Anesthetic propofol enhances plasma gamma-tocopherol levels in patients undergoing cardiac surgery.
BACKGROUND
Propofol (2,6-diisopropylphenol) is an anesthetic drug with antioxidant and antiinflammatory properties, documented both in vitro and in experimental models of ischemia-reperfusion injury and septic shock. These properties have been related to the similarity of its chemical structure to that of endogenous tocopherols, which are phenol-containing radical scavengers. This study evaluated the effects of propofol on alpha- and gamma-tocopherol (alpha- and gamma-T) levels and on selected markers of oxidant-antioxidant and inflammatory status in patients undergoing cardiac surgery.


METHODS
Patients were randomly assigned for anesthesia with either propofol (propofol group, n = 22) or sevoflurane (control group, n = 21). Plasma levels of alpha- and gamma-T, individual antioxidant capacity, malondialdehyde, and interleukin 10 were measured before, during, and after anesthesia. In addition, levels of the proinflammatory prostaglandin E2 as a marker of cyclooxygenase-2 activity and those of interleukin 10 were measured in whole blood cultured with bacterial lipopolysaccharide.


RESULTS
Gamma-T levels increased significantly during surgery in propofol group (P < 0.0001 vs. control group). By contrast, alpha-T similarly decreased in both groups. Malondialdehyde and interleukin 10 increased markedly and individual antioxidant capacity decreased, without differences between groups. Prostaglandin E2 levels measured 24 h after anesthesia induction were significantly lower in the propofol than in the control group. In vitro studies highlighted the different capacity of gamma- and alpha-T to impair prostaglandin E2 synthesis by human monocytes challenged with bacterial lipopolysaccharide.


CONCLUSIONS
The antiinflammatory properties of propofol that may be linked to its effect on gamma-T levels could be relevant in controlling the inflammatory response that accompanies tissue injury during reperfusion.
Cavalca
Viviana
V
Institute of Cardiology, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Milan, Italy. viviana.cavalca@unimi.it
Colli
Susanna
S
Veglia
Fabrizio
F
Eligini
Sonia
S
Zingaro
Lorenzo
L
Squellerio
Isabella
I
Rondello
Nicola
N
Cighetti
Giuliana
G
Tremoli
Elena
E
Sisillo
Erminio
E
D000368:Aged; D000369:Aged, 80 and over; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures / Q000379:methods*; D015232:Dinoprostone / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D008070:Lipopolysaccharides / Q000008:administration & dosage; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects; D015742:Propofol / Q000494:pharmacology*; D000077149:Sevoflurane; D024502:alpha-Tocopherol / Q000097:blood; D024504:gamma-Tocopherol / Q000097:blood*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D015415:Biomarkers; D008070:Lipopolysaccharides; D008738:Methyl Ethers; D016753:Interleukin-10; D000077149:Sevoflurane; D008315:Malondialdehyde; D024504:gamma-Tocopherol; D024502:alpha-Tocopherol; D015232:Dinoprostone; D015742:Propofol