Beilin B, Martin F C, Shavit Y, Gale R P, Liebeskind J C
Department of Anesthesiology, University of California, Los Angeles 90024.
Brain Behav Immun. 1989 Jun;3(2):129-37. doi: 10.1016/0889-1591(89)90013-5.
Suppression of natural killer (NK) cell activity in the postoperative period has been reported in several clinical studies. Endogenous opioids and cerebral injection of morphine have been shown to suppress NK cell activity. Since high-dose opiates are commonly used in anesthetic practice, we sought to determine the effects of three narcotic agents on NK cell activity. Male rats were injected subcutaneously with morphine (30 mg/kg), fentanyl (0.3 mg/kg), or sufentanil (0.06 mg/kg). Three, 12, or 24 h later the cytotoxic activity of splenic NK cells was measured in a 4-h chromium-51 release assay using radiolabeled target cells. All three drugs significantly suppressed NK cytotoxicity at 3 h after administration; this effect was blocked by an opiate antagonist, naltrexone. Fentanyl and sufentanil also caused a significant suppression 12 h after drug administration. By 24 h NK activity of all groups returned to normal values. Interferon is known to augment NK cell activity. Therefore, in another experiment rats were given an interferon inducer, polyinosinic:polycytidylic acid (poly I:C), to determine if it would alter the effects of these narcotics on splenic NK activity. Poly I:C treatment increased NK cytotoxicity to above baseline; fentanyl in these animals reduced NK activity and brought it back to control levels. These findings suggest that clinically used high-dose narcotic anesthesia can suppress NK cytotoxic activity and that pretreatment with interferon can attenuate this suppression.
多项临床研究报告了术后自然杀伤(NK)细胞活性受到抑制。内源性阿片类物质和脑室内注射吗啡已被证明会抑制NK细胞活性。由于大剂量阿片类药物常用于麻醉实践中,我们试图确定三种麻醉剂对NK细胞活性的影响。给雄性大鼠皮下注射吗啡(30毫克/千克)、芬太尼(0.3毫克/千克)或舒芬太尼(0.06毫克/千克)。给药后3小时、12小时或24小时,使用放射性标记的靶细胞,通过4小时的铬-51释放试验测量脾NK细胞的细胞毒性活性。所有三种药物在给药后3小时均显著抑制NK细胞毒性;这种作用可被阿片类拮抗剂纳曲酮阻断。芬太尼和舒芬太尼在给药后12小时也引起显著抑制。到24小时时,所有组的NK活性均恢复到正常值。已知干扰素可增强NK细胞活性。因此,在另一项实验中,给大鼠注射干扰素诱导剂聚肌苷酸:聚胞苷酸(聚肌胞),以确定其是否会改变这些麻醉剂对脾NK活性的影响。聚肌胞治疗使NK细胞毒性增加至基线以上;这些动物中的芬太尼降低了NK活性并使其恢复到对照水平。这些发现表明,临床使用的大剂量麻醉性麻醉可抑制NK细胞毒性活性,并且用干扰素预处理可减弱这种抑制作用。