CYTOKINE RELEASE AND CHANGES OF PERIPHERA L-BLOOD MONONUCLEAR-CELLS BY GENERAL-ANESTHESIA

Objective: Anaesthetic agents are believed to have an adverse effect o n human immune defense mechanisms. We investigated changes in peripher al immune cell numbers such as natural killer (NK) cells, B cells and T lymphocyte subpopulations (CD4+ and CD8+ cells) and differences in c ytokine production after stimulation with different mitogens before an d during narcosis. Methods:We studied 30 patients undergoing elective orthopedic surgery. Stimulatory experiments were performed with the mi togens lipopolysaccharide (LPS), phytohemagglutinin (PHA) and inactiva ted Newcastle Disease Virus (NDV). Results: During general anaesthesia with fentanyl, thiopental, isoflurane and nitrous oxide there was a s ignificant decrease of circulating NK cells in the peripheral blood ac companied by a significant increase of B cells and CD8+ T lymphocytes. We detected a significant anesthesia-associate of interferon (IFN)-ga mma, IFN-alpha, tumor necrosis factor (TNF)-alpha and soluble interleu kin-2 receptor (sIL-ZR) synthesis after stimulation with different mit ogens while interleukin (IL)-1 beta and IL-6 protein did not change si gnificantly. After the beginning of surgery CD8-positive cells showed a return to control values and NK cell number increased slightly. Conc lusion:These findings suggest that general anaesthesia interferes with immune cell number and immune cell response. This may explain the cli nically well-recognized disturbance of human immunity after surgery an d general anaesthesia.