Propofol Inhibits the Proliferation, Migration, and Stem-like Properties of Bladder Cancer Mainly by Suppressing the Hedgehog Pathway

Li, Gang; Zhang, Xu; Guo, Xiangyang; Li, Yang; Li, Chong

doi:10.1177/0963689720985113

Cited by 11 publications

(9 citation statements)

References 40 publications

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“…17 Several mechanisms by which propofol specifically exerts antitumor effects on bladder cancer have also been presented. [6][7][8][9][10] In addition, meta-analyses indicate a survival benefit with propofol-based anesthesia for various cancers. [18][19][20][21] Please note that the 5-yr survival rates were calculated using the Kaplan-Meier approach, adjusting for the patients that were censored during follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…4 Finally, a randomized, controlled trial comparing the combination of propofol and paravertebral block with sevoflurane and opioids showed noninferiority in cancer recurrence between the two groups. 5 However, specific to bladder cancer, a few in vitro studies [6][7][8][9] and one clinical study 10 indicate that propofol interferes positively with the immune system against bladder cancer by regulation of several different microRNA pathways and the Hedgehog pathway. However, it is unclear whether these proposed advantages really translate to better survival.…”

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confidence: 99%

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Long-term Survival after Volatile or Propofol General Anesthesia for Bladder Cancer Surgery: A Retrospective National Registry Cohort Study

Enlund,

Hållberg,

Berglund

et al. 2024

Anesthesiology

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Background Prospective interventional trials and retrospective observational analyses provide conflicting evidence regarding the relationship between propofol versus inhaled volatile general anesthesia and long-term survival after cancer surgery. In specific, bladder cancer surgery lacks prospective clinical trial evidence. Methods Data on bladder cancer surgery performed under general anesthesia between 2014 and 2021 from The National Quality Registry for Urinary Tract and Bladder Cancer and the Swedish Perioperative Registry were record-linked. Overall survival was compared between patients receiving propofol or inhaled volatile for anesthesia maintenance. The minimum clinically important difference was defined as a five-percentage point difference in five-year survival. Results Of 7,571 subjects, 4,519 (59.7%) received an inhaled volatile anesthetic and 3,052 (40.3%) received propofol for general anesthesia maintenance. The two groups were quite similar in most respects but differed in ASA physical status and tumor stage. Propensity score matching was used to address treatment bias. Survival did not differ during follow-up (median 45 months [interquartile range, 33 to 62]) in neither the full unmatched cohort, nor following 1:1 propensity score matching (3,052 matched pairs). The Kaplan-Meier adjusted five-year survival rates in the matched cohort were 898/3,052, 67.5% (65.7-69.3) for propofol and 852/3,052, 68.5% (66.7-70.4) for inhaled volatile general anesthesia, respectively (hazard ratio 1.05 [95% CI: 0.96 to 1.15], P = 0.332). A sensitivity analysis restricted to 1,766 propensity score matched pairs of patients who received only one general anesthetic during the study period did not demonstrate a difference in survival; Kaplan-Meier adjusted five-year-survival rates were 521/1,766, 67.1% (64.7-69.7) and 482/1,766, 68.9% (66.5-71.4) for propofol and inhaled volatile general anesthesia, respectively (hazard ratio 1.09 [95% CI: 0.97 to 1.23], P = 0.139). Conclusions Among patients undergoing bladder cancer surgery under general anesthesia, there was no statistically significant difference in long-term overall survival associated with the choice of propofol or an inhaled volatile maintenance.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Long-term Survival after Volatile or Propofol General Anesthesia for Bladder Cancer Surgery: A Retrospective National Registry Cohort Study

Enlund,

Hållberg,

Berglund

et al. 2024

Anesthesiology

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“…20,26,27 Besides, contradictory effects of propofol on cell apoptosis and regeneration ability have been reported. [28][29][30] This study, for the first time, investigated the effect of propofol on corneal activated keratocytes for inflammation, fibrogenesis, and apoptosis. We showed that propofol treatment could significantly decrease the expression level of IL-1b in CAKs treated with 0.5 and 5 mM propofol.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Effect of Propofol on the Expression of Genes Involved in Inflammation and Apoptosis in Corneal Activated Keratocytes

