THE EFFECTS OF GENERAL-ANESTHESIA ON HUMAN PERIPHERAL IMMUNE CELL DISTRIBUTION AND CYTOKINE PRODUCTION

Anesthetic agents are believed to have an adverse effect on human immu ne defense mechanisms. We investigated changes in peripheral immune ce ll numbers such as natural killer (NK) cells, B cells, and. T lymphocy te subpopulations (CD4(+) and CD8(+) cells) and differences in cytokin e production after stimulation with different mitogens before and duri ng narcosis, We studied 30 patients undergoing elective orthopedic sur gery. Stimulatory experiments were performed with the mitogens lipopol ysaccharide, phytohemagglutinin A, and inactivated Newcastle disease v irus. During general anesthesia with fentanyl, thiopental, and isoflur ane, there was a significant decrease of circulating NK cells in the p eripheral blood accompanied by a significant increase of B cells and C D8(+) T lymphocytes. We detected a significant anesthesia-associated i ncrease of interferon (IFN)-gamma, IFN-alpha, tumor necrosis factor-Lu , and soluble interleukin-2 receptor (sIL-2R) synthesis after stimulat ion with different mitogens while interleukin (IL)-1 beta and IL-6 pro tein did not change significantly. After the beginning of surgery, CDS -positive cells showed a return to control values and NK cell number i ncreased slightly. These findings suggest that general anesthesia inte rferes with immune cell number and immune cell response. This may expl ain the clinically web-recognized disturbance of human immunity after surgery and general anesthesia. (C) 1997 Academic Press.