  • Published online on: April 29, 2014     https://doi.org/10.3892/ijmm.2014.1762
  • Pages: 137-144
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Abstract

Post-operative pulmonary complications such as pneumonia, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are closely associated with morbidity and mortality after esophagectomy. One lung ventilation (OLV) is commonly used during esophagectomy. However, the effect of the anesthetic agents on the inflammatory response induced by OLV has yet to be evaluated, particularly during esophagectomy, which causes several complications in the lung. The aim of the present study was to determine the effects of anesthetic agents, such as sevoflurane or propofol, on the inflammatory reactions at the airway. Twenty patients undergoing esophagectomy were randomized to receive either sevoflurane (n=10) or propofol (n=10) as a main anesthetic agent. Epithelial lining fluid (ELF) was obtained from ventilated‑dependent lung (DL) and collapsed non-dependent lung (NDL) by a bronchoscopic microsampling method. The levels of inflammatory cytokines and chemokine [tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, IL-10 and IL-12p70] in the ELF were measured using multiplexed bead-based immunoassays before and after OLV. The results indicated that the levels of IL-6 in ELF were significantly increased in both the ventilated DL and collapsed NDL after OLV compared with the levels prior to OLV in the sevoflurane group. By contrast, there was no significant change in the IL-6 levels in the propofol group in the ventilated DL and collapsed NDL before and after OLV. Similarly, IL-8 levels were markedly increased in the ventilated DL and collapsed NDL after OLV compared with those before OLV in the sevoflurane group, whereas there was no significant change in IL-8 levels in the propofol group in the ventilated DL and collapsed NDL before and after OLV. In contrast to the changes in IL-6 and IL-8 levels, levels of IL-10, an anti-inflammatory cytokine, were not obviously changed in both the ventilated DL and collapsed NDL before and after OLV in the sevoflurane group. However, IL-10 levels in the propofol group were increased in the ventilated DL and collapsed NDL after OLV compared with those before OLV. Of note, the levels of TNF-α, IL-1β and IL-12p70 in ELF were below the detection limits. These observations suggested that propofol anesthesia more potently suppresses the surgical stress-induced inflammatory perturbation at the local milieu of the airway during esophagectomy compared with sevoflurane anesthesia.

References

1 

Yamaguchi K, Sugasawa Y, Takeuchi K, et al: Effects of sivelestat on bronchial inflammatory responses after esophagectomy. Int J Mol Med. 28:187–192. 2011.PubMed/NCBI

2 

Sato N, Endo S, Kimura Y, et al: Influence of a human protease inhibitor on surgical stress induced immunosuppression. Dig Surg. 19:300–305. 2002. View Article : Google Scholar : PubMed/NCBI

3 

Sugasawa Y, Yamaguchi K, Kumakura S, et al: The effect of one-lung ventilation upon pulmonary inflammatory responses during lung resection. J Anesth. 25:170–177. 2011. View Article : Google Scholar : PubMed/NCBI

4 

Sugasawa Y, Yamaguchi K, Kumakura S, et al: Effects of sevoflurane and propofol on pulmonary inflammatory responses during lung resection. J Anesth. 26:62–69. 2012. View Article : Google Scholar : PubMed/NCBI

5 

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

6 

Schilling T, Kozian A, Kretzschmar M, et al: Effects of propofol and desflurane anaesthesia on the alveolar inflammatory response to one-lung ventilation. Br J Anaesth. 99:368–375. 2007. View Article : Google Scholar : PubMed/NCBI

7 

Schilling T, Kozian A, Senturk M, et al: Effects of volatile and intravenous anesthesia on the alveolar and systemic inflammatory response in thoracic surgical patients. Anesthesiology. 115:65–74. 2011. View Article : Google Scholar : PubMed/NCBI

8 

Bernard GR, Artigas A, Brigham KL, et al: The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 149:818–824. 1994. View Article : Google Scholar

9 

American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 20:864–874. 1992. View Article : Google Scholar

