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Yu L, Zhu X, Peng K, Qin H, Yang K, Cai F, Hu J, Zhang Y. Propofol Alleviates Anxiety-Like Behaviors Associated with Pain by Inhibiting the Hyperactivity of PVN CRH Neurons via GABA A Receptor β3 Subunits. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2309059. [PMID: 38639389 PMCID: PMC11267288 DOI: 10.1002/advs.202309059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/21/2024] [Indexed: 04/20/2024]
Abstract
Pain, a comorbidity of anxiety disorders, causes substantial clinical, social, and economic burdens. Emerging evidence suggests that propofol, the most commonly used general anesthetic, may regulate psychological disorders; however, its role in pain-associated anxiety is not yet described. This study investigates the therapeutic potential of a single dose of propofol (100 mg kg-1) in alleviating pain-associated anxiety and examines the underlying neural mechanisms. In acute and chronic pain models, propofol decreased anxiety-like behaviors in the elevated plus maze (EPM) and open field (OF) tests. Propofol also reduced the serum levels of stress-related hormones including corticosterone, corticotropin-releasing hormone (CRH), and norepinephrine. Fiber photometry recordings indicated that the calcium signaling activity of CRH neurons in the paraventricular nucleus (PVNCRH) is reduced after propofol treatment. Interestingly, artificially activating PVNCRH neurons through chemogenetics interfered with the anxiety-reducing effects of propofol. Electrophysiological recordings indicated that propofol decreases the activity of PVNCRH neurons by increasing spontaneous inhibitory postsynaptic currents (sIPSCs). Further, reducing the levels of γ-aminobutyric acid type A receptor β3 (GABAAβ3) subunits in PVNCRH neurons diminished the anxiety-relieving effects of propofol. In conclusion, this study provides a mechanistic and preclinical rationale to treat pain-associated anxiety-like behaviors using a single dose of propofol.
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Affiliation(s)
- Le Yu
- Department of AnesthesiologyThe Second Affiliated Hospital of Anhui Medical UniversityHefei230601China
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education InstitutesAnhui Medical UniversityHefei230032China
| | - Xiaona Zhu
- School of Life Science and TechnologyShanghaiTech UniversityShanghai201210China
| | - Kang Peng
- Department of AnesthesiologyThe Second Affiliated Hospital of Anhui Medical UniversityHefei230601China
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education InstitutesAnhui Medical UniversityHefei230032China
| | - Huimin Qin
- School of Life Science and TechnologyShanghaiTech UniversityShanghai201210China
| | - Kexin Yang
- School of Life Science and TechnologyShanghaiTech UniversityShanghai201210China
| | - Fang Cai
- School of Life Science and TechnologyShanghaiTech UniversityShanghai201210China
| | - Ji Hu
- School of Life Science and TechnologyShanghaiTech UniversityShanghai201210China
| | - Ye Zhang
- Department of AnesthesiologyThe Second Affiliated Hospital of Anhui Medical UniversityHefei230601China
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education InstitutesAnhui Medical UniversityHefei230032China
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Gan TJ, Bertoch T, Habib AS, Yan P, Zhou R, Lai YL, Liu X, Essandoh M, Daley WL, Gelb AW. Comparison of the Efficacy of HSK3486 and Propofol for Induction of General Anesthesia in Adults: A Multicenter, Randomized, Double-blind, Controlled, Phase 3 Noninferiority Trial. Anesthesiology 2024; 140:690-700. [PMID: 38150544 DOI: 10.1097/aln.0000000000004886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
BACKGROUND Propofol is an intravenous anesthetic associated with hypotension, respiratory depression, and injection-site pain. HSK3486 injectable emulsion (ciprofol) is a 2,6-disubstituted phenol derivative with fast onset and quick, stable recovery. Previous studies support HSK3486 as an effective, safe anesthetic with substantially less injection-site pain than propofol. The primary objective of this study was to investigate the noninferiority of HSK3486 compared with propofol in successful general anesthesia induction. METHODS Two hundred fifty-five participants were enrolled in HSK3486-304, a multicenter, randomized (2:1), double-blind, propofol-controlled, phase 3 study evaluating HSK3486 for general anesthesia induction in adults undergoing elective surgery with tracheal intubation. The primary endpoint was successful anesthesia induction, defined as 1 or less on the Modified Observer's Assessment of Alertness/Sedation scale. Key secondary endpoints were proportion of participants with injection-site pain on the Numerical Rating Scale of 1 or greater and a composite endpoint, including the proportion of participants successfully induced while maintaining the desired anesthetic depth and without substantial cardiac and respiratory events. Safety endpoints included adverse events, abnormal vital signs, and injection-site pain. RESULTS Two hundred fifty-one participants (HSK3486, n = 168; propofol, n = 83) were included in the analyses. General anesthesia was successfully induced in 97.0% versus 97.6% of participants with HSK3486 and propofol, respectively. The difference in success rate was -0.57% (95% CI, -5.4 to 4.2%); the noninferiority boundary of -8% was not crossed. Thirty participants (18.0%) had injection-site pain with HSK3486 versus 64 (77.1%) with propofol (P < 0.0001). Eighty-one participants (48.2%) with HSK3486 versus 42 (50.6%) with propofol (P = 0.8780) satisfied the composite endpoint. When injection-site pain was excluded, the incidence of treatment-emergent adverse events related to study drug was 17.9% for HSK3486 and 14.5% for propofol. CONCLUSIONS The study met its primary objective and endpoint, demonstrating noninferiority of HSK3486 compared with propofol in successful anesthetic induction. Substantially less injection-site pain was associated with HSK3486 than with propofol. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Tong J Gan
- Anesthesiology, Critical Care and Pain Medicine Division, University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Ashraf S Habib
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
| | - Pangke Yan
- Haisco Pharmaceutical Group Co., Ltd., Shannan, China
| | - Rong Zhou
- Haisco Pharmaceutical Group Co., Ltd., Shannan, China
| | - Yu-Ling Lai
- Haisco-USA Pharmaceuticals, Inc., Bridgewater, New Jersey
| | - Xiao Liu
- Haisco Pharmaceutical Group Co., Ltd., Shannan, China
| | - Michael Essandoh
- Department of Anesthesiology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | | | - Adrian W Gelb
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California
