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使用地氟烷麻醉的手术患者的炎症和DNA损伤诱导

Inflammation and DNA damage induction in surgical patients maintained with desflurane anesthesia.

作者信息

Arruda Nayara M, Braz Leandro G, Nogueira Flávia R, Souza Kátina M, Aun Aline G, Figueiredo Drielle B S, Lara Juliana R, Silva Mariane Aparecida P, Golim Marjorie A, de Carvalho Lídia R, Braz José Reinaldo C, Braz Mariana G

机构信息

Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Departamento de Anestesiologia, Laboratório GENOTOX, Brazil.

Universidade Estadual Paulista - UNESP, Hospital das Clínicas da Faculdade de Medicina de Botucatu, Hemocentro - Laboratório de Citometria de Fluxo, Brazil.

出版信息

Mutat Res Genet Toxicol Environ Mutagen. 2019 Oct;846:403073. doi: 10.1016/j.mrgentox.2019.07.003. Epub 2019 Jul 10.

DOI:10.1016/j.mrgentox.2019.07.003
PMID:31585635
Abstract

The use of anesthetics during surgical interventions may contribute to disorders in the perioperative period. Desflurane is the newest volatile halogenated anesthetic to be introduced in clinical practice. Considering that inflammation and genotoxicity are linked events, and that little is known regarding possible genetic and inflammatory effects of desflurane in surgical patients, this study evaluated DNA damage, systemic inflammatory cytokines and related gene expression in adult patients without comorbidities who underwent minor otorhinological surgeries under general anesthesia maintained with the inhalational anesthetic desflurane. This study involved a self-controlled design in which venous blood samples were collected from subjects before anesthesia administration and after the surgical procedure. The comet assay was applied to assess DNA lesions, while the cytokines IL-1β, IL-6, IL-8, IL-10, IL-17A and TNF-α were evaluated by flow cytometry. A genotoxic effect was observed (p = 0.027), and pro-inflammatory IL-6 and IL-8 levels were significantly increased after surgery (p = 0.001 and p = 0.02, respectively), whereas the levels of the other cytokines did not significantly change. Considering that serum IL-6 and IL-8 were increased, we further evaluated IL-6 and IL-8 gene expression by quantitative real-time polymerase chain reaction (qPCR). However, IL-6 and IL-8 gene expression was unaltered (p >  0.05). In conclusion, anesthetic maintenance with the modern agent desflurane during minor surgeries led to genotoxic and inflammatory effects without altering the expression of inflammation related-genes the day after surgery in patients without comorbidities.

摘要

手术干预期间使用麻醉剂可能会导致围手术期出现紊乱。地氟烷是临床实践中引入的最新挥发性卤化麻醉剂。鉴于炎症和基因毒性是相关事件,且关于地氟烷对手术患者可能的遗传和炎症影响知之甚少,本研究评估了在吸入麻醉剂地氟烷维持全身麻醉下接受小型耳鼻喉科手术的无合并症成年患者的DNA损伤、全身炎症细胞因子及相关基因表达。本研究采用自身对照设计,在麻醉给药前和手术后从受试者采集静脉血样。应用彗星试验评估DNA损伤,同时通过流式细胞术评估细胞因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、白细胞介素-17A(IL-17A)和肿瘤坏死因子-α(TNF-α)。观察到有基因毒性作用(p = 0.027),术后促炎细胞因子IL-6和IL-8水平显著升高(分别为p = 0.001和p = 0.02),而其他细胞因子水平无显著变化。鉴于血清IL-6和IL-8升高,我们通过定量实时聚合酶链反应(qPCR)进一步评估IL-6和IL-8基因表达。然而,IL-6和IL-8基因表达未改变(p > 0.05)。总之,在小型手术期间使用现代麻醉剂地氟烷维持麻醉会导致基因毒性和炎症作用,但在无合并症患者术后第二天并未改变炎症相关基因的表达。

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