Alterations of bacterial clearance induced by propofol

Abstract

As the lipid emulsion by itself induced the same effects, the impaired immune function due to propofol is thought to be attributed to its solvent Intralipid.

Effect of short-term intralipid infusion on the immune response during low-dose endotoxemia in humans

“…Infusion of n-3 fatty acids 48 and 24 h before endotoxin bolus injection (2 ng/kg) has recently been shown to decrease the TNF-␣ response to endotoxin with no effect on IL-6 plasma concentrations (56), and high dose n-3 fatty acid infusion improves bacterial clearance from the blood compared with n-6 fatty acid infusion in rabbits (35). In accordance, infusion of Intralipid alters bacterial clearance in rabbits (36) and mice (20) and decreases neutrophil bacterial killing in human cells (76). Intralipid infusion for only 2 h increased the IL-6 and IL-8 response but not TNF-␣ response to high-dose endotoxemia in humans (74); however, this study addressed the effect of highly elevated TG levels and did not activate LPL with heparin, which was used in the present study to induce persistent and high levels of Fig.…”

Comparative Pharmacokinetics and Pharmacodynamics of the New Propofol Prodrug GPI 15715 and Propofol Emulsion: Retracted

“…1 Based on the assumption that GPI 15715 is completely hydrolyzed and according to the molecular weight ratio, 1.86 mg GPI 15715 should liberate 1 mg of propofol. The prodrug is intended to eliminate some disadvantages associated with the current lipid emulsion formulation of propofol, such as lipid intake, 2 risk of infection resulting from bacterial contamination and reduced bacterial clearance, 3 and pain on injection. 4 In addition, the cardiovascular effects of propofol may be influenced by the lipid solvent.…”

Dose-dependent influence of barbiturates but not of propofol on human leukocyte phagocytosis of viable Staphylococcus aureus

“…Our data corroborate the observation of Davidson and coworkers (6), who found no inhibition of phagocytosis after 30 mins up to a concentration of 2.5 ϫ 10 Ϫ3 M. In contrast, inhibition of phagocytosis was described for E. coli in whole blood (2.75 ϫ 10 Ϫ5 M propofol) (24) as well as for S. aureus and E. coli in a model with isolated leukocytes (3.3 ϫ 10 Ϫ4 M propofol) (26). In a rabbit model, bacterial clearance during propofol anesthesia was significantly attenuated (27). However, a comparable effect was observed with the lipid vehicle, which induced enhanced organ colonization with E. coli.…”