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Pinheiro AV, Petrucci GN, Dourado A, Pires I. Anaesthesia in Veterinary Oncology: The Effects of Surgery, Volatile and Intravenous Anaesthetics on the Immune System and Tumour Spread. Animals (Basel) 2023; 13:3392. [PMID: 37958147 PMCID: PMC10648213 DOI: 10.3390/ani13213392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Throughout the course of oncological disease, the majority of patients require surgical, anaesthetic and analgesic intervention. However, during the perioperative period, anaesthetic agents and techniques, surgical tissue trauma, adjuvant drugs for local pain and inflammation and other non-pharmacological factors, such as blood transfusions, hydration, temperature and nutrition, may influence the prognosis of the disease. These factors significantly impact the oncologic patient's immune response, which is the primary barrier to tumour progress, promoting a window of vulnerability for its dissemination and recurrence. More research is required to ascertain which anaesthetics and techniques have immunoprotective and anti-tumour effects, which will contribute to developing novel anaesthetic strategies in veterinary medicine.
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Affiliation(s)
- Ana Vidal Pinheiro
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
| | - Gonçalo N. Petrucci
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal;
- Center for Investigation Vasco da Gama (CIVG), Department of Veterinary Sciences, Vasco da Gama University School (EUVG), 3020-210 Coimbra, Portugal
- CECAV—Veterinary and Animal Research Center, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Amândio Dourado
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal;
| | - Isabel Pires
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
- CECAV—Veterinary and Animal Research Center, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
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Gerber TJ, Fehr VCO, Oliveira SDS, Hu G, Dull R, Bonini MG, Beck-Schimmer B, Minshall RD. Sevoflurane Promotes Bactericidal Properties of Macrophages through Enhanced Inducible Nitric Oxide Synthase Expression in Male Mice. Anesthesiology 2019; 131:1301-1315. [PMID: 31658116 PMCID: PMC6856440 DOI: 10.1097/aln.0000000000002992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Sevoflurane with its antiinflammatory properties has shown to decrease mortality in animal models of sepsis. However, the underlying mechanism of its beneficial effect in this inflammatory scenario remains poorly understood. Macrophages play an important role in the early stage of sepsis as they are tasked with eliminating invading microbes and also attracting other immune cells by the release of proinflammatory cytokines such as interleukin-1β, interleukin-6, and tumor necrosis factor-α. Thus, the authors hypothesized that sevoflurane mitigates the proinflammatory response of macrophages, while maintaining their bactericidal properties. METHODS Murine bone marrow-derived macrophages were stimulated in vitro with lipopolysaccharide in the presence and absence of 2% sevoflurane. Expression of cytokines and inducible NO synthase as well as uptake of fluorescently labeled Escherichia coli (E. coli) were measured. The in vivo endotoxemia model consisted of an intraperitoneal lipopolysaccharide injection after anesthesia with either ketamine and xylazine or 4% sevoflurane. Male mice (n = 6 per group) were observed for a total of 20 h. During the last 30 min fluorescently labeled E. coli were intraperitoneally injected. Peritoneal cells were extracted by peritoneal lavage and inducible NO synthase expression as well as E. coli uptake by peritoneal macrophages was determined using flow cytometry. RESULTS In vitro, sevoflurane enhanced lipopolysaccharide-induced inducible NO synthase expression after 8 h by 466% and increased macrophage uptake of fluorescently labeled E. coli by 70% compared with vehicle-treated controls. Inhibiting inducible NO synthase expression pharmacologically abolished this increase in bacteria uptake. In vivo, inducible NO synthase expression was increased by 669% and phagocytosis of E. coli by 49% compared with the control group. CONCLUSIONS Sevoflurane enhances phagocytosis of bacteria by lipopolysaccharide-challenged macrophages in vitro and in vivo via an inducible NO synthase-dependent mechanism. Thus, sevoflurane potentiates bactericidal and antiinflammatory host-defense mechanisms in endotoxemia.
