Skip to main content

The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial.

Publication ,  Journal Article
Berger, M; Ponnusamy, V; Greene, N; Cooter, M; Nadler, JW; Friedman, A; McDonagh, DL; Laskowitz, DT; Newman, MF; Shaw, LM; Warner, DS ...
Published in: Front Immunol
2017

INTRODUCTION: Aside from direct effects on neurotransmission, inhaled and intravenous anesthetics have immunomodulatory properties. In vitro and mouse model studies suggest that propofol inhibits, while isoflurane increases, neuroinflammation. If these findings translate to humans, they could be clinically important since neuroinflammation has detrimental effects on neurocognitive function in numerous disease states. MATERIALS AND METHODS: To examine whether propofol and isoflurane differentially modulate neuroinflammation in humans, cytokines were measured in a secondary analysis of cerebrospinal fluid (CSF) samples from patients prospectively randomized to receive anesthetic maintenance with propofol vs. isoflurane (registered with http://www.clinicaltrials.gov, identifier NCT01640275). We measured CSF levels of EGF, eotaxin, G-CSF, GM-CSF, IFN-α2, IL-1RA, IL-6, IL-7, IL-8, IL-10, IP-10, MCP-1, MIP-1α, MIP-1β, and TNF-α before and 24 h after intracranial surgery in these study patients. RESULTS: After Bonferroni correction for multiple comparisons, we found significant increases from before to 24 h after surgery in G-CSF, IL-10, IL-1RA, IL-6, IL-8, IP-10, MCP-1, MIP-1α, MIP-1β, and TNF-α. However, we found no difference in cytokine levels at baseline or 24 h after surgery between propofol- (n = 19) and isoflurane-treated (n = 21) patients (p > 0.05 for all comparisons). Increases in CSF IL-6, IL-8, IP-10, and MCP-1 levels directly correlated with each other and with postoperative CSF elevations in tau, a neural injury biomarker. We observed CSF cytokine increases up to 10-fold higher after intracranial surgery than previously reported after other types of surgery. DISCUSSION: These data clarify the magnitude of neuroinflammation after intracranial surgery, and raise the possibility that a coordinated neuroinflammatory response may play a role in neural injury after surgery.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Front Immunol

DOI

ISSN

1664-3224

Publication Date

2017

Volume

8

Start / End Page

1528

Location

Switzerland

Related Subject Headings

  • 3204 Immunology
  • 3105 Genetics
  • 3101 Biochemistry and cell biology
  • 1108 Medical Microbiology
  • 1107 Immunology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Berger, M., Ponnusamy, V., Greene, N., Cooter, M., Nadler, J. W., Friedman, A., … MAD-PIA Investigators, . (2017). The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial. Front Immunol, 8, 1528. https://doi.org/10.3389/fimmu.2017.01528
Berger, Miles, Vikram Ponnusamy, Nathaniel Greene, Mary Cooter, Jacob W. Nadler, Allan Friedman, David L. McDonagh, et al. “The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial.Front Immunol 8 (2017): 1528. https://doi.org/10.3389/fimmu.2017.01528.
Berger M, Ponnusamy V, Greene N, Cooter M, Nadler JW, Friedman A, et al. The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial. Front Immunol. 2017;8:1528.
Berger, Miles, et al. “The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial.Front Immunol, vol. 8, 2017, p. 1528. Pubmed, doi:10.3389/fimmu.2017.01528.
Berger M, Ponnusamy V, Greene N, Cooter M, Nadler JW, Friedman A, McDonagh DL, Laskowitz DT, Newman MF, Shaw LM, Warner DS, Mathew JP, James ML, MAD-PIA Investigators. The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial. Front Immunol. 2017;8:1528.

Published In

Front Immunol

DOI

ISSN

1664-3224

Publication Date

2017

Volume

8

Start / End Page

1528

Location

Switzerland

Related Subject Headings

  • 3204 Immunology
  • 3105 Genetics
  • 3101 Biochemistry and cell biology
  • 1108 Medical Microbiology
  • 1107 Immunology