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Zhang J, Liu R, Bi R, Li X, Xu M, Li L, Su Y, Yan W. Comparison of ciprofol-alfentanil and propofol-alfentanil sedation during bidirectional endoscopy: A prospective, double-blind, randomised, controlled trial. Dig Liver Dis 2024; 56:663-671. [PMID: 37813808 DOI: 10.1016/j.dld.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Although propofol is widely used for gastrointestinal endoscopic sedation, cardiopulmonary adverse events remain common. Ciprofol is a new intravenous anaesthetic agent demonstrating respiratory and hemodynamic stability. AIMS This study aimed to clarify the benefits of ciprofol combined with alfentanil in bidirectional endoscopy (esophagogastroduodenoscopy followed by colonoscopy) to reduce adverse events and improve post-endoscopic recovery. METHODS A total of 185 patients scheduled to undergo bidirectional endoscopy were randomly divided into two groups: ciprofol combined with alfentanil or propofol combined with alfentanil. All patients received 7 µg/kg alfentanil intravenously before the study drugs were administered. The propofol group received a bolus of 1.2 mg/kg (0.12 ml/kg) propofol intravenously, whereas the ciprofol group received a bolus of 0.3 mg/kg (0.12 ml/kg) ciprofol intravenously. The primary outcome was the proportion of patients with cardiopulmonary adverse events (i.e., any one of the airway obstruction, apnoea, hypotension, hypertension, bradycardia, tachycardia or arrhythmias). RESULTS Compared with propofol, ciprofol reduced cardiopulmonary adverse events by 43.51 % (34.4% vs. 60.9 %, P <0.001), mitigated respiratory adverse events by 54.74 % (17.2% vs. 38.0 %, P = 0.002) overall and by 59.05 % (12.9% vs. 31.5 %, P = 0.002) during the induction period. CONCLUSIONS Ciprofol can significantly decrease respiratory depression events and provides a better sedative efficacy than propofol with higher recovery quality and satisfaction.
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Affiliation(s)
- Jiqiang Zhang
- Department of Anaesthesiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruijuan Liu
- Department of Anaesthesiology, Gansu Provincial Hospital, No. 204 Dong-gang West Road, Lanzhou, Gansu 730030, China; Ningxia Medical University School of Clinical Medicine, Yinchuan, China
| | - Ruirui Bi
- Department of Anaesthesiology, Gansu Provincial Hospital, No. 204 Dong-gang West Road, Lanzhou, Gansu 730030, China
| | - Xia Li
- Department of Anaesthesiology, Gansu Provincial Hospital, No. 204 Dong-gang West Road, Lanzhou, Gansu 730030, China
| | - Mengjun Xu
- Department of Anaesthesiology, Gansu Provincial Hospital, No. 204 Dong-gang West Road, Lanzhou, Gansu 730030, China
| | - Lijuan Li
- Department of Anaesthesiology, Gansu Provincial Hospital, No. 204 Dong-gang West Road, Lanzhou, Gansu 730030, China; First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Yuxi Su
- Department of Anaesthesiology, Gansu Provincial Hospital, No. 204 Dong-gang West Road, Lanzhou, Gansu 730030, China
| | - Wenjun Yan
- Department of Anaesthesiology, Gansu Provincial Hospital, No. 204 Dong-gang West Road, Lanzhou, Gansu 730030, China.
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Masuda K, Furuyama A, Ohsuga K, Abe S, Kawaai H. Effect of propofol on salivary secretion from the submandibular, sublingual, and labial glands during intravenous sedation. J Dent Anesth Pain Med 2023; 23:153-162. [PMID: 37313266 PMCID: PMC10260352 DOI: 10.17245/jdapm.2023.23.3.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/28/2023] [Accepted: 04/25/2023] [Indexed: 06/15/2023] Open
Abstract
Background Recent animal studies have suggested the role of GABA type A (GABA-A) receptors in salivation, showing that GABA-A receptor agonists inhibit salivary secretion. This study aimed to evaluate the effects of propofol (a GABA-A agonist) on salivary secretions from the submandibular, sublingual, and labial glands during intravenous sedation in healthy volunteers. Methods Twenty healthy male volunteers participated in the study. They received a loading dose of propofol 6 mg/kg/h for 10 min, followed by 3 mg/kg/h for 15 min. Salivary flow rates in the submandibular, sublingual, and labial glands were measured before, during, and after propofol infusion, and amylase activity was measured in the saliva from the submandibular and sublingual glands. Results We found that the salivary flow rates in the submandibular, sublingual, and labial glands significantly decreased during intravenous sedation with propofol (P < 0.01). Similarly, amylase activity in the saliva from the submandibular and sublingual glands was significantly decreased (P < 0.01). Conclusion It can be concluded that intravenous sedation with propofol decreases salivary secretion in the submandibular, sublingual, and labial glands via the GABA-A receptor. These results may be useful for dental treatment when desalivation is necessary.
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Affiliation(s)
- Keisuke Masuda
- Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, Fukushima, Japan
| | - Akira Furuyama
- Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, Fukushima, Japan
| | - Kenji Ohsuga
- Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, Fukushima, Japan
| | - Shota Abe
- Department of Dental Anesthesiology, Ohu University School of Dentistry, Fukushima, Japan
| | - Hiroyoshi Kawaai
- Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, Fukushima, Japan
- Department of Dental Anesthesiology, Ohu University Dental Hospital, Fukushima, Japan
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Yin J, Qin J, Lin Z, Li A, Liu D, Jiang Y, Zhao Q, Chen L, Liu C. Glutamatergic neurons in the paraventricular hypothalamic nucleus regulate isoflurane anesthesia in mice. FASEB J 2023; 37:e22762. [PMID: 36719765 DOI: 10.1096/fj.202200974rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/11/2022] [Accepted: 12/27/2022] [Indexed: 02/01/2023]
Abstract
The glutamatergic-mediated excitatory system in the brain is vital for the regulation of sleep-wake and general anesthesia. Specifically, the paraventricular hypothalamic nucleus (PVH), which contains mainly glutamatergic neurons, has been shown to play a critical role in sleep-wake. Here, we sought to explore whether the PVH glutamatergic neurons have an important effect on the process of general anesthesia. We used c-fos staining and in vivo calcium signal recording to observe the activity changes of the PVH glutamatergic neurons during isoflurane anesthesia and found that both c-fos expression in the PVH and the calcium activity of PVH glutamatergic neurons decreased in isoflurane anesthesia and significantly increased during the recovery process. Chemogenetic activation of PVH glutamatergic neurons prolonged induction time and shortened emergence time from anesthesia by decreasing the depth of anesthesia. Using chemogenetic inhibition of PVH glutamatergic neurons under isoflurane anesthesia, we found that inhibition of PVH glutamatergic neurons facilitated the induction process and delayed the emergence accompanied by deepening the depth of anesthesia. Together, these results identify a crucial role for PVH glutamatergic neurons in modulating isoflurane anesthesia.
