In vivo effects of different anesthetic agents on apoptosis

Abstract

BackgroundThis study was designed to measure in vivo effects of propofol, isoflurane and sevoflurane on apoptosis by measuring caspase-3 and tumor necrosis factor (TNF)-related apoptosis inducing ligand (TRAIL) blood level as apoptotic markers.MethodsAfter obtaining ethical committee approval and informed written consents, sixty adult patients ASA I scheduled for open cholecystectomy participated in this study. They were randomally allocated into one of three equal groups to receive propofol infusion, low-flow isoflurane or sevoflurane for maintenance of anesthesia. Venous blood samples were collected preoperatively, immediately postoperative and after 24 hours to measure hemoglobin, hematocrit, creatinine, liver enzymes, serum TRAIL and caspase-3 levels.ResultsThere was no significant difference in hematological markers and serum creatinine. Liver enzymes showed significant postoperative rise (P < 0.05). In Propofol group, TRAIL and caspase-3 levels were significantly elevated immediately postoperative then decreased significantly after 24-hours (P < 0.05). In Isoflurane group, immediate postoperative level of TRAIL was significantly higher than 24 hours reading and significantly lower than its level in Propofol group at the same timing meanwhile caspase-3 levels were comparable at different timings. In Sevoflurane group, TRAIL and caspase-3 levels increased significantly in both postoperative samples than preoperative level and than those of Isoflurane and Propofol groups after 24 hours concerning TRAIL (P & 0.05).ConclusionsThis study concluded that isoflurane is superior and sevoflurane is the least effective among the three anesthetics in protection against apoptosis. This study neither proved nor excluded propofol-induced apoptosis. Further studies are required during lengthy procedure and in compromised patients.

Propofol Protects against Ischemia/Reperfusion Injury Associated with Reduced Apoptosis in Rat Liver

“…The antioxidant activity of propofol may mediate its potential role to modulate apoptosis [41]. Also, reduction of TNF-and caspase-3 levels, with increased BclxL/Bax ratio observed in this study, probably contributed to the protective effect of propofol on hepatic I/R in rats.…”

Propofol attenuates cytokine-mediated upregulation of expression of inducible nitric oxide synthase and apoptosis during regeneration post-partial hepatectomy

“…The latter include: reduction of the generation and scavenging of free radicals; inhibitory effects on calcium channels and reduction of intracellular calcium overload; reduction of the chemotaxis of inflammatory cells; reduction of NO production and apoptosis by downregulation of iNOS expression 34,38 . The antioxidant activity of propofol may mediate its potential role as a modulator of apoptosis 41 . Also, reduction in levels of TNF-α and caspase-3, with an increased BclxL/Bax ratio observed in the present study, probably contributed to the protective effect of propofol on hepatic ischemic-reperfusion injury in rats.…”

Total knee replacement induces peripheral blood lymphocytes apoptosis and it is not prevented by regional anesthesia – a randomized study

“…Pro-apoptotic effect of volatile and intravenous anesthetics, local anesthetics and opioids was established in vitro. 5,6 In one of the studies comparing the effect of general and epidural anesthesia on peripheral blood lymphocytes apoptosis no difference was found in patients undergoing abdominal surgery. 7 The difference was the patients' population ---in the previous study patients were undergoing abdominal surgery for nonmetastatic colon cancer.…”

“…Research focused on the influence of anesthetics on lymphocyte apoptosis in in vitro conditions shows pro-apoptotic effect of almost all inhalational, intravenous and local anesthetics. 5,6 Unfortunately, data collected from clinical research are ambiguous. Comparative research from 2009 did not indicate regional anesthesia being superior to general anesthesia (GA).…”