Kim Cheul-Hong, Jeong Seong Soon, Park Soon Ji, Choi Eun-Ji, Kim Yeon Ha, Ahn Ji-Hye
Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea.
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea.
J Dent Anesth Pain Med. 2019 Oct;19(5):253-260. doi: 10.17245/jdapm.2019.19.5.253. Epub 2019 Oct 30.
Sometimes general anesthesia is required for dental surgery in pregnant women. Facial bone fractures or neck abscess should be treated immediately. Dental surgery, however, creates a stressful situation that can cause inflammation. Inflammatory responses are a well-known major cause of preterm labor and preterm birth. Here we demonstrate the effects of remifentanil on the factors related to preterm labor and its mechanism of action on amniotic-derived epithelial cells (WISH cells).
WISH cells were exposed to lipopolysaccharide (LPS) for 24 h and co-treated with various concentrations of remifentanil. MTT assays were performed to measure cell viability. To explain the effects of remifentanil on the factors related to inflammation in WISH cells, activation of nuclear factor kappa B (NF-κB) and p38 and the expression of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, cyclooxygenase (COX)2, and prostaglandin E (PGE) were quantified using western blotting and RT-PCR, respectively.
Remifentanil did not affect WISH cell viability. In western blot analysis, co-treatment with remifentanil resulted in decreased phosphorylation of NF-κB, and expression of COX2 and PGE in LPS-induced inflammation, but the results were statistically significant only at low concentrations. Reduction of IL-1β and TNF-α expression was also observed with RT-PCR.
Co-treatment with remifentanil does not affect the viability of WISH cells, but reduces the expression of the factors related to inflammation, which can induce uterine contraction and preterm labor. These findings provide evidence that remifentanil may inhibit uterine contraction and preterm labor in clinical settings.
有时孕妇进行牙科手术需要全身麻醉。面部骨折或颈部脓肿应立即治疗。然而，牙科手术会造成应激状态，进而引发炎症。炎症反应是早产和分娩的一个众所周知的主要原因。在此，我们展示瑞芬太尼对与早产相关因素的影响及其对羊膜来源上皮细胞（WISH细胞）的作用机制。
将WISH细胞暴露于脂多糖（LPS）24小时，并与不同浓度的瑞芬太尼共同处理。进行MTT试验以测量细胞活力。为解释瑞芬太尼对WISH细胞中炎症相关因素的影响，分别使用蛋白质印迹法和逆转录-聚合酶链反应（RT-PCR）对核因子κB（NF-κB）和p38的激活以及白细胞介素（IL）-1β、肿瘤坏死因子（TNF）-α、环氧化酶（COX）2和前列腺素E（PGE）的表达进行定量。
瑞芬太尼不影响WISH细胞活力。在蛋白质印迹分析中，瑞芬太尼共同处理导致LPS诱导的炎症中NF-κB磷酸化、COX2和PGE表达降低，但结果仅在低浓度时具有统计学意义。RT-PCR也观察到IL-1β和TNF-α表达降低。
瑞芬太尼共同处理不影响WISH细胞活力，但可降低与炎症相关的因素的表达，这些因素可诱导子宫收缩和早产。这些发现提供了证据表明瑞芬太尼在临床环境中可能抑制子宫收缩和早产。