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Affiliation(s)
- Jianyin Yin
- Department of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital (Hunan Institute of Reproductive Medicine), Changsha, China
| | - Jie Qin
- Department of Anesthesiology, The Second Affiliated Hospital of University of South China, Hengyang, China.,Department of Anesthesiology, The First Affiliated Hospital of University of South China, Hengyang, China
| | - Zhaojing Lin
- Department of Anesthesiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Aiyuan Li
- Department of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital (Hunan Institute of Reproductive Medicine), Changsha, China
| | - Damin Liu
- Department of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital (Hunan Institute of Reproductive Medicine), Changsha, China
| | - Yurong Jiang
- Department of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital (Hunan Institute of Reproductive Medicine), Changsha, China
| | - Qiuni Zhao
- Department of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital (Hunan Institute of Reproductive Medicine), Changsha, China
| | - Liang Chen
- Department of Anesthesiology, Hunan Provincial Maternal and Child Health Care Hospital (Hunan Institute of Reproductive Medicine), Changsha, China
| | - Chengxi Liu
- Department of Anesthesiology, The Second Affiliated Hospital of University of South China, Hengyang, China.,Department of Anesthesiology, The First Affiliated Hospital of University of South China, Hengyang, China
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Li X, Yang D, Li Q, Wang H, Wang M, Yan P, Wu N, Li F, Ma S, Ding Y, Liu J, Wang H. Safety, Pharmacokinetics, and Pharmacodynamics of a Single Bolus of the γ-aminobutyric Acid (GABA) Receptor Potentiator HSK3486 in Healthy Chinese Elderly and Non-elderly. Front Pharmacol 2021; 12:735700. [PMID: 34512361 PMCID: PMC8430033 DOI: 10.3389/fphar.2021.735700] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/12/2021] [Indexed: 01/27/2023] Open
Abstract
Background: The present clinical trial investigated the potential influences of dosage and age on the pharmacokinetic properties and safety profile of HSK3486, and whether any adjustment in dosing regimen is necessary in elderly patients. Methods: Twenty-four elderly participants (65–73 years) were apportioned to three equal cohorts to receive a single IV bolus of 0.2, 0.3, and 0.4 mg/kg HSK3486, respectively. An additional control group comprised eight non-elderly participants (21–44 years), who each received a single IV bolus dose of 0.4 mg/kg. Safety was assessed throughout the study, and the clinical effects were assessed based on modified observer’s assessment of alertness/sedation and bispectral index (BIS) monitor. Pharmacokinetic parameters were calculated. Results: The rates of drug-related adverse reactions among the elderly groups were a little higher than that of the non-elderly, and were slightly higher in the elderly receiving 0.4 mg/kg compared with the elderly given lower doses. The pharmacokinetic characteristics of 0.4 mg/kg HSK3486 in the elderly and non-elderly were comparable. The time to recovery was similar in elderly 0.3 mg/kg, elderly 0.4 mg/kg and non-elderly 0.4 mg/kg groups. In the elderly 0.2 mg/kg group, the time to loss of consciousness was a little longer, and the time to recovery was shorter, relative to the other three groups. Conclusions: Administration of 0.3 mg/kg to the elderly and 0.4 mg/kg to the non-elderly were similarly efficacious. A dose of HSK3486 of 0.3 mg/kg may be chosen for clinical use in elderly patients.
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Affiliation(s)
- Xiaojiao Li
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Deming Yang
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Qianqian Li
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Hong Wang
- Jilin Medical Products Administration, Jilin, China
| | - Meng Wang
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Pangke Yan
- Haisco Pharmaceutical Group, Chengdu, China
| | - Nan Wu
- Haisco Pharmaceutical Group, Chengdu, China
| | | | - Shiping Ma
- Haisco Pharmaceutical Group, Chengdu, China
| | - Yanhua Ding
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Jingrui Liu
- Phase I Clinical Trial Unit, First Hospital, Jilin University, Jilin, China
| | - Hushan Wang
- Department of Anesthesiology, First Hospital, Jilin University, Jilin, China
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Zhang XY, Zhang YD, Cui BR, Jin R, Chu CP, Jin XH, Qiu DL. Propofol facilitates climbing fiber-Purkinje cell synaptic transmission via NMDA receptor in vitro in mice. Eur J Pharmacol 2020; 887:173474. [PMID: 32783960 DOI: 10.1016/j.ejphar.2020.173474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 11/19/2022]
Abstract
Propofol is generally used for the induction and maintenance of anesthesia in clinical procedures via activation of γ -aminobutyric acid A (GABAA) receptors. When administered at the clinical dose, propofol use is associated with movement disorders, including dystonia and ataxia, suggesting that propofol administration impacts the function of cerebellar neuronal circuitry. In this study, we investigated the effect of propofol on climbing fiber (CF)-Purkinje cell (PC) synaptic transmission in mouse cerebellar slices in the absence of GABAergic inhibition using a whole-cell recording technique and pharmacological methods. Our results showed that bath application of propofol enhanced CF-PC synaptic transmission, which was demonstrated by an increased amplitude and area under the curve (AUC) of the excitatory postsynaptic currents (EPSCs) accompanied by a decrease in the paired-pulse ratio (PPR). The propofol-induced increase in the amplitude of P1 was concentration-dependent with a half effective concentration (EC50) of 20.9 μM. The propofol-induced increases in the amplitude and AUC of CF-PC EPSCs were abolished by an N-Methyl-D-aspartate (NMDA) receptor blocker. Furthermore, the application of NMDA enhanced CF-PC EPSCs and overwhelmed the effect of propofol on CF-PC EPSCs. Moreover, intracellular blockade of NMDA receptors attenuated the propofol-induced enhancement of CF-PC synaptic transmission but strengthened the propofol-induced change in the PPR. These results indicate that propofol enhances CF-PC synaptic transmission by activation of NMDA receptors in the mouse cerebellar cortex, suggesting that propofol administration might be involved in propofol-induced dysfunction of the cerebellum via NMDA receptors.
