Effect of Anesthesia on Serum Cytokine Levels

Authors

  • Khanittha Vorasanon Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 Thailand
  • Araya Ongiem Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 Thailand
  • Kamonwan Rumthong Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 Thailand
  • Patcharaon Sangjak Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 Thailand
  • Warunee Buayam Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 Thailand
  • Phongthara Vichitvejpaisal Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 Thailand

Keywords:

Anesthesia, Cytokine, Cytokine Storm, Immune system

Abstract

Abstract
By and large, foreign bodies such as bacteria, viruses, microorganisms, parasites, chemical toxins, irritants, allergens or cancerous cells, can stimulate the immune system by secreting both pro-inflammatory and anti-inflammatory cytokines, which serve as messengers on themselves (autocrine), nearby cells (paracrine) or far-away cells (endocrine). Cytokines activate the inflammatory process via leukocytosis and macrophage aggregation, which engulf bizarre cells (phagocytosis). Then the process insidiously subsides to restore lost vitality to full health. However, if the stimulant is severe and out of control or carries antigens such as Corona viruses, it can lead to chronic inflammatory progression. Eventually, hypercytokinemia and a cytokine storm attack, resulting in multiorgan failures and quick death. What is interesting is that malnutrition, stress, anxiety, surgery, strenuous exercise or controlled ventilation can stimulate cytokines secretion whereas regional anesthesia and administration of certain anesthetics can reduce the inflammatory process and serum cytokine levels.

References

Kany S, Vollrath JT, Relja B. Cytokines in Inflammatory Disease. Int J Mol Sci. 2019;20(23):6008. doi:10.3390/ijms20236008

Haidari F, Mohammadshahi M, Abiri B, Zarei M, Fathi M. Cinnamon extract supplementation improves inflammation and oxidative stress induced by acrylamide: An experimental animal study. Avicenna J Phytomed. 2020;10(3):243-252.

Hato T, Dagher PC. How the Innate Immune System Senses Trouble and Causes Trouble. Clin J Am Soc Nephrol. 2015;10(8):1459-69. doi:10.2215/CJN.04680514

Jarczak D, Nierhaus A. Cytokine Storm-Definition, Causes, and Implications. Int J Mol Sci. 2022;23(19):11740. doi:10.3390/ijms231911740

Hughes CE, Nibbs RJB. A guide to chemokines and their receptors. FEBS J. 2018;285(16):2944-2971. doi:10.1111/febs.14466

Negishi H, Taniguchi T, Yanai H. The Interferon (IFN) Class of Cytokines and the IFN Regulatory Factor (IRF) Transcription Factor Family. Cold Spring Harb Perspect Biol. 2018;10(11):a028423. doi:10.1101/cshperspect.a028423

Tousoulis D, Oikonomou E, Economou EK, Crea F, Kaski JC. Inflammatory cytokines in atherosclerosis: current therapeutic approaches. Eur Heart J. 2016;37(22):1723-32. doi:10.1093/eurheartj/ehv759

Abdulkhaleq LA, Assi MA, Abdullah R, Zamri-Saad M, Taufiq-Yap YH, Hezmee MNM. The crucial roles of inflammatory mediators in inflammation: A review. Vet World. 2018;11(5):627-635. doi:10.14202/vetworld.2018.627-635

นธนีย์ ธิติชัย, ภันทิลา ทวีวิกยการ. การระบาดช่วงเดือนเมษายน - ตุลาคม 2564. รายงานผลการทบทวนสถานการณ์โรคโควิด-19 และมาตรการควบคุมป้องกันในระดับโลก และในประเทศไทย. กลุ่มเทคโนโลยี และระบาดวิทยา กองโรคไม่ติดต่อ กรมควบคุมโรค. 2564. เมื่อ 12 ตุลาคม 2565. http://www.thaincd.com/document/file/download/knowledge/COVID19.65.pdf

Lythgoe MP, Middleton P. Ongoing Clinical Trials for the Management of the COVID-19 Pandemic. Trends Pharmacol Sci. 2020;41(6):363-382. doi:10.1016/j.tips.2020.03.006

ณยฎา ธนกิจธรรมกุล. การพยาบาลผู้ป่วยโรคติดเชื้อโคโรนาไวรัส 19 ในระยะที่มีภาวะหายใจลำบากเฉียบพลัน. วารสารสภาการพยาบาล. 2564;36(3):16-30.

รณกฤต ลิ้มวราภัส, อนันต์ เชื้อสุวรรณ, พงศธร คชเสนี. ผลของการใช้ hemoadsorption ต่อการขจัดของ cytokine และอัตราการรอดชีวิต ในผู้ป่วย ที่มีภาวะไตวายเฉียบพลัน จากภาวะติดเชื้อในกระแสเลือด. วารสารสมาคมโรคไตแห่งประเทศไทย. 2560;23(4):40-58.

