Binding of volatile anesthetics to serum albumin: measurements of enthalpy and solvent contributions

This study directly examines the enthalpic contributions to binding in aqueous solution of closely related anesthetic haloethers (desflurane, isoflurane, enflurane, and sevoflurane), a haloalkane (halothane), and an intravenous anesthetic (propofol) to bovine and human serum albumin (BSA and HSA) using isothermal titration calorimetry. Binding to serum albumin is exothermic, yielding enthalpies (DeltaH(obs)) of -3 to -6 kcal/mol for BSA with a rank order of apparent equilibrium association constants (K(a) values): desflurane > isoflurane approximately enflurane > halothane >or= sevoflurane, with the differences being largely ascribed to entropic contributions. Competition experiments indicate that volatile anesthetics, at low concentrations, share the same sites in albumin previously identified in crystallographic and photo-cross-linking studies. The magnitude of the observed DeltaH increased linearly with increased reaction temperature, reflecting negative changes in heat capacities (DeltaC(p)). These -DeltaC(p) values significantly exceed those calculated for burial of each anesthetic in a hydrophobic pocket. The enhanced stabilities of the albumin/anesthetic complexes and -DeltaC(p) are consistent with favorable solvent rearrangements that promote binding. This idea is supported by substitution of D(2)O for H(2)O that significantly reduces the favorable binding enthalpy observed for desflurane and isoflurane, with an opposing increase of DeltaS(obs). From these results, we infer that solvent restructuring, resulting from release of water weakly bound to anesthetic and anesthetic-binding sites, is a dominant and favorable contributor to the enthalpy and entropy of binding to proteins.

A model membrane protein for binding volatile anesthetics

Earlier work demonstrated that a water-soluble four-helix bundle protein designed with a cavity in its nonpolar core is capable of binding the volatile anesthetic halothane with near-physiological affinity (0.7 mM Kd). To create a more relevant, model membrane protein receptor for studying the physicochemical specificity of anesthetic binding, we have synthesized a new protein that builds on the anesthetic-binding, hydrophilic four-helix bundle and incorporates a hydrophobic domain capable of ion-channel activity, resulting in an amphiphilic four-helix bundle that forms stable monolayers at the air/water interface. The affinity of the cavity within the core of the bundle for volatile anesthetic binding is decreased by a factor of 4-3.1 mM Kd as compared to its water-soluble counterpart. Nevertheless, the absence of the cavity within the otherwise identical amphiphilic peptide significantly decreases its affinity for halothane similar to its water-soluble counterpart. Specular x-ray reflectivity shows that the amphiphilic protein orients vectorially in Langmuir monolayers at higher surface pressure with its long axis perpendicular to the interface, and that it possesses a length consistent with its design. This provides a successful starting template for probing the nature of the anesthetic-peptide interaction, as well as a potential model system in structure/function correlation for understanding the anesthetic binding mechanism.

An isothermal titration calorimetry study on the binding of four volatile general anesthetics to the hydrophobic core of a four-alpha-helix bundle protein

A molecular understanding of volatile anesthetic mechanisms of action will require structural descriptions of anesthetic-protein complexes. Previous work has demonstrated that the halogenated alkane volatile anesthetics halothane and chloroform bind to the hydrophobic core of the four-alpha-helix bundle (Aalpha(2)-L38M)(2) (Johansson et al., 2000, 2003). This study shows that the halogenated ether anesthetics isoflurane, sevoflurane, and enflurane are also bound to the hydrophobic core of the four-alpha-helix bundle, using isothermal titration calorimetry. Isoflurane and sevoflurane both bound to the four-alpha-helix bundle with K(d) values of 140 +/- 10 micro M, whereas enflurane bound with a K(d) value of 240 +/- 10 micro M. The DeltaH degrees values associated with isoflurane, sevoflurane, and enflurane binding were -7.7 +/- 0.1 kcal/mol, -8.2 +/- 0.2 kcal/mol, and -7.2 +/- 0.1 kcal/mol, respectively. The DeltaS degrees values accompanying isoflurane, sevoflurane, and enflurane binding were -8.5 cal/mol K, -10.4 cal/mol K, and -8.0 cal/mol K, respectively. The results indicate that the hydrophobic core of (Aalpha(2)-L38M)(2) is able to accommodate three modern ether anesthetics with K(d) values that approximate their clinical EC(50) values. The DeltaH degrees values point to the importance of polar interactions for volatile general anesthetic binding, and suggest that hydrogen bonding to the ether oxygens may be operative.