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Affiliation(s)
- Xin-Yuan Zhang
- Brain Science Research Center, Yanbian University, Yanji City, Jilin Province, 133002, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China
| | - Yi-Dan Zhang
- Brain Science Research Center, Yanbian University, Yanji City, Jilin Province, 133002, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China
| | - Bai-Ri Cui
- Brain Science Research Center, Yanbian University, Yanji City, Jilin Province, 133002, China; Department of Osteology, Affiliated Hospital of Yanbian University, Yanji, Jilin Province, China
| | - Ri Jin
- Brain Science Research Center, Yanbian University, Yanji City, Jilin Province, 133002, China; Department of Osteology, Affiliated Hospital of Yanbian University, Yanji, Jilin Province, China
| | - Chun-Ping Chu
- Brain Science Research Center, Yanbian University, Yanji City, Jilin Province, 133002, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China
| | - Xian-Hua Jin
- Brain Science Research Center, Yanbian University, Yanji City, Jilin Province, 133002, China; Department of Neurology, Affiliated Hospital of Yanbian University, Yanji, Jilin Province, China.
| | - De-Lai Qiu
- Brain Science Research Center, Yanbian University, Yanji City, Jilin Province, 133002, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China.
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Yim PD, Gallos G, Lee-Kong SA, Dan W, Wu AD, Xu D, Berkowitz DE, Emala CW. Novel Expression of GABAA Receptors on Resistance Arteries That Modulate Myogenic Tone. J Vasc Res 2020; 57:113-125. [PMID: 32097943 DOI: 10.1159/000505456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/16/2019] [Indexed: 01/17/2023] Open
Abstract
The clinical administration of GABAergic medications leads to hypotension which has classically been attributed to the modulation of neuronal activity in the central and peripheral nervous systems. However, certain types of peripheral smooth muscle cells have been shown to express GABAA receptors, which modulate smooth muscle tone, by the activation of these chloride channels on smooth muscle cell plasma membranes. Limited prior studies demonstrate that non-human large-caliber capacitance blood vessels mounted on a wire myograph are responsive to GABAA ligands. We questioned whether GABAA receptors are expressed in human resistance arteries and whether they modulate myogenic tone. We demonstrate the novel expression of GABAA subunits on vascular smooth muscle from small-caliber human omental and mouse tail resistance arteries. We show that GABAA receptors modulate both plasma membrane potential and calcium responses in primary cultured cells from human resistance arteries. Lastly, we demonstrate functional physiologic modulation of myogenic tone via GABAA receptor activation in human and mouse arteries. Together, these studies demonstrate a previously unrecognized role for GABAA receptors in the modulation of myogenic tone in mouse and human resistance arteries.
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Affiliation(s)
- Peter D Yim
- Department of Anesthesiology, Columbia University, New York, New York, USA,
| | - George Gallos
- Department of Anesthesiology, Columbia University, New York, New York, USA
| | | | - William Dan
- Department of Anesthesiology, Columbia University, New York, New York, USA
| | - Amy D Wu
- Department of Anesthesiology, Columbia University, New York, New York, USA
| | - Dingbang Xu
- Department of Anesthesiology, Columbia University, New York, New York, USA
| | - Dan E Berkowitz
- Department of Anesthesiology and Perioperative Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Charles W Emala
- Department of Anesthesiology, Columbia University, New York, New York, USA
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9
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Chang CY, Chien YJ, Wu MY. Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysis. J Adv Res 2020; 24:223-238. [PMID: 32373356 PMCID: PMC7191318 DOI: 10.1016/j.jare.2020.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/28/2020] [Accepted: 02/11/2020] [Indexed: 11/26/2022] Open
Abstract
Attenuation of an increase in intraocular pressure (IOP) is crucial to preventing devastating postoperative visual loss following surgery. IOP is affected by several factors, including the physiologic alteration due to pneumoperitoneum and patient positioning and differences in anesthetic regimens. This study aimed to investigate the effects of propofol-based total intravenous anesthesia (TIVA) and volatile anesthesia on IOP. We searched multiple databases for relevant studies published before October 2019. Randomized controlled trials comparing the effects of propofol-based TIVA and volatile anesthesia on IOP during surgery were considered eligible for inclusion. Twenty studies comprising 980 patients were included. The mean IOP was significantly lower in the propofol-based TIVA group after intubation, pneumoperitoneum, Trendelenburg positioning, and lateral decubitus positioning. Moreover, mean arterial pressure and peak inspiratory pressure were also lower after intubation in the propofol-based TIVA group. Trial sequential analyses for these outcomes were conclusive. Propofol-based TIVA is more effective than volatile anesthesia during surgery at attenuating the elevation of IOP and should be considered, especially in at-risk patients.
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Affiliation(s)
- Chun-Yu Chang
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Yung-Jiun Chien
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan
| | - Meng-Yu Wu
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan.,Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
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Lee KY, Jang Y, Lee MH, Kim YI, Jung SC, Han SY, Kim SH, Park HS, Kim DK. Intravenous Anesthetic, Propofol Affects Synaptic Responses in Cerebellar Purkinje Cells. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2018; 16:176-183. [PMID: 29739131 PMCID: PMC5953017 DOI: 10.9758/cpn.2018.16.2.176] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/30/2017] [Accepted: 04/07/2017] [Indexed: 11/24/2022]
Abstract
Objective Propofol is an intravenously administered anesthetic that enhances γ-aminobutyric acid-mediated inhibition in the central nerve system. Other mechanisms may also be involved in general anesthesia. Propofol has been implicated in movement disorders. The cerebellum is important for motor coordination and motor learning. The aim of the present study was to investigate the propofol effect on excitatory synaptic transmissions in cerebellar cortex. Methods Excitatory postsynaptic currents by parallel fiber stimulation and complex spikes by climbing fiber stimulation were monitored in Purkinje cells of Wister rat cerebellar slice using whole-cell patch-clamp techniques. Results Decay time, rise time and amplitude of excitatory postsynaptic currents at parallel fiber Purkinje cell synapses and area of complex spikes at climbing fiber Purkinje cell synapses were significantly increased by propofol administration. Conclusion The detected changes of glutamatergic synaptic transmission in cerebellar Purkinje cell, which determine cerebellar motor output, could explain cerebellar mechanism of motor deficits induced by propofol.