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Affiliation(s)
- Thomas J Gerber
- From the Departments Anesthesiology (T.J.G., V.C.O.F., S.D.S.O., G.H., R.D., B.B.-S., R.D.M.) Medicine (M.G.B.) Pharmacology (R.D.M.), University of Illinois at Chicago, Chicago, Illinois Institute of Anesthesiology (V.C.O.F., B.B.-S.) the Institute of Physiology and Zurich Center for Integrative Human Physiology (T.J.G., V.C.O.F., B.B.-S.), University of Zurich, Zurich, Switzerland
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Li J, Zhu X, Yang S, Xu H, Guo M, Yao Y, Huang Z, Lin D. Lidocaine Attenuates Cognitive Impairment After Isoflurane Anesthesia by Reducing Mitochondrial Damage. Neurochem Res 2019; 44:1703-1714. [PMID: 30989480 DOI: 10.1007/s11064-019-02799-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 04/03/2019] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
Abstract
Mitochondrial dysfunction has been proposed to be one of the earliest triggering events in isoflurane-induced neuronal damage. Lidocaine has been demonstrated to attenuate the impairment of cognition in aged rats induced by isoflurane in our previous study. In this study, we hypothesized that lidocaine could attenuate isoflurane anesthesia-induced cognitive impairment by reducing mitochondrial damage. H4 human neuroglioma cells and 18-month-old male Fischer 344 rats were exposed to isoflurane or isoflurane plus lidocaine. Cognitive function was tested at 14 days after treatment by the Barnes Maze test in male Fischer 344 rats. Morphology was observed under electron microscope, and mitochondrial transmembrane potential, electron transfer chain (ETC) enzyme activity, complex-I-IV activity, immunofluorescence and flow cytometry of annexin V-FITC binding, TUNEL assay, and Western blot analyses were applied. Lidocaine attenuated cognitive impairment caused by isoflurane in aged Fischer 344 rat. Lidocaine was effective in reducing mitochondrial damage, mitigating the decrease in mitochondrial membrane potential (ΔΨm), reversing isoflurane-induced changes in complex activity in the mitochondrial electron transfer chain and inhibiting the apoptotic activities induced by isoflurane in H4 cells and Fischer 344 rats. Additionally, lidocaine suppressed the ratio of Bax (the apoptosis-promoting protein) to Bcl-2 (the apoptosis-inhibiting protein) caused by isoflurane in H4 cells. Lidocaine proved effective in attenuating isoflurane-induced POCD by reducing mitochondrial damage.
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Affiliation(s)
- Jin Li
- Department of Anesthesiology, Sun-Yat sen Memorial Hospital, Sun-Yat sen University, Guangzhou, 510120, Guangdong, China
| | - Xiaoqiu Zhu
- Department of Anesthesiology, Sun-Yat sen Memorial Hospital, Sun-Yat sen University, Guangzhou, 510120, Guangdong, China
| | - Shangze Yang
- Department of Anesthesiology, Sun-Yat sen Memorial Hospital, Sun-Yat sen University, Guangzhou, 510120, Guangdong, China
| | - Hui Xu
- Department of Anesthesiology, Sun-Yat sen Memorial Hospital, Sun-Yat sen University, Guangzhou, 510120, Guangdong, China
| | - Mingyan Guo
- Department of Anesthesiology, Sun-Yat sen Memorial Hospital, Sun-Yat sen University, Guangzhou, 510120, Guangdong, China
| | - Yiyi Yao
- Department of Anesthesiology, Sun-Yat sen Memorial Hospital, Sun-Yat sen University, Guangzhou, 510120, Guangdong, China
| | - Zhiquan Huang
- Department of Oral and Maxillofacial Surgery, Sun-Yat sen Memorial Hospital, Sun-Yat sen University, Guangzhou, 510120, Guangdong, China.
| | - Daowei Lin
- Department of Anesthesiology, Sun-Yat sen Memorial Hospital, Sun-Yat sen University, Guangzhou, 510120, Guangdong, China.
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Abstract
Historically, volatile anesthetics have demonstrated interesting interactions with both the innate and adaptive immune systems. This review organizes these interactions into four phases: recognition, recruitment, response, and resolution. These phases represent a range of proinflammatory, inflammatory, and innate and adaptive immune regulatory responses. The interaction between volatile anesthetics and the immune system is discussed in the context of pathogenesis of infectious disease.
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Affiliation(s)
| | - Hilliard L Kutscher
- b Institute for Lasers, Photonics and Biophotonics , University of Buffalo, State University of New York , Buffalo , NY USA
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