The analysis of the mechanisms by which anesthetics enhance the glucocorticoid-induced lymphocyte apoptosis.

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K10944
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Fukushima Medical University
• Principal Investigator: Kurosawa Shin 福島県立医科大学, 医学部, 教授 (60272043)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 麻酔薬 / リンパ球 / アポトーシス / 糖質コルチコイド

Outline of Final Research Achievements

Glucocorticoids　are commonly used for their immunosuppressive and anti-inflammatory effects. The immunomodulatory effects of glucocorticoids on lymphoid cells include induction of apoptosis to thymocytes, peripheral lymphocyte, and leukemic cell lines. On the other hand, many studies have shown immunosuppressive effects of general anesthetics on various immune cells. In this point of view, there is a concern that general anesthetics augment glucocorticoid-induced immunosuppression in cancer patients undergoing steroids treatment before surgery, which may lead to the post-operative cancer recurrence and metastasis. The aim of this study is to investigate the effects of general anesthetics on the immunomodulation of glucocorticoids.
Results of this study indicate that general anesthetics such as volatile anesthetics and propofol promote the glucocorticoid-induced lymphocyte apoptosis. General anesthetics might have a potential to aggravate a glucocorticoid-immunosuppressive condition.

Free Research Field

麻酔科学

Academic Significance and Societal Importance of the Research Achievements

全身麻酔薬による免疫細胞へのアポトーシス誘導などのその直接的免疫抑制作用は周術期の全体的免疫能を負の方向にもたらし、手術後の癌再発・転移、術後感染症誘発など、長期予後に影響をあたえることが予想される。研究結果から、糖質コルチコイド使用患者の免疫能を維持、または低下させない麻酔法・麻酔薬の選択が可能になることが予想され、将来的にこれらの基礎研究結果を麻酔臨床に結びつけることにより麻酔を標準化することができる。また、個々の患者の全身状態を考慮したテーラーメイドの麻酔管理をすることは結果的に患者の長期予後改善に貢献する意義があると考えられる。