Analysis and Quantification on Immunosuppressive Effects of Inhalation Anesthetics

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The authors hypothesized that perioperative lymphocytopenia is partially caused by apoptosis of lymphocytes induced by inhalation anesthetics. Therefore, they evaluated whether sevoflurane and isoflurane induce apoptosis of normal peripheral lymphocytes.Methods: Normal peripheral blood mononuclear cells were exposed to sevoflurane and isoflurane, and the percentages of apoptotic lymphocytes was measured by Annexin V-fluorescein isothiocyanate-7-amino actinomycin D flow cytometry after 24h of exposure(0.5,1.0,and 1.5mm) and after 6, 12, and 24h of exposure(1.5mm). The percentages of lymphocytes with caspase 3-like activity were also measured after 24h of exposure(1.5mm).Results : The percentages of apoptotic lymhocytes were increased in a dose-dependent manner(controls: 5.1±1.4%; sevo-flurane: 7.3±1.3% [0.5mm], 9.1±1.5% [1.0mm], 12.6±2.1% [1.5mm]; isoflurane: 7.5±1.6% [0.5mm], 10.5±1.5% [1.0mm], 16.3±2.7% [1.5mm]) after 24h of exposure and in a time-dependent manner ( controls: 1.2±0.4% [6h], 3.4±0.7% [12h], 5.6±1.2% [24h]; sevoflurane: 1.8±0.4% [6 h], 6.4±1.2% [12h], 11.3±2.2% [24±h]; isoflurane: 2.6±0.5% [6h],8.8±1.5% [12h],16.0±1.9% [24h]) at the concentration of 1.5mm. The percentages of lymphocytes with caspase 3-like activity were increased (controls: 10.0±1.1%; sevoflurane: 13.8±1.2%; isoflurane: 17.0±1.3%).Conclusions : Both sevoflurane and isoflurane induced apoptosis in peripheral lymphocytes indose-dependent and time-dependent manners in vitro.