Newly Published
Perioperative Medicine  |   August 2018
Effect of Equipotent Doses of Propofol versus Sevoflurane Anesthesia on Regulatory T Cells after Breast Cancer Surgery
Author Notes
  • From the Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea (C.-S.O., J.L., S.-H.K.); Department of Anesthesiology and Pain Medicine, Sejong Hospital, Bucheon, Korea (T.-G.Y.); Department of Microbiology (E.-H.S., H.-J.P., L.P., S.-H.L.); Research Institute of Medical Science (S.-H.L., S.-H.K.); and the Department of Infection and Immunology, Konkuk University School of Medicine, Seoul, Korea (S.-H.K.).
  • Submitted for publication October 17, 2017. Accepted for publication June 29, 2018.
    Submitted for publication October 17, 2017. Accepted for publication June 29, 2018.×
  • Research Support: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning (grant No. 2015R1A2A2A01006779, 2015), Gwacheon-si, Gyeonggi-do, Korea. This study was supported by the National Research Foundation of Korea grant funded by the Korean government (grant No. NRF-2016R1A5A2012284), Seoul, Korea.
    Research Support: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning (grant No. 2015R1A2A2A01006779, 2015), Gwacheon-si, Gyeonggi-do, Korea. This study was supported by the National Research Foundation of Korea grant funded by the Korean government (grant No. NRF-2016R1A5A2012284), Seoul, Korea.×
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Reproducible Science: Full protocol available at: yshkim75@daum.net. Raw data available at: yshkim75@daum.net.
    Reproducible Science: Full protocol available at: yshkim75@daum.net. Raw data available at: yshkim75@daum.net.×
  • Correspondence: Address correspondence to Dr. Kim: Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, 120–1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea. yshkim75@daum.net. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Pharmacology
Perioperative Medicine   |   August 2018
Effect of Equipotent Doses of Propofol versus Sevoflurane Anesthesia on Regulatory T Cells after Breast Cancer Surgery
Anesthesiology Newly Published on August 2, 2018. doi:10.1097/ALN.0000000000002382
Anesthesiology Newly Published on August 2, 2018. doi:10.1097/ALN.0000000000002382
Abstract

What We Already Know about This Topic:

  • Cluster of differentiation enzymes on regulatory T cells are immunosuppressive and promote cancer recurrence

  • The investigators tested the hypothesis that cluster of differentiation 39 and 73 expression is increased less with propofol than sevoflurane

What This Article Tells Us That Is New:

  • A total of 201 women having breast cancer surgery were randomly assigned to propofol or sevoflurane anesthesia

  • Cluster of differentiation 39 and 73 expression did not differ nor did any other evaluated immune functions

  • These results do not support the putative protective effect of propofol on cancer recurrence

Background: Clusters of differentiation 39 and 73, enzymes expressed on the surface of regulatory T cells, promote cancer recurrence and metastasis by suppressing immune cells. The authors hypothesized that propofol is less immunosuppressive than volatile anesthetics. The objective of this randomized trial was to compare the changes in cluster of differentiation 39 and 73 expression on regulatory T cells between propofol- and sevoflurane-based anesthesia during breast cancer surgery.

Methods: A total of 201 patients having breast cancer surgery were randomly assigned and analyzed (n = 99 for propofol, n = 102 for sevoflurane). Blood samples were obtained immediately before anesthesia induction and 1 and 24 h postoperatively. The frequency of cluster of differentiation 39 and 73 expression on circulating regulatory T cells (primary outcome) and the frequency of circulating type 1 and type 17 helper T cells, natural killer cells, and cytotoxic T cells were investigated. Serum cytokines and the neutrophil-to-lymphocyte ratio were also evaluated.

Results: Changes in cluster of differentiation 39 and 73 expression on regulatory T cells over time did not differ with propofol and sevoflurane groups (difference [95% confidence interval]: 0.01 [−2.04 to 2.06], P = 0.995 for cluster of differentiation 39; −0.93 [−3.12 to 1.26], P = 0.403 for cluster of differentiation 73). There were no intergroup differences in type 1, type 17 helper T cells, natural killer cells, cytotoxic T cells, cytokines, or the neutrophil-to-lymphocyte ratio.

Conclusions: Changes in immune cells were similar with propofol and sevoflurane during breast cancer surgery. The effect of anesthetics on the perioperative immune activity may be minimal during cancer surgery.