Theoretical Scales of Hydrogen Bond Acidity and Basicity for Application in QSAR/QSPR Studies and Drug Design. Partitioning of Aliphatic Compounds

Phenomenological analysis of existing hydrogen bond (HB) donor and acceptor scales and apparent physical considerations have enabled the establishment of new quantitative scales of hydrogen bond basicity and acidity. Chemical structures represented by molecular graphs and the orbital electronegativities of Hinze and Jaffe are utilized as an input data. The scales obtained correlate well with several experimental solvent polarity scales such as and, pK(HB), and E(T)(30). To demonstrate the applicability of the new quantities, we have applied them to seven equilibrium partitioning data sets: octanol-water, hexadecane-water, chloroform-water, gas-water, gas-octanol, gas-hexadecane, and gas-chloroform partition coefficients. The hydrogen bond descriptors when supplemented by a cavity-forming term and a dipolarity term show high performance in correlations of the partition coefficients of aliphatic compounds. These new HB descriptors can be used in studying hydrogen bonding and fluid phase equilibria as well as scoring functions in ligand docking and descriptors in ADME evaluations.

Inhalational anesthetic-binding proteins in rat neuronal membranes

Molecular targets of inhaled anesthetics must be represented in the group that specifically bind these drugs, but the paucity of direct binding data has limited the number of candidates for further evaluation. To find candidate targets, we used a combination of photolabeling, two-dimensional gel electrophoresis, and mass spectrometry to identify halothane-binding targets in rat neuronal membranes. Of the 265 spots detected on the two-dimensional gels, 90 were labeled by [(14)C]halothane, and 34 were identified. Mitochondrial proteins, especially respiratory complex and voltage-dependent anion channels, dominated the labeled group, and there were several examples of subunit- and state-dependent binding. A significant correlation was found between internal protein cavities and binding in a group of proteins with high resolution structures. Therefore, in addition to identifying novel neuronal targets, these data suggest a general molecular feature, the buried cavity, as a dominant attribute of volatile anesthetic-binding sites found in a limited number of neuronal membrane proteins.

In vitro evaluation of the dissolving effect of solvents on root canal sealers

The purpose of this in vitro study was to evaluate two commonly used gutta-percha solvents for their effectiveness in dissolving several types of root canal sealers. Seven different sealers (AH26, AH Plus, Diaket, Roekoseal, Sankin Apatite Root Sealer, Sealapex, and Sultan U/P) were used in this study. After mixing according to the manufacturers' directions, each material was syringed into 30 glass capillary tubes, and a total of 210 tubes were placed in a humidifier at 37 degrees C for one week to allow the materials to set completely. Each group of 30 tubes, obturated with one type of sealer, was then randomly divided into three subgroups, including 10 tubes each. Chloroform was used in the first ten tubes from each sealer group. Halothane was used for the second group. In the last group, the sealer was removed with files, without using any solvent. The time necessary to pass a file through to the end of the tube was recorded for each sample in seconds. Results were analyzed using one-way analysis of variance. Sealapex did not set at all unless in contact with air. Roekoseal did not adhere to the glass capillary tubes, and was therefore easily removed from the tube in all samples. AH26 and AH Plus root canal sealers tightly adhered to the tube walls, so none of the techniques were effective in removing them from the tubes within 30 min. Diaket root canal sealer was easily removed using solvents (P < 0.05). There was no advantage in using solvents to remove Sankin Apatite Root Sealer (P > 0.05). Solvents were found to be very effective in dissolving the Sultan U/P root canal sealer (P < 0.05).

