Effect of Different Anesthetic Techniques on Cytokine Gene Expression in Patients who Underwent Elective Cesarean Section
-
Abdollah Jafarzadeh
,
Maryam Hadavi
,
Gholamhossein Hasanshahi
,
Mohsen Rezaeian
,
Reza Vazirinejad
,
Ali Sarkoohi
,
Fariba Aminzadeh
Abstract
Cesarean section (CS) is an important challenge for a pregnant woman and her newborn. The most common anesthesia techniques used for CS are general anesthesia (GA) and spinal anesthesia (SA). This study was designed to compare the modulation of genes whose expression level is indicative of the immune system following exposure to GA and SA. The present study was performed on 40 women who were scheduled for elective CS receiving GA or SA. The expression levels of the relative mRNA of Interleukin (IL)-4, IL-6, IL-10, IL-17, Interferon (IFN)-γ, and tumor growth factor (TGF)-β before anesthesia (T0) and 24 hours post-anesthesia (T1) were analyzed by real-time polymerase chain reaction (RT-PCR) technique. Twenty-four hours post-anesthesia, the expression levels of IL-10, IL-17, and IFN-γ genes were decreased while the expressions of IL-4, IL-6, and TGF-β genes were upregulated in two groups, however, the differences were not significant. The mRNA level of IL-4 was increased in the SA group significantly. The post-CS mRNA levels of IL-4 in the SA group may indicate that SA is more appropriate than GA for the initiation of tissue repair pathways.
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23. Alsina E, Matute E, Ruiz-Huerta AD, Gilsanz F. The effects of sevoflurane or remifentanil on the stress response to surgical stimulus. Curr Pharm Des. 2014;20:5449–68.
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26. Zura M, Kozmar A, Sakic K, Malenica B, Hrgovic Z. Effect of spinal and general anesthesia on serum concentration of pro-inflammatory and anti-inflammatory cytokines. Immunobiology. 2012;217(6):622–7.
27. Kochiyama T, Li X, Nakayama H, Kage M, Yamane Y, Takamori K. Effect of Propofol on the Production of Inflammatory Cytokines by Human Polarized Macrophages. Mediators Inflamm. 2019;1919538:2019.
28. Kawasaki T, Ogata M, Kawasaki C, Okamoto K, Sata T. Effects of epidural anaesthesia on surgical stress-induced immunosuppression during upper abdominal surgery. Br J Anaesth. 2007;98:196–203.
29. Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J,et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018;9(6):7204-18.
30. Akdis CA. Therapies for allergic inflammation: refining strategies to induce tolerance. Nat med. 2012;18(5):736-49.
31. Stollings LM, Jia LL, Tang P, Dou H, Lu B, Xu Y. Immune Modulation by Volatile Anesthetics. Anesthesiology. 2016;125(2):399–411.
32. Geginat J, Larghi P, Paroni M, Nizzoli G, Penatti AE, Pagani m, et al. The light and the dark sides of Interleukin-10 in immune-mediated diseases and cancer. Cytokine Growth Factor Rev. 2016; 30: 87–93.
33. Matsuzaki J, Tsuji T, Luescher IF, Shiku H, Mineno J, Okamoto S, et al. Direct tumor recognition by a human CD4(+) T-cell subset potently mediates tumor growth inhibition and orchestrates anti-tumor immune responses. Sci Rep. 2015;8(5):14896.
34. Cho EJ, Yoon JH, Hong SJ, Lee SH, Sim SB. The effects of sevoflurane on systemic and pulmonary inflammatory responses after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2009;23:639–45.
35. Kong HY, Zhu SM, Wang LQ, He Y, Xie HY, Zheng SS. Sevoflurane protects against acute kidney injury in a small-size liver transplantation model. Am J Nephrol. 2010;32:347–55.
36. Tylman M, Sarbinowski R, Bengtson JP, Kvarnstrom A, Bengtsson A. Inflammatory response in patients undergoing colorectal cancer surgery: the effect of two different anesthetic techniques. Minerva Anestesiol. 2011;77:275–82.
37. Van Dyken SJ, Locksley RM. Interleukin-4- and interleukin-13- mediated alternatively activated macrophages: roles in homeostasis and disease. Annual review of immunology. 2013; 31: 317-43.
38. Bosurgi L, Cao YG, Cabeza-Cabrerizo M, A Tucci, Hughes LD, Kong Y. Macrophage function in tissue repair and remodeling requires IL-4 or IL-13 with apoptotic cells. Science. 2017; 356(6342): 1072–6.