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Affiliation(s)
- Kwan Young Lee
- Department of Molecular and Integrative Physiology, School of Molecular and Cellular Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yujin Jang
- Department of Physiology, Konyang University College of Medicine, Daejeon, Korea
| | - Min Hee Lee
- Department of Physiology, Konyang University College of Medicine, Daejeon, Korea
| | - Young Im Kim
- Department of Anesthesiology, Yeosu Chonnam Hospital, Yeosu, Korea
| | - Sung-Cherl Jung
- Department of Physiology, Jeju National University School of Medicine, Jeju, Korea
| | - Seung-Yun Han
- Department of Anatomy, Konyang University College of Medicine, Daejeon, Korea
| | - Se Hoon Kim
- Department of Physiology, Konyang University College of Medicine, Daejeon, Korea
| | - Hyung Seo Park
- Department of Physiology, Konyang University College of Medicine, Daejeon, Korea
| | - Dong Kwan Kim
- Department of Physiology, Konyang University College of Medicine, Daejeon, Korea.,Myunggok Medical Research Institute, Konyang University, Daejeon, Korea
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Zhong Q, Chen X, Zhao Y, Liu R, Yao S. Association of Polymorphisms in Pharmacogenetic Candidate Genes with Propofol Susceptibility. Sci Rep 2017; 7:3343. [PMID: 28611364 PMCID: PMC5469860 DOI: 10.1038/s41598-017-03229-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 04/24/2017] [Indexed: 12/31/2022] Open
Abstract
Significant individual susceptibility to intravenous anesthetic propofol exists. The etiology of individual variability in the response to propofol may be influenced by genetic polymorphisms in metabolic and functional pathways. With current pharmacogenetics and modern molecular biology technologies, it is possible to study the influence of genetic polymorphisms on susceptibility to propofol. When inducing general anesthesia with intravenous propofol, high individual susceptibility to propofol was found. Using Sequenom MassARRAY single-nucleotide polymorphism (SNP) genotyping, we identified a mutation (rs6313) in the 5HT2A gene that was correlated to individual susceptibility to propofol effect-site concentration (Cep) and onset time of propofol induction. Carriers of the minor allele (G) of 5HT2A rs6313 required less propofol (20% decrease in Cep) and less time (40% decrease in onset time) to induce anesthesia. Moreover, associations were found between the gamma-aminobutyric acid (GABA) receptor SNP rs2279020 and the SCN9A SNP rs6746030 and the susceptibility of bispectral index (BIS) after propofol-induced anesthesia. In addition, dominant mutations in GABAA1 rs2279020, GABAA2 rs11503014, and CHRM2 rs1824024 were putatively associated with cardiovascular susceptibility to propofol anesthesia. No gene-gene interactions were found through a standardized measure of linkage disequilibrium and a multifactor dimensionality reduction analysis. Our results suggest that genetic polymorphisms related to mechanisms of propofol anesthesia are involved in propofol susceptibility.
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Affiliation(s)
- Qi Zhong
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Xiangdong Chen
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.
| | - Yan Zhao
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Ru Liu
- Department of Anesthesiology, the First Affiliated Hospital of University of South China, Hengyang, Hunan, 421000, China
| | - Shanglong Yao
- Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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Propofol enhances facial stimulation-evoked responses in the cerebellar granule cell layer via NMDA receptor activation in mice in vivo. Eur J Pharmacol 2016; 788:37-44. [DOI: 10.1016/j.ejphar.2016.05.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 05/23/2016] [Indexed: 11/20/2022]
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Norberg Å, Koch P, Kanes SJ, Björnsson MA, Barassin S, Ahlén K, Kalman S. A Bolus and Bolus Followed by Infusion Study of AZD3043, an Investigational Intravenous Drug for Sedation and Anesthesia. Anesth Analg 2015; 121:894-903. [DOI: 10.1213/ane.0000000000000804] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Jin R, Liu H, Jin WZ, Shi JD, Jin QH, Chu CP, Qiu DL. Propofol depresses cerebellar Purkinje cell activity via activation of GABA(A) and glycine receptors in vivo in mice. Eur J Pharmacol 2015; 764:87-93. [PMID: 26142083 DOI: 10.1016/j.ejphar.2015.06.052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 06/25/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
Abstract
Propofol is an intravenous sedative-hypnotic agen, which causes rapid and reliable loss of consciousness. Under in vitro conditions, propofol activates GABAA and glycine receptors in spinal cord, hippocampus and hypothalamus neurons. However, the effects of propofol on the cerebellar neuronal activity under in vivo conditions are currently unclear. In the present study, we examined the effects of propofol on the spontaneous activity of Purkinje cells (PCs) in urethane-anesthetized mice by cell-attached recording and pharmacological methods. Our results showed that cerebellar surface perfusion of propofol (10-1000 μM) induced depression of the PC simple spike (SS) firing rate in a dose-dependent manner, but without significantly changing the properties of complex spikes (CS). The IC50 of propofol for inhibiting SS firing of PCs was 144.5 μM. Application of GABAA receptor antagonist, SR95531 (40 μM) or GABAB receptor antagonist, saclofen (20 μM), as well as glycine receptor antagonist, strychnine (10 μM) alone failed to prevent the propofol-induced inhibition of PCs spontaneous activity. However, application the mixture of SR95531 (40 μM) and strychnine (10 μM) completely blocked the propofol-induced inhibition of PC SS firing. These data indicated that cerebellar surface application of propofol depressed PC SS firing rate via facilitation of GABAA and functional glycine receptors activity in adult cerebellar PCs under in vivo conditions. Our present results provide a new insight of the anesthetic action of propofol in cerebellar cortex, suggesting that propofol depresses the SS outputs of cerebellar PCs which is involved in both GABAA and glycine receptors activity.