Identification of nicotinic acetylcholine receptor amino acids photolabeled by the volatile anesthetic halothane

To identify inhalational anesthetic binding domains in a ligand-gated ion channel, we photolabeled nicotinic acetylcholine receptor (nAChR)-rich membranes from Torpedo electric organ with [(14)C]halothane and determined by Edman degradation some of the photolabeled amino acids in nAChR subunit fragments isolated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and high-performance liquid chromatography. Irradiation at 254 nm for 60 s in the presence of 1 mM [(14)C]halothane resulted in incorporation of approximately 0.5 mol of (14)C/mol of subunit, with photolabeling distributed within the nAChR extracellular and transmembrane domains, primarily at tyrosines. GammaTyr-111 in ACh binding site segment E was labeled, while alphaTyr-93 in segment A was not. Within the transmembrane domain, alphaTyr-213 within alphaM1 and deltaTyr-228 within deltaM1 were photolabeled, while no labeled amino acids were identified within the deltaM2 ion channel domain. Although the efficiency of photolabeling at the subunit level was unaffected by agonist, competitive antagonist, or isoflurane, state-dependent photolabeling was seen in a delta subunit fragment beginning at deltaPhe-206. Labeling of deltaTyr-212 in the extracellular domain was inhibited >90% by d-tubocurarine, whereas addition of either carbamylcholine or isoflurane had no effect. Within M1, the level of photolabeling of deltaTyr-228 with [(14)C]halothane was increased by carbamylcholine (90%) or d-tubocurarine (50%), but it was inhibited by isoflurane (40%). Within the structure of the nAChR transmembrane domain, deltaTyr-228 projects into an extracellular, water accessible pocket formed by amino acids from the deltaM1-deltaM3 alpha-helices. Halothane photolabeling of deltaTyr-228 provides initial evidence that halothane and isoflurane bind within this pocket with occupancy or access increased in the nAChR desensitized state compared to the closed channel state. Halothane binding at this site may contribute to the functional inhibition of nAChRs.

Application of the 19F NMR Technique to Observe Binding of the General Anesthetic Halothane to Human Serum Albumin

19F NMR techniques were employed to characterize the binding property of the widely used general anesthetic halothane with human serum albumin (HSA). It was found that 19F(1H) NOE and 2D 1H-19F HOESY experiments detected intermolecular NOEs between halothane 19F and HSA protons. Measurements of the diffusion coefficients for halothane were also carried out by 1H and 19F NMR, indicating the interaction of halothane with HSA. The present results indicate that these techniques are very suitable to identify a fluorine-containing ligand binding with a protein receptor in the drug-discovery process.

Biological activity of bacterial lectins and their molecular complexes with heterocyclic bis-adducts

A new convenient method for the preparation of heterocyclic bis-adducts: of imidazole, benzimidazole, uracile with 1,1,1-trifluoro-2-bromo-2-chloroethane is described. The reactions are catalysed by the 18-crown-6-complex. The critical toxicity and antitumour activity of saprophytic strains Bacillus genus (B. subtilis 668 IMV and B. polymyxa 102 KSU) extracellular lectins were studies. It was discovered that these substances apply to a few toxic preparations and have a expression antitumour action on the tumours: Walker carcinosarcoma 256, Pliss' lymphosarcoma and Sarcoma 45. The new molecular complexes were created with bacterial lectins and the same heterocyclic-bis-adducts of unsubstituted benzimidazole and 6-methyluracile. A strongly antitumour effect of these complexes has been discovered: of growth relaxation of Pliss' lymphosarcoma tumour mass was 62.5-82.01%.

