Area under the plasma concentration-time curve of inorganic fluoride following sevoflurane anesthesia correlates with CYP2E1 mRNA level in mononuclear cells

Backgrounds Because the amount of inorganic fluoride released after anesthe sia with sevoflurane depends on the dose of administered sevoflurane and cy tochrome P450 (CYP) 2E1 activity in the liver, a reliable and noninvasive p robe for CYP2E1 would be useful for predicting plasma inorganic fluoride le vels after anesthesia. In this study, the authors evaluated the relation be tween plasma concentration of inorganic fluoride after sevoflurane anesthes ia and CYP2E1 mRNA level in mononuclear cells. Methods: Twenty patients (American Society of Anesthesiologists physical st atus I), aged 20-68 yr undergoing body surface surgery with general anesthe sia with sevoflurane were enrolled. One milliliter of blood was obtained be fore administration of sevoflurane and mononuclear cells were obtained. Lev els of CYP2E1 mRNA in mononuclear cells were measured by competitive revers e transcription polymerase chain reaction with a specific primer and compet itor for CYP2E1 mRNA. Results: There was a significant correlation between level of CYP2E1 mRNA i n mononuclear cells and the area under the plasma concentration-time curve of plasma Inorganic fluoride from the beginning of sevoflurane administrati on to infinity in uninduced and uninhibited patients (r(2) = 0.56; p < 0.01 ), Conclusions: Area under the plasma concentration-time curve of inorganic fl uoride after sevoflurane anesthesia correlates with CYP2E1 mRNA in mononucl ear cells in peripheral blood.