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Affiliation(s)
- Ri Jin
- Cellular Function Research Center, Yanbian University, Yanji, Jilin Province, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China; Department of Osteology, Affiliated Hospital of Yanbian University, Yanji City, Jilin Province, China
| | - Heng Liu
- Cellular Function Research Center, Yanbian University, Yanji, Jilin Province, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China
| | - Wen-Zhe Jin
- Cellular Function Research Center, Yanbian University, Yanji, Jilin Province, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China; Department of Pain, Affiliated Hospital of Yanbian University, Yanji City, Jilin Province, China
| | - Jin-Di Shi
- Cellular Function Research Center, Yanbian University, Yanji, Jilin Province, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China
| | - Qing-Hua Jin
- Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China
| | - Chun-Ping Chu
- Cellular Function Research Center, Yanbian University, Yanji, Jilin Province, China.
| | - De-Lai Qiu
- Cellular Function Research Center, Yanbian University, Yanji, Jilin Province, China; Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji, Jilin Province, China.
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Costa FLPD, Monteiro LDS, Binda NS, Gomez MV, Gomez RS. Effect of Propofol on the Release of [3H] Acetylcholine from Rat Hippocampal Synaptosomes. INT J PHARMACOL 2014. [DOI: 10.3923/ijp.2014.494.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Iwata C, Abe C, Nakamura M, Morita H. Hypergravity exposure for 14 days increases the effects of propofol in rats. Anesth Analg 2013; 118:125-31. [PMID: 24247228 DOI: 10.1213/ane.0000000000000041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND It is thought that the gravitational environment of space exploration alters the effects of anesthetics; however, no evidence has as yet been reported. In the present study, we sought to provide direct evidence showing that hypergravity exposure for 14 days increases anesthetic effects and to examine the possible causes. METHODS Sprague-Dawley rats were raised in a 3g environment for 14 days. On the day of the experiment, rats were brought out of 3g and rested at 1g for 1 to 2 hours before IV propofol infusion (20 mg/kg, for 5 minutes). Control rats were continuously raised in a 1g environment. The effects of propofol were compared between rats raised in 1g and 3g environment by measuring time taken to induce the burst suppression in an electroencephalogram, nadir of arterial blood pressure, and time taken for the appearance of the righting response to noxious electrical stimulations. The time course of plasma propofol concentrations was also examined. Experiments were also conducted on rats with vestibular lesions to examine whether the vestibular system participated in the observed results. All values were expressed as mean ± SD. RESULTS In rats raised in 3g environment, the mean time to induce burst suppression in the electroencephalogram was earlier (195.7 ± 15.1 seconds, P = 0.00037), the nadir of mean arterial blood pressure was lower (75.0 ± 15.5 mm Hg, P = 0.019), and mean time for the righting response to appear was later (39.0 ± 8.4 minutes, P < 0.0001) than in rats raised in 1g environment (267.3 ± 29.4 seconds, 100.6 ± 9.1 mm Hg, and 22.0 ± 3.1 minutes, respectively). However, mean time to induce burst suppression and for the righting response to appear did not change in rats with vestibular lesions raised in 3g environment (275 ± 29.4 seconds, 108.7 ± 14.6 mm Hg, and 20.8 ± 2.8 minutes, P = 0.95, 0.73, and 0.98 vs sham-treated rats continuously raised in a 1g environment, respectively). There was no difference between groups in the time course assessment of plasma propofol concentrations. CONCLUSION The results provide evidence that hypergravity exposure for 14 days increases the effects of propofol. It is suggested that the results were not caused by differences in plasma propofol concentrations but by increased sensitivity, which was mediated via the vestibular system.
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Affiliation(s)
- Chihiro Iwata
- From the *Department of Physiology, Gifu University Graduate School of Medicine; and †Laboratory of Drug Informatics, Gifu Pharmaceutical University, Gifu, Japan
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Wakita M, Kotani N, Nonaka K, Shin MC, Akaike N. Effects of propofol on GABAergic and glutamatergic transmission in isolated hippocampal single nerve-synapse preparations. Eur J Pharmacol 2013; 718:63-73. [DOI: 10.1016/j.ejphar.2013.09.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 08/26/2013] [Accepted: 09/04/2013] [Indexed: 01/12/2023]
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Jin Z, Choi MJ, Park CS, Park YS, Jin YH. Propofol facilitated excitatory postsynaptic currents frequency on nucleus tractus solitarii (NTS) neurons. Brain Res 2012; 1432:1-6. [DOI: 10.1016/j.brainres.2011.11.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 10/12/2011] [Accepted: 11/04/2011] [Indexed: 12/01/2022]
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Jeong JA, Kim EJ, Jo JY, Song JG, Lee KS, Kim HW, Lee SD, Jeon BH, Lee JU, Park JB. Major role of GABAA-receptor mediated tonic inhibition in propofol suppression of supraoptic magnocellular neurons. Neurosci Lett 2011; 494:119-23. [DOI: 10.1016/j.neulet.2011.02.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 01/20/2011] [Accepted: 02/25/2011] [Indexed: 11/29/2022]
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Leite LF, Gomez RS, Fonseca MDC, Gomez MV, Guatimosim C. Effect of intravenous anesthetic propofol on synaptic vesicle exocytosis at the frog neuromuscular junction. Acta Pharmacol Sin 2011; 32:31-7. [PMID: 21113178 DOI: 10.1038/aps.2010.175] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AIM To investigate the presynaptic effects of propofol, a short-acting intravenous anesthetic, in the frog neuromuscular junction. METHODS Frog cutaneous pectoris nerve muscle preparations were prepared. A fluorescent tool (FM1-43) was used to visualize the effect of propofol on synaptic vesicle exocytosos in the frog neuromuscular junction. RESULTS Low concentrations of propofol, ranging from 10 to 25 μmol/L, enhanced spontaneous vesicle exocytosis monitored by FM1-43 in a Ca(2+)-dependent and Na(+)-independent fashion. Higher concentrations of propofol (50, 100, and 200 μmol/L) had no effect on spontaneous exocytosis. By contrast, higher concentrations of propofol inhibited the Na(+)-dependent exocytosis evoked by 4-aminopyridine but did not affect the Na(+)-independent exocytosis evoked by KCl. This action was similar and non-additive with that observed by tetrodotoxin, a Na(+) channel blocker. CONCLUSION Our data suggest that propofol has a dose-dependent presynaptic effect at the neuromuscular transmission which may help to understand some of the clinical effects of this agent on neuromuscular function.