Equilibrium titration of protein-ligand binding affinity in the presence of volatile reagents--a semiautomated approach

An existing method of equilibrium titration was significantly improved for investigating the effects of volatile anesthetics on Ca(2+) binding characteristics of human recombinant cardiac troponin C in in vitro conditions. The modified method increases stability of volatile compound concentrations in solution and allows for faster and more accurate data acquisition. The time to complete a titration series could be reduced from 28.3 +/- 6.2 min to 9.3 +/- 2.1 min, whereas the dispersion for pK(d) was decreased from 2.16 +/- 0.27 to 0.63 +/- 0.27. The method utilizes a semiautomatic approach to continuously monitor stability of fluorescence signals in a sealed chamber with greatly reduced air space.

Large-scale molecular dynamics simulations of general anesthetic effects on the ion channel in the fully hydrated membrane: the implication of molecular mechanisms of general anesthesia

Interactions of volatile anesthetics with the central nervous system are characterized by low yet specific binding affinities. Although neurotransmitter-gated ion channels are considered the primary anesthetic targets, the mechanism of action at the molecular level remains elusive. We consider here the theoretical implications of channel dynamics on anesthetic action in a simplified membrane-channel system. Large-scale 2.2-ns all-atom molecular dynamics simulations were performed to study the effects of halothane, a clinical anesthetic, on a gramicidin A (gA) channel in a fully hydrated dimyristoyl phosphatidylcholine membrane. In agreement with experimental results, anesthetics preferentially target the anchoring residues at the channel-lipid-water interface. Although the anesthetic effect on channel structure is minimal, the presence of halothane profoundly affects channel dynamics. For 2.2-ns simulation, the rms fluctuation of gA backbone in the lipid core increases from approximately equal 1 A in the absence of anesthetics to approximately equal 1.5 A in the presence of halothane. Autocorrelation analysis reveals that halothane (i) has no effect on the subpicosecond librational motion, (ii) prolongs the backbone autocorrelation time in the 10- to 100-ps time scale, and (iii) significantly decreases the asymptotic values of generalized order parameter and correlation time of nanosecond motions for the inner but not the outer residues. The simulation results discount the viewpoint of a structure-function paradigm that overrates the importance of structural fitting between general anesthetics and yet-unidentified hydrophobic protein pockets. Instead, the results underscore the global, as opposed to local, effects of anesthetics on protein dynamics as the underlying mechanisms for the action of general anesthetics and possibly of other low-affinity drugs.

Halogenated diazirines as photolabel mimics of the inhaled haloalkane anesthetics

The inhaled anesthetics are low affinity volatile compounds whose mechanism of action remains unclear, in part due to the difficulty of determining their binding targets. Photolabeling may help resolve this difficulty, and thus we have synthesized six compounds (four previously unreported) with structural and physical similarity to halothane (1-bromo-1-chloro-2,2,2-trifluoroethane), a commonly used clinical anesthetic. These compounds incorporate either a diazo, diazirine, or azido group to provide photolability in the long-UV range and to provide a highly reactive photolysis product. While several of the compounds have immobilizing activity in tadpoles, it is complicated by either toxicity or very low potency. One compound however, a halogenated three-carbon diazirine 4, is a potent anesthetic, is apparently nontoxic, potentiates GABA(A) Cl(-) currents, and stabilizes serum albumin, all of which are features of halothane. When tagged with radioactivity, this compound should serve as a reasonable probe of haloalkane anesthetic binding targets and sites.

Selected ion flow tube studies of the reactions of H3O+, NO+ and O2+ with the anaesthetic gases halothane, isoflurane and sevoflurane

We have carried out a study of the reactions of H(3)O(+), NO(+) and O(2) (+), the commonly used precursor ions for selected ion flow tube mass spectrometry (SIFT-MS), with three anaesthetic gases, halothane, isoflurane and sevoflurane. The motivation for this study was to provide the necessary kinetic data that would allow the quantification of these anaesthetic gases in operating theatre air and in the breath of theatre staff and post-operative patients. A clear negative result from these experiments is that NO(+), although undergoing the simplest chemistry, is unsuitable for this SIFT-MS application. However, although the ion chemistry of H(3)O(+) and O(2) (+) with these compounds is very complex, there being several product ions in each reaction, many of which react rapidly with water molecules, monitor ions have been identified for all three anaesthetic gases when using H(3)O(+) and O(2) (+) as precursor ions. The detailed ion chemistry is discussed and the specific monitor ions are indicated. Hence, the feasibility of on-line breath monitoring is demonstrated by simple examples. These studies have opened the way to measurements in the clinical environment.

