Kawasaki Takashi, Choudhry Mashkoor A, Schwacha Martin G, Bland Kirby I, Chaudry Irshad H
Center for Surgical Research, Department of Surgery, University of Alabama at Birmingham, AL 35294-0019, USA.
Am J Physiol Cell Physiol. 2006 Nov;291(5):C1049-55. doi: 10.1152/ajpcell.00252.2006. Epub 2006 Jun 28.
Traumatic and/or surgical injury as well as hemorrhage induces profound suppression of cellular immunity. Although local anesthetics have been shown to impair immune responses, it remains unclear whether lidocaine affects lymphocyte functions following trauma-hemorrhage (T-H). We hypothesized that lidocaine will potentiate the suppression of lymphocyte functions after T-H. To test this, we randomly assigned male C3H/HeN (6-8 wk) mice to sham operation or T-H. T-H was induced by midline laparotomy and approximately 90 min of hemorrhagic shock (blood pressure 35 mmHg), followed by fluid resuscitation (4x shed blood volume in the form of Ringer lactate). Two hours later, the mice were killed and splenocytes and bone marrow cells were isolated. The effects of lidocaine on concanavalin A-stimulated splenocyte proliferation and cytokine production in both sham-operated and T-H mice were assessed. The effects of lidocaine on LPS-stimulated bone marrow cell proliferation and cytokine production were also assessed. The results indicate that T-H suppresses cell proliferation, Th1 cytokine production, and MAPK activation in splenocytes. In contrast, cell proliferation, cytokine production, and MAPK activation in bone marrow cells were significantly higher 2 h after T-H compared with shams. Lidocaine depressed immune responses in splenocytes; however, it had no effect in bone marrow cells in either sham or T-H mice. The enhanced immunosuppressive effects of lidocaine could contribute to the host's enhanced susceptibility to infection following T-H.
创伤和/或手术损伤以及出血会引起细胞免疫的深度抑制。尽管局部麻醉药已被证明会损害免疫反应,但利多卡因是否会影响创伤性出血(T-H)后的淋巴细胞功能仍不清楚。我们假设利多卡因会增强T-H后淋巴细胞功能的抑制作用。为了验证这一点,我们将雄性C3H/HeN(6-8周龄)小鼠随机分为假手术组或T-H组。通过中线剖腹术和大约90分钟的失血性休克(血压35 mmHg)诱导T-H,随后进行液体复苏(以乳酸林格液形式补充4倍失血量)。两小时后,处死小鼠并分离脾细胞和骨髓细胞。评估利多卡因对假手术组和T-H组小鼠中伴刀豆球蛋白A刺激的脾细胞增殖和细胞因子产生的影响。还评估了利多卡因对脂多糖刺激的骨髓细胞增殖和细胞因子产生的影响。结果表明,T-H抑制脾细胞中的细胞增殖、Th1细胞因子产生和MAPK激活。相比之下,与假手术组相比,T-H后2小时骨髓细胞中的细胞增殖、细胞因子产生和MAPK激活显著更高。利多卡因抑制脾细胞中的免疫反应;然而,它对假手术组或T-H组小鼠的骨髓细胞均无影响。利多卡因增强的免疫抑制作用可能导致宿主在T-H后对感染的易感性增加。