Intensive Care Medicine

, Volume 38, Issue 9, pp 1548–1555

Effects of anesthetic regimes on inflammatory responses in a rat model of acute lung injury

  • Spyridon Fortis
  • Peter M. Spieth
  • Wei-Yang Lu
  • Matteo Parotto
  • Jack J. Haitsma
  • Arthur S. Slutsky
  • Nanshan Zhong
  • C. David Mazer
  • Haibo Zhang
Experimental

DOI: 10.1007/s00134-012-2610-4

Cite this article as:
Fortis, S., Spieth, P.M., Lu, WY. et al. Intensive Care Med (2012) 38: 1548. doi:10.1007/s00134-012-2610-4

Abstract

Purpose

Gamma-aminobutyric acid (GABA) is the major inhibitory neurotransmitter through activation of GABA receptors. Volatile anesthetics activate type-A (GABAA) receptors resulting in inhibition of synaptic transmission. Lung epithelial cells have been recently found to express GABAA receptors that exert anti-inflammatory properties. We hypothesized that the volatile anesthetic sevoflurane (SEVO) attenuates lung inflammation through activation of lung epithelial GABAA receptors.

Methods

Sprague–Dawley rats were anesthetized with SEVO or ketamine/xylazine (KX). Acute lung inflammation was induced by intratracheal instillation of endotoxin, followed by mechanical ventilation for 4 h at a tidal volume of 15 mL/kg without positive end-expiratory pressure (two-hit lung injury model). To examine the specific effects of GABA, healthy human lung epithelial cells (BEAS-2B) were challenged with endotoxin in the presence and absence of GABA with and without addition of the GABAA receptor antagonist picrotoxin.

Results

Anesthesia with SEVO improved oxygenation and reduced pulmonary cytokine responses compared to KX. This phenomenon was associated with increased expression of the π subunit of GABAA receptors and glutamic acid decarboxylase (GAD). The endotoxin-induced cytokine release from BEAS-2B cells was attenuated by the treatment with GABA, which was reversed by the administration of picrotoxin.

Conclusion

Anesthesia with SEVO suppresses pulmonary inflammation and thus protects the lung from the two-hit injury. The anti-inflammatory effect of SEVO is likely due to activation of pulmonary GABAA signaling pathways.

Keywords

Volatile anesthetics Mechanical ventilation Inflammation 

Copyright information

© Copyright jointly held by Springer and ESICM 2012

Authors and Affiliations

  • Spyridon Fortis
    • 1
    • 2
    • 3
    • 4
  • Peter M. Spieth
    • 1
    • 2
    • 3
    • 4
    • 5
  • Wei-Yang Lu
    • 6
  • Matteo Parotto
    • 1
    • 2
    • 3
    • 4
  • Jack J. Haitsma
    • 1
    • 3
  • Arthur S. Slutsky
    • 1
    • 3
    • 7
  • Nanshan Zhong
    • 7
  • C. David Mazer
    • 1
    • 2
    • 3
    • 4
  • Haibo Zhang
    • 1
    • 2
    • 3
    • 4
    • 7
  1. 1.Keenan Research Center, Li Ka Shing Knowledge Institute of St. Michael’s HospitalUniversity of TorontoTorontoCanada
  2. 2.Department of AnesthesiaUniversity of TorontoTorontoCanada
  3. 3.Interdepartmental Division of Critical Care MedicineUniversity of TorontoTorontoCanada
  4. 4.Department of PhysiologyUniversity of TorontoTorontoCanada
  5. 5.Department of Anesthesiology and Intensive Care TherapyUniversity Hospital DresdenDresdenGermany
  6. 6.Robarts Research InstituteUniversity of Western OntarioLondonCanada
  7. 7.State Key Laboratory in Respiratory DiseasesGuangzhou Medical UniversityGuangzhouChina

Personalised recommendations