Mauricio Del Rio J, Nicoara A, Swaminathan M. Neuroendocrine stress response: implications for cardiac surgery-associated acute kidney injury. Rom J Anaesth Intensive Care. 2017;24(1):57-63. doi:10.21454/rjaic.7518.241.hav

Vosoughian M, Dahi M, Dabir S, Moshari M, Tabashi S, Mosavi Z. Effects of General Anesthesia Versus Spinal Anesthesia on Serum Cytokine Release After Cesarean Section: A Randomized Clinical Trial. Anesth Pain Med. 2021;11(2):e111272. doi:10.5812/aapm.111272

Jafarzadeh A, Hadavi M, Hassanshahi G, Rezaeian M, Vazirinejad R. General Anesthetics on Immune System Cytokines: A Narrative Review Article. Anesth Pain Med. 2020;10(4):e103033. doi:10.5812/aapm.103033

Ibrahim TH, Abdelrahman HS, Alharbi MA, Zabani IA, Ismail MF, Kary H. Effect of ketamine on pro- and anti-inflammatory cytokine response in paediatric cardiac surgery: A prospective randomised controlled study. Indian J Anaesth. 2017;61(7):549-555. doi:10.4103/ija.IJA_607_16

Cruz FF, Rocco PR, Pelosi P. Anti-inflammatory properties of anesthetic agents. Crit Care. 2017;21(1):67. doi:10.1186/s13054-017-1645-x

Dang Y, Shi X, Xu W, Zuo M. The Effect of Anesthesia on the Immune System in Colorectal Cancer Patients. Can J Gastroenterol Hepatol. 2018;2018:7940603. doi:10. 1155/2018/7940603

Arruda NM, Braz LG, Nogueira FR, Souza KM, Aun AG, Figueiredo DBS, et al. Inflammation and DNA damage induction in surgical patients maintained with desflurane anesthesia. Mutat Res Genet Toxicol Environ Mutagen. 2019;846:403073. doi:10.1016/j.mrgentox.2019.07.003

Chalkias A, Barreto EF, Laou E, Kolonia K, Scheetz MH, Gourgoulianis K, et al. A Critical Appraisal of the Effects of Anesthetics on Immune-system Modulation in Critically Ill Patients With COVID-19. Clin Ther. 2021;43(3):e57-e70. doi:10.1016/j.clinthera.2021.01.00 4

Chen JS, Alfajaro MM, Chow RD, Wei J, Filler RB, Eisenbarth SC, et al. Non-steroidal anti-inflammatory drugs dampen the cytokine and antibody response to SARS-CoV-2 infection. J Virol. 2021;95(7):e00014-21. doi:10.1128/JVI.00014-21

Whitaker EE, Christofi FL, Quinn KM, Wiemann BZ, Xia JC, Tobias JD, et al. Selective induction of IL-1β after a brief isoflurane anesthetic in children undergoing MRI examination. J Anesth. 2017;31(2):219-224. doi:10.1007/s00540-016-2294-y

Stollings LM, Jia LJ, Tang P, Dou H, Lu B, Xu Y. Immune Modulation by Volatile Anesthetics. Anesthesiology. 2016;125(2):399-411. doi:10.1097/ALN.0000000000001195

Wakabayashi S, Yamaguchi K, Kumakura S, Murakami T, Someya A, Kajiyama Y, et al. Effects of anesthesia with sevoflurane and propofol on the cytokine/chemokine production at the airway epithelium during esophagectomy. Int J Mol Med. 2014;34(1): 137-44. doi:10.3892/ijmm.2014.1762

Hwang JW, Jeon YT, Lim YJ, Park HP. Sevoflurane Postconditioning-Induced Anti-Inflammation via Inhibition of the Toll-Like Receptor-4/Nuclear Factor Kappa B Pathway Contributes to Neuroprotection against Transient Global Cerebral Ischemia in Rats. Int J Mol Sci. 2017;18(11):2347. doi:10.3390/ijms18112347

ศศิมา ดุสิตเกษม, ลลินทิพย์ วารีสุนทร. เทคนิคการดมยาสลบกับผลต่อการเกิดมะเร็งซ้ำ.วารสารวิสัญญีสาร. 2018;44(4):192-196.

Weinschenk S, Weiss C, Benrath J, von Baehr V, Strowitzki T, Feißt M. Anti-Inflammatory Characteristics of Local Anesthetics: Inhibition of TNF-α Secretion of Lipopolysaccharide-Stimulated Leucocytes in Human Blood Samples. Int J Mol Sci. 2022;23(6):3283. doi:10.3390/ijms23063283

Additional Files

Published

2024-01-01

How to Cite

1.
Vorasanon K, Ongiem A, Rumthong K, Sangjak P, Buayam W, Vichitvejpaisal P. Effect of Anesthesia on Serum Cytokine Levels. J Chulabhorn Royal Acad [Internet]. 2024 Jan. 1 [cited 2024 Apr. 29];6(1):26-31. Available from: https://he02.tci-thaijo.org/index.php/jcra/article/view/260170

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Section

Academic Articles