Carbon monoxide production from desflurane, enflurane, halothane, isoflurane, and sevoflurane with dry soda lime

BACKGROUND

Previous studies in which volatile anesthetics were exposed to small amounts of dry soda lime, generally controlled at or close to ambient temperatures, have demonstrated a large carbon monoxide (CO) production from desflurane and enflurane, less from isoflurane, and none from halothane and sevoflurane. However, there is a report of increased CO hemoglobin in children who had been induced with sevoflurane that had passed through dry soda lime. Because this clinical report appears to be inconsistent with existing laboratory work, the authors investigated CO production from volatile anesthetics more realistically simulating conditions in clinical absorbers.

METHODS

Each agent, 2.5 or 5% in 2 l/min oxygen, were passed for 2 h through a Dräger absorber canister (bottom to top) filled with dried soda lime (Drägersorb 800). CO concentrations were continuously measured at the absorber outlet. CO production was calculated. Experiments were performed in ambient air (19-20 degrees C). The absorbent temperature was not controlled.

RESULTS

Carbon monoxide production peaked initially and was highest with desflurane (507 +/- 70, 656 +/- 59 ml CO), followed by enflurane (460 +/- 41, 475 +/- 99 ml CO), isoflurane (176 +/- 2.8, 227 +/- 21 ml CO), sevoflurane (34 +/- 1, 104 +/- 4 ml CO), and halothane (22 +/- 3, 20 +/- 1 ml CO) (mean +/- SD at 2.5 and 5%, respectively).

CONCLUSIONS

The absorbent temperature increased with all anesthetics but was highest for sevoflurane. The reported magnitude of CO formation from desflurane, enflurane, and isoflurane was confirmed. In contrast, a smaller but significant CO formation from sevoflurane was found, which may account for the CO hemoglobin concentrations reported in infants. With all agents, CO formation appears to be self-limited.

Viscosity and density of common anaesthetic gases: implications for flow measurements

Although viscosity (mu) is a crucial factor in measurements of flow with a pneumotachograph, and density (rho) also plays a role in the presence of turbulent flow, these material constants are not available for the volatile anaesthetic agents commonly administered in clinical practice. Thus, we determined experimentally mu and rho of pure volatile anaesthetic agents. Input impedance of a rigid-wall polyethylene tube (Zt) was measured when the tube was filled with various mixtures of carrier gases (air, 100% oxygen, 50% oxygen+50% nitrogen) to which different concentrations of volatile anaesthetic inhalation agents (halothane, isoflurane, sevoflurane, and desflurane) had been added. Mu and rho were calculated from real and imaginary portions of Zt, respectively, using the appropriate physical equations. Multiple linear regression was applied to estimate mu and rho of pure volatile agents. Viscosity values of pure volatile agents were markedly lower than those for oxygen or nitrogen. Clinically applied concentrations, however, did not markedly affect the viscosity of the gas mixture (maximum of 3.5% decrease in mu for 2 MAC desflurane). In contrast, all of the volatile agents significantly affected rho even at routinely used concentrations. Our results suggest that the composition of the carrier gas has a greater impact on viscosity than the amount and nature of the volatile anaesthetic agent whereas density is more influenced by volatile agent concentrations. Thus, the need for a correction factor in flow measurements with a pneumotachograph depends far more on the carrier gas than the concentration of volatile agent administered, although the latter may play a role in particular experimental or clinical settings.

Dynamic changes in blood solubility of desflurane, isoflurane, and halothane during cardiac surgery

OBJECTIVE

To determine an estimate of blood/gas partition coefficients of volatile anesthetics during cardiac surgery.

