Effects of sevoflurane exposure on apoptosis and cell cycle of peripheral blood lymphocytes, and immunologic function

Abstract

Background Waste anesthetic gases (WAGs) leaked from new-type halogenated inhalational anesthetics such as sevoflurane have been were reported to pose a risk for the health of operating room personnel. The effects of WAGs on peripheral blood lymphocytes, however, remain yet controversial. The present study was undertaken to examine the effects of occupational sevoflurane exposure on the peripheral blood lymphocytes of medical personnel who work in the operating room. Methods A cohort of 56 medical residents were divided into exposed group (n = 28) and control group (non-exposed group) (n = 28). Gas chromatography was used to measure the concentration of sevoflurane in the medical resident’s breathing zone during surgeries under inhalation anesthesia in the exposure group. The gas collection lasted an hour. Peripheral blood lymphocytes were isolated from venous blood, and then apoptosis and cell cycle were analyzed by flow cytometry. EDTA-anticoagulated whole blood was harvested to analyze the lymphocyte subsets by flow cytometry. Immunoglobulins (IgA, IgM, IgG) were quantified by immunoturbidimetry. Results The average concentration of sevoflurane in the exposed group was 1.03 ppm with a range from 0.03 ppm to 2.24 ppm. No significant effects were found on the apoptosis rates or cell cycles of peripheral blood lymphocytes in the exposed group relative to the control group (P > 0.05). Similarly, there were no significant differences in the lymphocyte subsets or the levels of immunoglobulins (IgA, IgM, IgG) between the two groups (P > 0.05). Conclusions Occupational exposure to low-level sevoflurane has no significant effect on the peripheral blood lymphocytes of operating room staff, but this conclusion needs to be confirmed by multicenter and long-term follow-up studies with large samples. Trial registration number and date of registration ChiCTR2000040772, December 9, 2020 (Retrospective registration).

Veterinarians exposed to inhaled anesthetic present chromosome damage, apoptosis and cell cycle changes

“…There is only one recent study, to our knowledge, in which changes in the cell cycle distribution of peripheral blood lymphocytes were not reported in medical residents who T A B L E 1 Comparison of lymphocyte DNA damage (micronuclei and phosphorylated histone gamma-H2AX; γ-H2AX) between groups. worked in a surgical center compared to those in a control group (Ji et al, 2021). However, in contrast to our study, in the aforementioned study, medical residents with short-term exposure to the inhaled anesthetic sevoflurane, not isoflurane, were evaluated; they worked in operating rooms with modern laminar flow and were exposed to low traces of sevoflurane (average of 1 ppm in the work environment).…”

“…Thus, different results reported between the studies can be explained by the differences in the studied population, anesthetic exposure, period of exposure, and work conditions. The low exposure noted in the study conducted by Ji et al (2021) may have contributed to the absence of changes in the cell cycle and apoptosis rates. Additionally, owing to the small sample size, Hoerauf et al (1999) did not observe changes in the cell cycle kinetics of the peripheral lymphocytes of veterinarian surgeons.…”

“…Although no change in the cell cycle was observed in mononuclear cells in our study, an increase in the percentage of polymorphonuclear cells in G0/G1 and a decrease in the percentage of these cells in G2/M stage were found in veterinarians exposed to isoflurane; these findings are the first to be described in the literature. There is only one recent study, to our knowledge, in which changes in the cell cycle distribution of peripheral blood lymphocytes were not reported in medical residents who worked in a surgical center compared to those in a control group (Ji et al, 2021). However, in contrast to our study, in the aforementioned study, medical residents with short‐term exposure to the inhaled anesthetic sevoflurane, not isoflurane, were evaluated; they worked in operating rooms with modern laminar flow and were exposed to low traces of sevoflurane (average of 1 ppm in the work environment).…”

Acupuncture improves immunity and fatigue after chemotherapy in breast cancer patients by inhibiting the Leptin/AMPK signaling pathway

“…The serum was stored in a refrigerator at − 80 °C and kept to determine serum IgG, IgM, and IgA levels. Serum IgG, IgM, and IgA expression levels were determined by an immunoturbidimetric assay using IMMAGE800 specific protein instrument [ 33 – 35 ].…”