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CARDIOVASCULAR ANESTHESIA

Isoflurane Inhibits Neutrophil-Endothelium Interactions in the Coronary Circulation: Lack of a Role for Adenosine Triphosphate-Sensitive Potassium Channels

Guochang Hu, MD^*, Jakob Vinten-Johansen, PhD, M. Ramez Salem, MD^*, Zhi-Qing Zhao, MD, PhD, and George J. Crystal, PhD^*

*Department of Anesthesiology, Advocate Illinois Masonic Medical Center, and Department of Anesthesiology, University of Illinois College of Medicine, Chicago, Illinois; Department of Cardiothoracic Surgery, Emory University, Atlanta, Georgia; and Department of Physiology and Biophysics, University of Illinois College of Medicine, Chicago, Illinois

Address correspondence and reprint requests to George J. Crystal, PhD, Department of Anesthesiology, Advocate Illinois Masonic Medical Center, University of Illinois College of Medicine, 836 W. Wellington Ave., Chicago, IL 60657-5193. Address e-mail to gcrystal{at}uic.edu

Isoflurane protects myocardium during ischemia-reperfusion via a mechanism involving the adenosine triphosphate-sensitive potassium channels. We tested the hypothesis that an inhibition of the neutrophil-endothelium interactions by isoflurane contributes to this effect. Polymorphonuclear neutrophils and coronary artery segments were obtained from 35 healthy dogs. Superoxide production by neutrophils, stimulated with platelet-activating factor (PAF; 1.0 µM), was measured spectrophotometrically. Adherence of PAF-activated neutrophils to the endothelium of coronary segments was assessed by direct counting of neutrophils labeled with fluorescent dye. Coronary artery rings were exposed to PAF-activated neutrophils, and, after washing and preconstriction with U46619, they were evaluated for vasorelaxation responses to acetylcholine (endothelium dependent) and sodium nitroprusside (endothelium independent). Measurements were performed in the absence and presence of isoflurane (1 and 2 minimum alveolar anesthetic concentration) both with and without glibenclamide (10 µM). Isoflurane inhibited superoxide production and adherence by neutrophils and abolished neutrophil-induced reductions in coronary vascular relaxation responses to acetylcholine. Glibenclamide did not alter the effects of isoflurane on neutrophils or coronary artery endothelium. In conclusion, isoflurane had an inhibitory action on neutrophil-endothelium interactions and neutrophil-mediated coronary endothelial dysfunction—effects that may be involved in its cardioprotective action in vivo. These inhibitory actions of isoflurane were not mediated by adenosine triphosphate-sensitive potassium channels.

IMPLICATIONS: Isoflurane inhibited neutrophil-endothelium interactions and the inflammatory response in vitrovia a pathway independent of the adenosine triphosphate-sensitive potassium channels. This action could be involved in the cardioprotection by isoflurane observed in vivo.

This article has been cited by other articles:

				G. Hu, M. R. Salem, and G. J. Crystal Isoflurane Prevents Platelets from Enhancing Neutrophil-Induced Coronary Endothelial Dysfunction Anesth. Analg., November 1, 2005; 101(5): 1261 - 1268. [Abstract] [Full Text] [PDF]

				Y. Gozal, J. Raphael, J. Rivo, E. Berenshtein, M. Chevion, and B. Drenger Isoflurane does not mimic ischaemic preconditioning in decreasing hydroxyl radical production in the rabbit Br. J. Anaesth., October 1, 2005; 95(4): 442 - 447. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999