Cavalca Viviana, Colli Susanna, Veglia Fabrizio, Eligini Sonia, Zingaro Lorenzo, Squellerio Isabella, Rondello Nicola, Cighetti Giuliana, Tremoli Elena, Sisillo Erminio
Institute of Cardiology, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Milan, Italy.
Anesthesiology. 2008 Jun;108(6):988-97. doi: 10.1097/ALN.0b013e318173efb4.
Propofol (2,6-diisopropylphenol) is an anesthetic drug with antioxidant and antiinflammatory properties, documented both in vitro and in experimental models of ischemia-reperfusion injury and septic shock. These properties have been related to the similarity of its chemical structure to that of endogenous tocopherols, which are phenol-containing radical scavengers. This study evaluated the effects of propofol on alpha- and gamma-tocopherol (alpha- and gamma-T) levels and on selected markers of oxidant-antioxidant and inflammatory status in patients undergoing cardiac surgery.
Patients were randomly assigned for anesthesia with either propofol (propofol group, n = 22) or sevoflurane (control group, n = 21). Plasma levels of alpha- and gamma-T, individual antioxidant capacity, malondialdehyde, and interleukin 10 were measured before, during, and after anesthesia. In addition, levels of the proinflammatory prostaglandin E2 as a marker of cyclooxygenase-2 activity and those of interleukin 10 were measured in whole blood cultured with bacterial lipopolysaccharide.
Gamma-T levels increased significantly during surgery in propofol group (P < 0.0001 vs. control group). By contrast, alpha-T similarly decreased in both groups. Malondialdehyde and interleukin 10 increased markedly and individual antioxidant capacity decreased, without differences between groups. Prostaglandin E2 levels measured 24 h after anesthesia induction were significantly lower in the propofol than in the control group. In vitro studies highlighted the different capacity of gamma- and alpha-T to impair prostaglandin E2 synthesis by human monocytes challenged with bacterial lipopolysaccharide.
The antiinflammatory properties of propofol that may be linked to its effect on gamma-T levels could be relevant in controlling the inflammatory response that accompanies tissue injury during reperfusion.
丙泊酚（2,6 - 二异丙基苯酚）是一种具有抗氧化和抗炎特性的麻醉药物，这在缺血 - 再灌注损伤和脓毒性休克的体外及实验模型中均有记载。这些特性与其化学结构与内源性生育酚相似有关，内源性生育酚是含酚的自由基清除剂。本研究评估了丙泊酚对心脏手术患者α - 生育酚和γ - 生育酚（α - T和γ - T）水平以及氧化 - 抗氧化和炎症状态的选定标志物的影响。
患者被随机分配接受丙泊酚麻醉（丙泊酚组，n = 22）或七氟醚麻醉（对照组，n = 21）。在麻醉前、麻醉期间和麻醉后测量血浆α - T和γ - T水平、个体抗氧化能力、丙二醛和白细胞介素10。此外，在与细菌脂多糖一起培养的全血中测量促炎前列腺素E2作为环氧化酶 - 2活性的标志物水平以及白细胞介素10水平。
丙泊酚组手术期间γ - T水平显著升高（与对照组相比，P < 0.0001）。相比之下，两组中α - T均同样下降。丙二醛和白细胞介素10显著升高，个体抗氧化能力下降，两组间无差异。麻醉诱导后24小时测量的前列腺素E2水平，丙泊酚组显著低于对照组。体外研究强调了γ - T和α - T对受细菌脂多糖刺激的人单核细胞损害前列腺素E2合成的不同能力。
丙泊酚的抗炎特性可能与其对γ - T水平的影响有关，这可能在控制再灌注期间伴随组织损伤的炎症反应中发挥作用。
