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CRITICAL CARE AND TRAUMA

Ketamine Suppresses Proinflammatory Cytokine Production in Human Whole Blood In Vitro

Department of Anesthesiology, University of Occupational and Environmental Health, Kitakyushu, Japan

Address correspondence and reprint requests to Masanori Ogata, MD, Department of Anesthesiology, University of Occupational and Environmental Health, 1–1-1 Iseigaoka Yahata-nishi-ku Kitakyushu, 807-8555, Japan. Address e-mail to mogata{at}med.uoeh-u.ac.jp

The production of proinflammatory cytokines, such as tumor necrosis factor (TNF) , interleukin (IL)-6, and IL-8, increases in patients with sepsis; marked production causes organ failure and septic shock. We previously reported that ketamine suppressed lipopolysaccharide (LPS)-induced TNF- production in mice. However, there are no reports on the effect of ketamine on cytokine production in human whole blood. Therefore, in this study, we investigated the efficacy of ketamine on LPS-induced TNF-, IL-6, and IL-8 production and recombinant human (rh) TNF-–induced IL-6 and IL-8 production in human whole blood. After adding different doses of ketamine to whole blood, the blood was stimulated with LPS or rhTNF. After incubation, the plasma TNF- activity and IL-6 and IL-8 concentrations were measured using the L929 cell cytotoxic assay or an enzyme-linked immunoassay. Ketamine significantly suppressed LPS-induced TNF- production at concentrations >20 µg/mL. At concentrations >100 µg/mL, ketamine also significantly suppressed both LPS-induced and rhTNF-induced IL-6 and IL-8 production. In this study, we demonstrated that ketamine directly inhibits the production of proinflammatory cytokines such as TNF-, IL-6, and IL-8 in human whole blood.

Implications: We found that ketamine suppressed lipopolysaccharide-induced tumor necrosis factor , interleukin (IL)-6, and IL-8 production and recombinant human tumor necrosis factor-induced IL-6 and IL-8 production in human whole blood. Ketamine directly suppresses proinflammatory cytokine production.

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