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Shirasaka T, Yonaha T, Onizuka S, Tsuneyoshi I. Effects of orexin-A on propofol anesthesia in rats. J Anesth 2010; 25:65-71. [PMID: 21153424 DOI: 10.1007/s00540-010-1071-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 11/22/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE An active sleep homeostatic process is present during propofol anesthesia. Activation of the orexin system induces wakefulness, and inhibition of the orexin system causes narcolepsy. We hypothesized that orexin would affect propofol anesthesia. METHODS The effects of an intracerebroventricular (i.c.v.) injection of orexin-A (OXA) or an orexin-1 (OX-1) receptor antagonist, SB-334867, on the times to the loss and return of the righting reflex induced by propofol were examined in Wistar rats. The effects of propofol or OXA on norepinephrine (NE) and dopamine (DA) release from the prefrontal cortex (PFC) were examined using in vivo microdialysis. RESULTS An i.c.v. injection of OXA (1 nmol) decreased the time to emergence from propofol anesthesia mediated by the OX-1 receptor without changing anesthetic induction (n = 8). An i.c.v. injection of SB-334867 (5 and 50 nmol) increased the time to emergence from propofol anesthesia without changing anesthetic induction (n = 8). Intravenous infusion of propofol decreased NE (48 ± 8%; n = 8) and DA (61.2 ± 11%; n = 8) release from PFC mediated by the GABA(A) receptor. An i.c.v. injection of OXA reversed the decreases in NE and DA release induced by propofol mediated by the OX-1 receptor (n = 8). CONCLUSION These results indicate that the orexin system may accelerate the emergence from propofol anesthesia associated with increases in the central noradrenergic and dopaminergic activity.
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Affiliation(s)
- Tetsuro Shirasaka
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki 889-1692, Japan.
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Kang BJ, Kim SK, Lee GW, Kwon MA, Song JG, Ahn SC. The correlation between the effects of propofol on the auditory brainstem response and the postsynaptic currents of the auditory circuit in brainstem slices in the rat. Korean J Anesthesiol 2009; 56:552-558. [PMID: 30625787 DOI: 10.4097/kjae.2009.56.5.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although there have been reports showing the changes of the auditory brainstem response (ABR) waves by propofol, no detailed studies have been done at the level of brainstem auditory circuit. So, we studied the effects of propofol on the postsynaptic currents of the medial nucleus of the trapezoid body (MNTB)-lateral superior olive (LSO) synapses by using the whole cell voltage clamp technique and we compared this data with that obtained by the ABR. METHODS 5 rats at postnatal (P) 15 days were used for the study of the ABR. After inducing deep anesthesia using xylazine 6 mg/kg and ketamine 25 mg/kg, the ABRs were recorded before and after intraperitoneal propofol injection (10 mg/kg) and the effects of propofol on the latencies of the I, III, and V waves and the I-III and III-V interwave intervals were evaluated. Rats that were aged under P11 were used in the voltage clamp experiments. After making brainstem slices, the postsynaptic currents (PSCs) elicited by MNTB stimulation were recorded at the LSO, and the changes of the PSCs by the bath application of propofol (100 microM) were monitored. RESULTS We found small, but statistically significant increases in the latencies of ABR waves III and V and the interwave intervals of I-III and III-V by propofol. However, no significant changes were observed in the glycinergic or glutamatergic PSCs of the MNTB-LSO synpases by the application of propofol (100 microM). CONCLUSIONS Glycinergic or glutamatergic transmission of the MNTB-LSO synapses might not contribute to the propofol-induced changes of the ABR.
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Affiliation(s)
- Bong Jin Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheoan, Korea.
| | - Seok Kon Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheoan, Korea.
| | - Gwan Woo Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheoan, Korea.
| | - Min A Kwon
- Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheoan, Korea.
| | - Jae Gyok Song
- Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheoan, Korea.
| | - Seung Chul Ahn
- Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheoan, Korea.
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Behavior and cellular evidence for propofol-induced hypnosis involving brain glycine receptors. Anesthesiology 2009; 110:326-32. [PMID: 19194159 DOI: 10.1097/aln.0b013e3181942b5b] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND It is well documented that several general anesthetics, including propofol, potentiate glycine receptor function. Furthermore, glycine receptors exist throughout the central nervous system, including areas of the brain thought to be involved in sleep. However, the role of glycine receptors in anesthetic-induced hypnosis has not been determined. METHODS Experiments were conducted in rats where the loss of righting reflex (LORR) was used as a marker of the hypnotic state. Propofol-induced LORR was examined in the presence and absence of strychnine (a glycine receptor antagonist), GABAzine (a gamma-aminobutyric acid A receptor antagonist), as well as ketamine (an antagonist of N-methyl-D-aspartic acid subtype of glutamate receptors). Furthermore, the effects of propofol on the currents elicited by glycine and gamma-aminobutyric acid were analyzed in neurons isolated from the posterior hypothalamus of rats. The effects of strychnine and GABAzine on propofol-induced currents were also evaluated. RESULTS Strychnine and GABAzine dose-dependently reduced the percentage of rats exhibiting LORR induced by propofol. Furthermore, strychnine significantly increased the onset time and reduced the duration of LORR induced by propofol. In contrast, strychnine did not affect the LORR induced by ketamine. In addition, propofol markedly increased the currents elicited by glycine and GABA of hypothalamic neurons. Conversely, strychnine and GABAzine both profoundly attenuated the current induced by propofol. CONCLUSION Strychnine, the glycine receptor antagonist, dose-dependently reduced propofol-induced LORR in rats and propofol-induced current of rat hypothalamic neurons. These results suggest that neuronal glycine receptors partially contribute to propofol-induced hypnosis.