DESIGN

Descriptive

SETTING

University hospital

PARTICIPANTS

Six adult patients undergoing valvular replacement with hypothermic cardiopulmonary bypass.

MEASUREMENTS AND MAIN RESULTS

Blood samples were obtained from patients at 6 time points: before induction, at skin incision, at aortic cannulation, at rewarming during bypass, at weaning off bypass, and at skin suture. Measured blood/gas partition coefficients were plotted against corresponding solubilities estimated according to the combined effects of hypothermia and hemodilution. Significant differences were found in blood/gas partition coefficients of the 3 anesthetics at different times during surgery (p < 0.05). Blood/gas partition coefficients at weaning off bypass were the lowest, about 75% of that before anesthetic induction. A direct linear relationship for estimated solubility against measured solubility was found (r2 = 0.94; p < 0.05).

CONCLUSION

Dynamic changes in blood/gas partition coefficients of volatile anesthetics were found during cardiac surgery. They could be estimated by using multiple linear regression equations reflecting the combined effects of hypothermia and hemodilution.

Anesthetic stabilization of protein intermediates: myoglobin and halothane

Halothane, an inhaled anesthetic, destabilizes the folded structure of myoglobin. To determine whether this is due to preferential interactions with less stable folded conformers of myoglobin versus the completely unfolded state, we used photoaffinity labeling, hydrogen exchange, fluorescence spectroscopy, and circular dichroism spectroscopy. Apomyoglobin was used as a model of a less stable conformer of myoglobin. Halothane destabilizes myoglobin and binds with low affinity and stoichiometry but stabilizes and binds with higher affinity to apomyoglobin. The same halothane concentration has no effect on cytochrome c stability. The apomyoglobin/halothane complex is favored at pH 6.5 as compared to pH 4.5 or pH 2.5. Halothane photoincorporates into several sites in apomyoglobin, some allosteric to the heme pocket. Guanidinium unfolding of myoglobin, monitored by CD spectroscopy, shows destabilization at less than 1.3 M Gdm but stabilization at greater than 1.3 M Gdm, consistent with the hypothesis that less stable conformers of myoglobin bind halothane preferentially. We suggest the structural feature underlying preferential binding to less stable conformers is an enlarged cavity volume distribution, since myoglobin has several intermediate-sized cavities, while cytochrome c is more well packed and has no cavities detected by GRASP. Specific binding to less stable intermediates may underlie anesthetic potentiation of protein activity.

Evidence for a common binding cavity for three general anesthetics within the GABAA receptor

The GABA(A) receptor is an important target for a variety of general anesthetics (Franks and Lieb, 1994) and for benzodiazepines such as diazepam. Specific point mutations in the GABA(A) receptor selectively abolish regulation by benzodiazepines (Rudolph et al., 1999; McKernan et al., 2000) and by anesthetic ethers (Mihic et al., 1997; Krasowski et al., 1998; Koltchine et al., 1999), suggesting the existence of discrete binding sites on the GABA(A) receptor for these drugs. Using anesthetics of different molecular size (isoflurane > halothane > chloroform) together with complementary mutagenesis of specific amino acid side chains, we estimate the volume of a proposed anesthetic binding site as between 250 and 370 A(3). The results of the "cutoff" analysis suggest a common site of action for the anesthetics isoflurane, halothane, and chloroform on the GABA(A) receptor. Moreover, the data support a crucial role for Leu232, Ser270, and Ala291 in the alpha subunit in defining the boundaries of an amphipathic cavity, which can accommodate a variety of small general anesthetic molecules.

