The volatile anesthetic sevoflurane inhibits activation of neutrophil granulocytes during simulated extracorporeal circulation

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• 作者：Eckhard Schmid ; Stefanie Krajewski ; Daniel Bachmann ; Julia Kurz ; Hans Peter Wendel ; Peter Rosenberger ; Beverley Balkau ; Karlheinz Peter ; Klaus Unertl ; Andreas Straub
• 关键词：Sevoflurane ; Inflammatory response ; Extracorporeal circulation
• 刊名：International Immunopharmacology
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：14
• 期：2
• 页码：202-208
• 全文大小：581 K

文摘

Extracorporeal circulation (ECC) is an essential tool for the execution of cardiac operations. However, ECC is also associated with undesirable side effects. These include the induction of a systemic inflammatory response associated with leukocyte activation and cytokine release as well as potentially life-threatening complications. The volatile anesthetic sevoflurane has been reported to exert anti-ischemic and anti-inflammatory effects. We therefore investigated whether sevoflurane modulates the ECC-triggered inflammatory response.

Heparinized human blood was circulated for 90 min in a normothermic (37 ¡ãC) ex vivo ECC circuit. An air-oxygen mixture was administered via an oxygenator in controls (n = 5). Sevoflurane (2 vol. % ) was added to the gas mixture in a second group (n = 5). At baseline and after 30, 60 and 90 min of ECC, blood samples were taken. In each sample whole blood counts were determined. Expression of the activation-indicating Mac-1 receptor on granulocytes and monocytes as well as leukocyte-platelet aggregate formation was measured in flow cytometry. Levels of the granulocyte activation marker PMN-elastase and of the cytokines IL-1¦Â, IL-8 and TNF-¦Á were analyzed using ELISA.

ECC induced significant increases in Mac-1 expression on granulocytes (p < 0.001) and PMN-elastase release (p < 0.001). Sevoflurane decreased granulocyte Mac-1 expression during ECC (p < 0.05) and inhibited the ECC-induced PMN-elastase release (p < 0.05). Sevoflurane had no effect on whole blood cell counts, leukocyte-platelet aggregate formation and cytokine release during ECC.

Sevoflurane inhibits granulocyte activation during ex vivo ECC and therefore has the potential to decrease the ECC-triggered inflammatory response. This promising finding warrants further investigation under clinical conditions.