Sanie-Jahromi,

Sanie Jahromi

2023

Cornea

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Purpose: We investigated the effect of propofol (0.5, 5, and 50 μM) on the gene expression of inflammatory cytokines [IL-1β, IL-6, transforming growth factor β (TGF-β), and LIF] and apoptosis process (BCL-2 and Bax) in corneal activated keratocytes (CAKs). Methods: CAKs (106 cells/10 cm2) were exposed to propofol at a concentration of 0.5, 5, and 50 μM for 24 hours at 37°C. The control group did not receive propofol at the same time or under the same condition. Ribonucleic acid (RNA) extraction, complementary DNA (cDNA) synthesis, and real-time polymerase chain reaction (PCR) were performed to quantify the relative expression of IL-1β, IL-6, TGF-β, LIF, BCL-2, and Bax expression in the treated versus control cells. Result: The results of this study showed that propofol treatment (0.5 and 5 μM) led to the downregulation of IL-1β and IL-6 gene expression in CAKs. TGF-β (with a role in fibrogenesis) was not changed in 0.5 and 5 μM propofol-treated CAKs, whereas CAKs treated with 50 μM propofol showed upregulation of the TGF-β gene. LIF (with a role in regeneration) was upregulated in 0.5 and 5 μM propofol-treated CAKs. The BCL-2/Bax ratio (as the antiapoptosis index) was increased in CAKs treated with 0.5 μM propofol and indicated the induction of an antiapoptotic effect. Conclusions: We showed that CAKs treatment with propofol, at concentrations of 0.5 and 5 μM, could decrease the expression of genes related to inflammation and enhance the genes associated with cell regeneration. While 50 μM propofol treatment might induce CAK fibrogenesis. This proof-of-concept study could preserve a groundwork for future drug design for the treatment of corneal stromal diseases and ocular regenerative medicine.

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“…Inclusion criteria are as follows: (1) all the included patients met the corresponding criteria for bladder cancer resection [ 8 ], (2) aged between 18 and 85 years, and (3) the clinical data of all included patients were complete.…”

Section: Methodsmentioning

confidence: 99%

Effects of Propofol Intravenous Anesthesia on Serum NGF, S100B Protein, and Immune Function in Patients with Bladder Cancer after Resection

Guan

Peng

Liu

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To explore the efficacy of intravenous propofol anesthesia on patients with bladder cancer after resection, as well as its effect on cognitive and immune function. Methods. Patients with bladder cancer and received resection of bladder cancer at our hospital from May 1, 2019, to November 30, 2021, were retrospectively retrieved and included in this study. The included patients were summarized into group A (isoflurane) and group B (intravenous propofol). The anesthesia intervention effect, serum NGF level, serum S100B protein level, and immune function before surgery, 6 h after surgery, 1 d after surgery, and 3 d after surgery were compared between the two groups. Results. Eighty-six patients were retrieved. The anesthesia intervention effective rate of patients in group B was significantly higher than that of patients in group A ( P < 0.01 ). The serum NGF and S100B of patients in both groups were significantly lower on postsurgical day 1, but in the trend to returning to those before intervention level on day 3. There were also fluctuations in immune function represented by changes in CD3+, CD4+, CD8+, and CD4+/CD8+ T cells, which showed return of function by postsurgical day 3. Conclusion. The anesthetic effect of intravenous propofol in patients with bladder cancer resection is significantly more satisfactory than isoflurane, with a transient effect on serum NGF and S100B protein levels and patients’ immune function, which suggests that intravenous propofol can be widely used for general anesthesia in clinical practice.

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Propofol Inhibits the Proliferation, Migration, and Stem-like Properties of Bladder Cancer Mainly by Suppressing the Hedgehog Pathway

Cited by 11 publications

References 40 publications

Long-term Survival after Volatile or Propofol General Anesthesia for Bladder Cancer Surgery: A Retrospective National Registry Cohort Study

Long-term Survival after Volatile or Propofol General Anesthesia for Bladder Cancer Surgery: A Retrospective National Registry Cohort Study

In Vitro Effect of Propofol on the Expression of Genes Involved in Inflammation and Apoptosis in Corneal Activated Keratocytes

Effects of Propofol Intravenous Anesthesia on Serum NGF, S100B Protein, and Immune Function in Patients with Bladder Cancer after Resection

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