10 

Nakayama H, Kitayama J, Muto T and Nagawa H: Characterization of intracellular cytokine profile of CD4+ T cells in peripheral blood and tumor-draining lymph nodes of patients with gastrointestinal cancer. Jpn J Clin Oncol. 30:301–305. 2000.PubMed/NCBI

11 

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

12 

Takizawa H: Airway epithelial cells as regulators of airway inflammation (Review). Int J Mol Med. 1:367–378. 1998.PubMed/NCBI

13 

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

14 

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. 6:612005. View Article : Google Scholar : PubMed/NCBI

15 

Asadullah K, Sterry W and Volk HD: Interleukin-10 therapy-review of a new approach. Pharmacol Rev. 55:241–269. 2003. View Article : Google Scholar : PubMed/NCBI

16 

Kumakura S, Yamaguchi K, Sugasawa Y, et al: Effects of nitrous oxide on the production of cytokines and chemokines by the airway epithelium during anesthesia with sevoflurane and propofol. Mol Med Rep. 8:1643–1648. 2013.PubMed/NCBI

17 

Kotani N, Hashimoto H, Sessler DI, et al: Intraoperative modulation of alveolar macrophage function during isoflurane and propofol anesthesia. Anesthesiology. 89:1125–1132. 1998. View Article : Google Scholar : PubMed/NCBI

18 

Sato N, Koeda K, Kimura Y, et al: Cytokine profile of serum and bronchoalveolar lavage fluids following thoracic esophageal cancer surgery. Eur Surg Res. 33:279–284. 2001. View Article : Google Scholar : PubMed/NCBI

19 

Abe T, Oka M, Tangoku A, et al: Interleukin-6 production in lung tissue after transthoracic esophagectomy. J Am Coll Surg. 192:322–329. 2001. View Article : Google Scholar : PubMed/NCBI

20 

Galley HF, Dubbels AM and Webster NR: The effect of midazolam and propofol on interleukin-8 from human polymorphonuclear leukocytes. Anesth Analg. 86:1289–1293. 1998.PubMed/NCBI

21 

O’Donnell NG, McSharry CP, Wilkinson PC and Asbury AJ: Comparison of the inhibitory effect of propofol, thiopentone and midazolam on neutrophil polarization in vitro in the presence or absence of human serum albumin. Br J Anaesth. 69:70–74. 1992.

22 

Ma L, Wu X, Chen W and Fujino Y: Propofol has anti-inflammatory effects on alveolar type II epithelial cells. Acta Anaesthesiol Scand. 54:362–369. 2010. View Article : Google Scholar : PubMed/NCBI

23 

Murphy PG, Ogilvy AJ and Whiteley SM: The effect of propofol on the neutrophil respiratory burst. Eur J Anaesthesiol. 13:471–473. 1996. View Article : Google Scholar : PubMed/NCBI

24 

Mathy-Hartert M, Mouithys-Mickalad A, Kohnen S, Deby-Dupont G, Lamy M and Hans P: Effects of propofol on endothelial cells subjected to a peroxynitrite donor (SIN-1). Anaesthesia. 55:1066–1071. 2000. View Article : Google Scholar : PubMed/NCBI

25 

Ledowski T, Paech MJ, Patel B and Schug SA: Bronchial mucus transport velocity in patients receiving propofol and remifentanil versus sevoflurane and remifentanil anesthesia. Anesth Analg. 102:1427–1430. 2006. View Article : Google Scholar : PubMed/NCBI

26 

Takala RS, Soukka HR, Salo MS, et al: Pulmonary inflammatory mediators after sevoflurane and thiopentone anaesthesia in pigs. Acta Anaesthesiol Scand. 48:40–45. 2004. View Article : Google Scholar : PubMed/NCBI

27 

Kotani N, Takahashi S, Sessler DI, et al: Volatile anesthetics augment expression of proinflammatory cytokines in rat alveolar macrophages during mechanical ventilation. Anesthesiology. 91:187–197. 1999. View Article : Google Scholar