Prediction of volatile anaesthetic solubility in blood and priming fluids for extracorporeal circulation

Volatile anaesthetics are often used during cardiopulmonary bypass (CPB). To understand the kinetics of inhaled anaesthetics during CPB, anaesthetists should understand changes in blood solubility caused by fluid use. We set out to predict the solubility of three volatile anaesthetics, desflurane, isoflurane and halothane, during CPB by determining: (i) their solubility in fresh whole blood and eight CPB priming fluids at 37 degrees C; (ii) the effect of temperature on the solubility of these anaesthetics in lactated Ringer's, gelofusin, banked blood and plasma; (iii) their solubility in different mixtures of these four priming fluids at different temperatures; and (iv) their estimated and actual solubility in blood during hypothermic CPB. We calculated solubility using a concept of volume fraction partition coefficient and compared estimated and measured solubilities. For the three anaesthetics tested, solubilities are in the order: fresh whole blood approximately = plasma > banked blood > normal saline approximately = lactated Ringer's approximately = gelofusin approximately = Haemaccel approximately = hydroxyethyl starch > mannitol. The solubilities of the anaesthetics in all priming fluids increased logarithmically at lower temperatures (P<0.05). The volume-fraction estimates of the partition coefficients were within approximately +/-20% of the measured values for all values of solubility. The corresponding estimates of solubility for CPB blood samples were between -36% and +24% of the measured values. During normothermic CPB, blood solubility of volatile anaesthetics would be unchanged when using plasma, slightly reduced when using banked blood and markedly reduced when using crystalloids and colloids.

Cytotoxicity of halothane on human gingival fibroblast cultures in vitro

Recently halothane has been reported to be the most suitable alternative to chloroform in dissolving gutta-percha. Periapical tissue toxicity of halothane is not completely known. In this study gutta-percha dissolved by halothane was evaluated with the almar blue dye assay using human gingival fibroblast cultures. The cytotoxic effects of halothane on human gingival fibroblasts depended on the exposure dose, frequency, and duration. A reduced concentration and smaller amount of gutta-percha solvents may minimize the cytotoxic effects on host tissues.

Binding of the general anesthetics propofol and halothane to human serum albumin. High resolution crystal structures

Human serum albumin (HSA) is one of the most abundant proteins in the circulatory system and plays a key role in the transport of fatty acids, metabolites, and drugs. For many drugs, binding to serum albumin is a critical determinant of their distribution and pharmacokinetics; however, there have as yet been no high resolution crystal structures published of drug-albumin complexes. Here we describe high resolution crystal structures of HSA with two of the most widely used general anesthetics, propofol and halothane. In addition, we describe a crystal structure of HSA complexed with both halothane and the fatty acid, myristate. We show that the intravenous anesthetic propofol binds at two discrete sites on HSA in preformed pockets that have been shown to accommodate fatty acids. Similarly we show that the inhalational agent halothane binds (at concentrations in the pharmacologically relevant range) at three sites that are also fatty acid binding loci. At much higher halothane concentrations, we have identified additional sites that are occupied. All of the higher affinity anesthetic binding sites are amphiphilic in nature, with both polar and apolar parts, and anesthetic binding causes only minor changes in local structure.

Water vapour in a closed anaesthesia circuit reduces degradation/adsorption of halothane by dried soda lime

Dry lime causes a loss of volatile anaesthetics by degrading and adsorbing them. Degradation produces toxic substances and heat. Rehydration of lime stops degradation. If humidified breathing gases rehydrate lime, closed anaesthesia-circuits may reduce the loss of anaesthetics. To test this hypothesis we ventilated a reservoir bag with PhysioFlex-devices using fresh (F) and dried (D) soda lime both in the presence (+H) and absence (-H) of halothane. We measured halothane delivery, humidity, temperature, and lime weight. Halothane was lost for 13 min in D + H. Humidity increased steeper with fresh lime, whereas absorbent weight increased more with dried lime; halothane increased both variables (F + H: 99%, 8 g; F - H: 93%, 6 g; D + H: 58%, 17 g; D - H: 24%, 15 g). Surprisingly, temperature remained constant, probably because of the high gas flow (70 litres min-1) generated inside the Physioflex. These findings indicate rehydration of dried lime by humid gases and a rapid cessation of the loss of halothane in the PhysioFlex.