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The mechanisms of propofol-induced block on ion currents in differentiated H9c2 cardiac cells. Eur J Pharmacol 2008; 590:93-8. [DOI: 10.1016/j.ejphar.2008.05.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 05/09/2008] [Accepted: 05/22/2008] [Indexed: 11/20/2022]
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Li KY, Xiao C, Xiong M, Delphin E, Ye JH. Nanomolar propofol stimulates glutamate transmission to dopamine neurons: a possible mechanism of abuse potential? J Pharmacol Exp Ther 2008; 325:165-74. [PMID: 18216287 DOI: 10.1124/jpet.107.132472] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Anesthesiologists among physicians are on the top of the drug abuse list, and the mechanism is unclear. Recent studies suggest occupation-related second-hand exposure to i.v. drugs, including propofol, may play a role. Growing evidence indicates that propofol is one of the choices of drugs being abused. In this study, we show that propofol at minute concentrations increases glutamatergic excitatory synaptic transmission and discharges of dopamine neurons in the ventral tegmental area (VTA). We found that acute application of propofol (0.1-10 nM) to the VTA in midbrain slices of rats increased the frequency but not the amplitude of spontaneous excitatory postsynaptic currents (EPSCs) mediated by alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. We observed that propofol increased the amplitude but decreased the paired-pulse ratio of EPSCs evoked by stimulation in the absence and the presence of gabazine (SR 95531), a GABA(A) receptor antagonist. Moreover, the propofol-induced facilitation of EPSCs was mimicked by 6-phenyl-4-azabicyclo[5.4.0]undeca-7,9,11-triene-9,10-diol (SKF38393), an agonist of dopamine D(1) receptor, and by 1-[2-(diphenylmethoxy)ethyl]-4-(3-phenylpropyl)piperazine dihydrochloride (GBR 12935), a dopamine reuptake inhibitor, but blocked by (+/-)-7-bromo-8-hydroxy-3-methyl-1-phenyl-2,3,4, 5-tetrahydro-1H-3-benzazepine hydrochloride (SKF83566), a D(1) antagonist, or by depleting dopamine stores with reserpine. Finally, 1 nM propofol increased the spontaneous discharge rate of dopamine neurons. These findings suggest that propofol at minute concentrations enhances presynaptic D(1) receptor-mediated facilitation of glutamatergic synaptic transmission and the excitability of VTA dopamine neurons, probably by increasing extracellular dopamine levels. These changes in synaptic plasticity in the VTA, an addiction-related brain area might contribute to the development of propofol abuse and the increased susceptibility to addiction of other drugs.
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Affiliation(s)
- Ke-Yong Li
- Department of Anesthesiology, New Jersey Medical School, 185 South Orange Ave., Newark, NJ 07103-2714, USA
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McDougall SJ, Bailey TW, Mendelowitz D, Andresen MC. Propofol enhances both tonic and phasic inhibitory currents in second-order neurons of the solitary tract nucleus (NTS). Neuropharmacology 2007; 54:552-63. [PMID: 18082229 DOI: 10.1016/j.neuropharm.2007.11.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2007] [Revised: 10/26/2007] [Accepted: 11/04/2007] [Indexed: 02/07/2023]
Abstract
The anesthetic propofol is thought to induce rapid hypnotic sedation by facilitating a GABAergic tonic current in forebrain neurons. The depression of cardiovascular and respiratory regulation often observed during propofol suggests potential additional actions within the brainstem. Here we determined the impacts of propofol on both GABAergic and glutamatergic synaptic mechanisms in a class of solitary tract nucleus (NTS) neurons common to brainstem reflex pathways. In horizontal brainstem slices, we recorded from NTS neurons directly activated by solitary tract (ST) axons. We identified these second-order NTS neurons by time-invariant ("jitter"<200 micros), "all-or-none" glutamatergic excitatory postsynaptic currents (EPSCs) in response to shocks to the ST. In order to assess propofol actions, we measured ST-evoked, spontaneous and miniature EPSCs and inhibitory postsynaptic currents (IPSCs) during propofol exposure. Propofol prolonged miniature IPSC decay time constants by 50% above control at 1.8 microM. Low concentrations of gabazine (SR-95531) blocked phasic GABA currents. At higher concentrations, propofol (30 microM) induced a gabazine-insensitive tonic current that was blocked by picrotoxin or bicuculline. In contrast, total propofol concentrations up to 30 microM had no effect on EPSCs. Thus, propofol enhanced phasic GABA events in NTS at lower concentrations than tonic current induction, opposite to the relative sensitivity observed in forebrain regions. These data suggest that therapeutic levels of propofol facilitate phasic (synaptic) inhibitory transmission in second-order NTS neurons which likely inhibits autonomic reflex pathways during anesthesia.
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Affiliation(s)
- Stuart J McDougall
- Department of Physiology and Pharmacology L334, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland OR 97239-3098, USA.
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Ying SW, Goldstein PA. Propofol-block of SK channels in reticular thalamic neurons enhances GABAergic inhibition in relay neurons. J Neurophysiol 2004; 93:1935-48. [PMID: 15563549 DOI: 10.1152/jn.01058.2004] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The GABAergic reticular thalamic nucleus (RTN) is a major source of inhibition for thalamocortical neurons in the ventrobasal complex (VB). Thalamic circuits are thought to be an important anatomic target for general anesthetics. We investigated presynaptic actions of the intravenous anesthetic propofol in RTN neurons, using RTN-retained and RTN-removed brain slices. In RTN-retained slices, focal and bath application of propofol increased intrinsic excitability, temporal summation, and spike firing rate in RTN neurons. Propofol-induced activation was associated with suppression of medium afterhyperpolarization potentials. This activation was mimicked and completely occluded by the small conductance calcium-activated potassium (SK) channel blocker apamin, indicating that propofol could enhance RTN excitability by blocking SK channels. Propofol increased GABAergic transmission at RTN-VB synapses, consistent with excitation of presynaptic RTN neurons. Stimulation of RTN resulted in synaptic inhibition in postsynaptic neurons in VB, and this inhibition was potentiated by propofol in a concentration-dependent manner. Removal of RTN resulted in a dramatic reduction of both spontaneous postsynaptic inhibitory current frequency and propofol-mediated inhibition of VB neurons. Thus the existence and activation of RTN input were essential for propofol to elicit thalamocortical suppression; such suppression resulted from shunting through the postsynaptic GABA(A) receptor-mediated chloride conductance. The results indicate that propofol enhancement of RTN-mediated inhibitory input via blockade of SK channels may play a critical role in "gating" spike firing in thalamocortical relay neurons.
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Affiliation(s)
- Shui-Wang Ying
- C.V. Starr Laboratory for Molecular Neuropharmacology, Deptartment of Anesthesiology A-1050, Weill Medical College, Cornell University, 1300 York Ave., New York, NY 10021, USA
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