28 

Koksal GM, Sayilgan C, Gungor G, et al: Effects of sevoflurane and desflurane on cytokine response during tympanoplasty surgery. Acta Anaesthesiol Scand. 49:835–839. 2005. View Article : Google Scholar : PubMed/NCBI

29 

Kalimeris K, Christodoulaki K, Karakitsos P, et al: Influence of propofol and volatile anaesthetics on the inflammatory response in the ventilated lung. Acta Anaesthesiol Scand. 55:740–748. 2011. View Article : Google Scholar : PubMed/NCBI

30 

Wei H, Liang G, Yang H, et al: The common inhalational anesthetic isoflurane induces apoptosis via activation of inositol 1,4,5-trisphosphate receptors. Anesthesiology. 108:251–260. 2008. View Article : Google Scholar : PubMed/NCBI

31 

Moore KW, de Waal Malefyt R, Coffman RL and O’Garra A: Interleukin-10 and the interleukin-10 receptor. Annu Rev Immunol. 19:683–765. 2001. View Article : Google Scholar

32 

Gilliland HE, Armstrong MA, Carabine U and McMurray TJ: The choice of anesthetic maintenance technique influences the antiinflammatory cytokine response to abdominal surgery. Anesth Analg. 85:1394–1398. 1997.PubMed/NCBI

33 

Dimopoulou I, Armaganidis A, Douka E, et al: Tumour necrosis factor-alpha (TNFα) and interleukin-10 are crucial mediators in post-operative systemic inflammatory response and determine the occurrence of complications after major abdominal surgery. Cytokine. 37:55–61. 2007.

34 

Hudson LD, Milberg JA, Anardi D and Maunder RJ: Clinical risks for development of the acute respiratory distress syndrome. Am J Respir Crit Care Med. 151:293–301. 1995. View Article : Google Scholar : PubMed/NCBI

35 

Helmy SA, Wahby MA and El-Nawaway M: The effect of anaesthesia and surgery on plasma cytokine production. Anaesthesia. 54:733–738. 1999. View Article : Google Scholar : PubMed/NCBI

36 

Michelet P, D’Journo XB, Roch A, et al: Protective ventilation influences systemic inflammation after esophagectomy: a randomized controlled study. Anesthesiology. 105:911–919. 2006. View Article : Google Scholar : PubMed/NCBI

37 

D’Journo XB, Michelet P, Marin V, et al: An early inflammatory response to oesophagectomy predicts the occurrence of pulmonary complications. Eur J Cardiothorac Surg. 37:1144–1151. 2010.PubMed/NCBI

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Copy and paste a formatted citation
APA
Wakabayashi, S., Yamaguchi, K., Kumakura, S., Murakami, T., Someya, A., Kajiyama, Y. ... Inada, E. (2014). Effects of anesthesia with sevoflurane and propofol on the cytokine/chemokine production at the airway epithelium during esophagectomy . International Journal of Molecular Medicine, 34, 137-144. https://doi.org/10.3892/ijmm.2014.1762
MLA
Wakabayashi, S., Yamaguchi, K., Kumakura, S., Murakami, T., Someya, A., Kajiyama, Y., Nagaoka, I., Inada, E."Effects of anesthesia with sevoflurane and propofol on the cytokine/chemokine production at the airway epithelium during esophagectomy ". International Journal of Molecular Medicine 34.1 (2014): 137-144.
Chicago
Wakabayashi, S., Yamaguchi, K., Kumakura, S., Murakami, T., Someya, A., Kajiyama, Y., Nagaoka, I., Inada, E."Effects of anesthesia with sevoflurane and propofol on the cytokine/chemokine production at the airway epithelium during esophagectomy ". International Journal of Molecular Medicine 34, no. 1 (2014): 137-144. https://doi.org/10.3892/ijmm.2014.1762