2. Chestnut DH, Wong CA, Tsen LC, Kee WDN, Beilin Y, Mhyre J. Chestnut's obstetric anesthesia: principles and practice: Elsevier Health Sciences; 2014.
3. Abdollahpour A, Azadi R, Bandari R, Mirmohammadkhani M. Effects of adding midazolam and sufentanil to intrathecal bupivacaine on analgesia quality and postoperative complications in elective cesarean section. Anesth pain med. 2015;5(4):e23565.
4. RD. M. Miller's anesthesia. Philadelphia: Elsevier; 2015.
5. Sun X, Wang D, Yu H, Hu L. Serial cytokine levels during wound healing in rabbit maxillary sinus mucosa. Acta otolaryngol. 2010;130(5):607-13.
6. Ito M, Nakashima A, Hidaka T, Okabe M, Bac ND, Ina S, et al. A role for IL-17 in induction of an inflammation at the fetomaternal interface in preterm labour. J Reprod Immunol. 2010;84(1):75-85.
7. Robertson SA, Bromfield JJ, Tremellen KP. Seminal ‘priming’for protection from pre-eclampsia—a unifying hypothesis. J Reprod Immunol. 2003;59(2):253-65.
8. Jinushi M. Yin and yang of tumor inflammation: how innate immune suppressors shape the tumor microenvironments. Int J Cancer. 2014;135(6):1277–85.
9. Kobayashi K., Takemori K. Sakamoto A. Circadian gene expression is suppressed during sevoflurane anesthesia and the suppression persists after awakening. Brain res. 2007;1185:1–7.
10. Sakamoto A, Imai J, Nishikawa A, Honma R, Ito E, Yanagisawa Y, et al. Influence of inhalation anaesthesia assessed by comprehensive gene expression profiling. Gene. 2005;356:39–48.
11. Lowes DA, Galley HF, Moura AP, Webster NR. Brief isoflurane anaesthesia affects differential gene expression, gene ontology and gene networks in rat brain. Behav Brain Res. 2017;317:453–60.
12. Pan JZ, Wei H, Hecker JG, Tobias JW, Eckenhoff RG, Eckenhoff MF. Rat brain DNA transcript profile of halothane and isoflurane exposure. Pharmacogenet Genomics. 2006; 16:171–82.
13. 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.
14. Gottschalk A, Ford J. G., Regelin C. C., You J, Mascha EJ, Sessler DI, et al. Association between epidural analgesia and cancer recurrence after colorectal cancer surgery. Anesthesiology. 2010;113(1):27–34.
15. Conrick-Martin I., Kell M. R., Buggy D. J. Meta-analysis of the effect of central neuraxial regional anesthesia compared with general anesthesia on postoperative natural killer T lymphocyte function. J Clin Anesth. 2012;24(1):3–7.
16. Dermitzaki E, Staikou C, Petropoulos G, Rizos D, Siafaka I, Fassoulaki A. A randomized study of maternal serum cytokine levels following cesarean section under general or neuraxial anesthesia. Int j obstet anesth. 2009;18(1):33-7.
17. Cyna AM, Andrew M, Emmett RS, Middleton P, Simmons SW. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev. 2006;18(4):CD002251.
18. Eroğlu M, Kokulu S, Koca HB, Demirboğan ME, Baki ED, Özcan O. The effects of general and spinal anesthesia on systemic inflammatory response in patients undergoing total knee arthroplasty. Eklem Hastalik Cerrahisi. 2016;27(3):153-9.
19. Watt Sk, Hasselbalch HC, Skov V, Kjaer L, Thomassen M, Kruse TA, et al. Whole blood gene expression profiling in patients undergoing colon cancer surgery identifies differential expression of gene involved in immune surveillance, inflammation and carcinogenesis. Surg oncol. 2018:27(2):208-15.
20. Livak KJ, Schmittgen TD. Analysis of Relative Gene Expression Data Using RealTime Quantitative PCR and the 22DDCT Method. Methods. 2001;25:402–8.
21. Pirbudak Cocelli L, Ugur MG, Karadasli H. Comparison of effects of low-flow sevoflurane and desflurane anesthesia on neutrophil and T-cell populations. Curr Ther Res Clin Exp. 2012;73:41–51.
