Influence of propofol and volatile anaesthetics on the inflammatory response in the ventilated lung (Journal article)

Kalimeris, K./ Christodoulaki, K./ Karakitsos, P./ Batistatou, A./ Lekka, M./ Bai, M./ Kitsiouli, E./ Nakos, G./ Kostopanagiotou, G.

Background: The immunomodulatory effects of volatile anaesthetics in vitro and the protective effect of propofol in lung injury spurred us to study the effects of volatile anaesthetics and propofol on lung tissue in vivo. Methods: Twenty-seven pigs were randomized to 4-h general anaesthesia with propofol (8 mg/kg/h, group P, n=9), sevoflurane [minimum alveolar concentration (MAC)=1.0, group S, n=9) or desflurane (MAC=1.0, group D, n=9). Four healthy animals served as the no-ventilation group. Bronchoalveolar lavage fluid (BALF) was obtained to measure the cell counts, platelet-activating factor acetylhydrolase (PAF-AcH), phospholipase A(2) (PLA(2)) and superoxide dismutase (SOD) activity. Lung tissues were evaluated histologically and for caspase-3 expression. Results: Volatile anaesthetics reduced PAF-AcH levels without affecting PLA(2) activity and resulted in decreased alveolar macrophage and increased lymphocyte counts in BALF (sevoflurane: 29 +/- 23%; desflurane: 26 +/- 6%, both P<0.05 compared with 4 +/- 2% in the no-ventilation group). These findings were accompanied by atelectasis and inflammatory cells' infiltration in the inhalational anaesthetics groups. Also, sevoflurane reduced SOD activity and both sevoflurane and desflurane induced significant caspase-3 expression. In contrast, propofol resulted in a minor degree of inflammation and preserved BALF cells' composition without triggering apoptosis. Conclusion: Halogenated anaesthetics seem to trigger an immune lymphocytic response in the lung, inducing significant apoptosis and impairment of PAF-AcH. In contrast, propofol preserves anti-inflammatory and antioxidant defences during mechanical ventilation, thus preventing the emergence of apoptosis.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Θετικών Επιστημών. Τμήμα Χημείας
Keywords: activating-factor acetylhydrolase,oxidative stress status,mechanical ventilation,alveolar macrophages,sevoflurane anesthesia,epithelial-cells,oleic-acid,ii cells,injury,halothane
ISSN: 0001-5172
Link: <Go to ISI>://000292100800017
Publisher: Wiley-Blackwell
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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