22. Gong L, Qin Q, Zhou L, Ouyang W, Li Y, Wu Y, Li Y. Effects of fentanyl anesthesia and sufentanil anesthesia on regulatory T cells frequencies. Int J Clin Exp Pathol. 2014;7:7708–16.
23. Alsina E, Matute E, Ruiz-Huerta AD, Gilsanz F. The effects of sevoflurane or remifentanil on the stress response to surgical stimulus. Curr Pharm Des. 2014;20:5449–68.
24. Takala RSK, Soukka H, Salo MS, Kirvela O, Kaapa P, Aantaa R. Gene expression of pulmonary cytokines after sevoflurane or thiopentone anaesthesia in pigs. Acta Anaesthesiol Scand. 2006;50:163–7.
25. Altun MA, Ozaydin A, Arkan H, Demiryas S, Akbas F, Bahtiyar N, et al. Anesthesia may alter Mrna expression of certain wound healing-associated genes in dermal wound environment of the rats. Mol Biol Rep. 2019;46(3):2819-27.
26. Zura M, Kozmar A, Sakic K, Malenica B, Hrgovic Z. Effect of spinal and general anesthesia on serum concentration of pro-inflammatory and anti-inflammatory cytokines. Immunobiology. 2012;217(6):622–7.
27. Kochiyama T, Li X, Nakayama H, Kage M, Yamane Y, Takamori K. Effect of Propofol on the Production of Inflammatory Cytokines by Human Polarized Macrophages. Mediators Inflamm. 2019;1919538:2019.
28. Kawasaki T, Ogata M, Kawasaki C, Okamoto K, Sata T. Effects of epidural anaesthesia on surgical stress-induced immunosuppression during upper abdominal surgery. Br J Anaesth. 2007;98:196–203.
29. Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J,et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018;9(6):7204-18.
30. Akdis CA. Therapies for allergic inflammation: refining strategies to induce tolerance. Nat med. 2012;18(5):736-49.
31. Stollings LM, Jia LL, Tang P, Dou H, Lu B, Xu Y. Immune Modulation by Volatile Anesthetics. Anesthesiology. 2016;125(2):399–411.
32. Geginat J, Larghi P, Paroni M, Nizzoli G, Penatti AE, Pagani m, et al. The light and the dark sides of Interleukin-10 in immune-mediated diseases and cancer. Cytokine Growth Factor Rev. 2016; 30: 87–93.
33. Matsuzaki J, Tsuji T, Luescher IF, Shiku H, Mineno J, Okamoto S, et al. Direct tumor recognition by a human CD4(+) T-cell subset potently mediates tumor growth inhibition and orchestrates anti-tumor immune responses. Sci Rep. 2015;8(5):14896.
34. Cho EJ, Yoon JH, Hong SJ, Lee SH, Sim SB. The effects of sevoflurane on systemic and pulmonary inflammatory responses after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2009;23:639–45.
35. Kong HY, Zhu SM, Wang LQ, He Y, Xie HY, Zheng SS. Sevoflurane protects against acute kidney injury in a small-size liver transplantation model. Am J Nephrol. 2010;32:347–55.
36. Tylman M, Sarbinowski R, Bengtson JP, Kvarnstrom A, Bengtsson A. Inflammatory response in patients undergoing colorectal cancer surgery: the effect of two different anesthetic techniques. Minerva Anestesiol. 2011;77:275–82.
37. Van Dyken SJ, Locksley RM. Interleukin-4- and interleukin-13- mediated alternatively activated macrophages: roles in homeostasis and disease. Annual review of immunology. 2013; 31: 317-43.
38. Bosurgi L, Cao YG, Cabeza-Cabrerizo M, A Tucci, Hughes LD, Kong Y. Macrophage function in tissue repair and remodeling requires IL-4 or IL-13 with apoptotic cells. Science. 2017; 356(6342): 1072–6.
| Files | ||
| Issue | Vol 19 No 6 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v19i6.4933 | |
| PMID | 33463133 | |
| Keywords | ||
| Cytokine Gene expression General anesthesia Spinal anesthesia | ||
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How to Cite
1.
Jafarzadeh A, Hadavi M, Hasanshahi G, Rezaeian M, Vazirinejad R, Sarkoohi A, Aminzadeh F. Effect of Different Anesthetic Techniques on Cytokine Gene Expression in Patients who Underwent Elective Cesarean Section. Iran J Allergy Asthma Immunol. 2020;19(6):640-646.
