CoChat
Sign Up
Cited by 11Cancer, Stress, Anesthesia, and Immune ResponseAnesthesia and Sedative AgentsAnesthesia and Neurotoxicity Research

The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.

Effects of Desflurane and Sevoflurane anesthesia on regulatory T cells in patients undergoing living donor kidney transplantation: a randomized intervention trial

Open access
Chutipongtanate, Arpa, Prukviwat, Sasichol, Pongsakul, Nutkridta, Srisala, Supanart, Kamanee, Nakarin, Arpornsujaritkun, Nuttapon, Gesprasert, Goragoch, Apiwattanakul, Nopporn, Hongeng, Suradej, Ittichaikulthol, Wichai, Sumethkul, Vasant, Chutipongtanate, Somchai·2020·BMC Anesthesiology
DOI 10.1186/s12871-020-01130-7PMC PMC7450591

Published version of a preprint

Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Volatile anesthetic agents used during surgery have immunomodulatory effects which could affect postoperative outcomes. Recognizing that regulatory T cells (Tregs) plays crucial roles in transplant tolerance and high peripheral blood Tregs associated with stable kidney graft function, knowing which volatile anesthetic agents can induce peripheral blood Tregs increment would have clinical implications. This study aimed to compare effects of desflurane and sevoflurane anesthesia on peripheral blood Tregs induction in patients undergoing living donor kidney transplantation. Methods: A prospective, randomized, double-blind trial in living donor kidney transplant recipients was conducted at a single center, tertiary-care, academic university hospital in Thailand during August 2015 – June 2017. Sixty-six patients were assessed for eligibility and 40 patients who fulfilled the study requirement were equally randomized and allocated to desflurane versus sevoflurane anesthesia during transplant surgery. The primary outcome included absolute changes of peripheral blood CD4 + CD25 + FoxP3 + Tregs which measured by flow cytometry and expressed as the percentage of the total population of CD4 + T lymphocytes at pre-exposure (0-h) and post-exposure (2-h and 24-h) to anesthetic gas. P -value < 0.05 denoted statistical significance. Results: Demographic data were comparable between groups. No statistical difference of peripheral blood Tregs between desflurane and sevoflurane groups observed at the baseline pre-exposure (3.6 ± 0.4% vs. 3.1 ± 0.4%; p = 0.371) and 2-h post-exposure (3.0 ± 0.3% vs. 3.5 ± 0.4%; p = 0.319). At 24-h post-exposure, peripheral blood Tregs was significantly higher in desflurane group (5.8 ± 0.5% vs. 4.1 ± 0.3%; p = 0.008). Within group analysis showed patients receiving desflurane, but not sevoflurane, had 2.7% increase in peripheral blood Treg over 24-h period ( p < 0.001). Conclusion: This study provides the clinical trial-based evidence that desflurane induced peripheral blood Tregs increment after 24-h exposure, which could be beneficial in the context of kidney transplantation. Mechanisms of action and clinical advantages of desflurane anesthesia based on Treg immunomodulation should be investigated in the future. Trial registration: ClinicalTrials.gov, NCT02559297 . Registered 22 September 2015 - retrospectively registered

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12871-020-01130-7

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

Figures

Fig. 1 Flow diagram of study participants
Fig. 1 Flow diagram of study participantsCC BY · PubMed Central
Fig. 2 Effects of desflurane and sevoflurane anesthesia on the CD4 + CD25 + FoxP3+ Tregs (n = 20 per group). a Representative gating strategy of Treg enumeration. b The percentage of Treg in the CD4 + cell population. c The absolute number of white blood cells (left), and the calculated numbers of CD4 + cells (center) and Treg (right), in peripheral blood (details in the Method section). The result showed that the LDKT patients who received desflurane anesthesia, but not sevoflurane, had significantly increased Tregs in the peripheral blood at 24-h post-exposure. All experiments were performed in triplicate. Des, desflurane; NS, not significant; Sevo, sevoflurane
Fig. 2 Effects of desflurane and sevoflurane anesthesia on the CD4 + CD25 + FoxP3+ Tregs (n = 20 per group). a Representative gating strategy of Treg enumeration. b The percentage of Treg in the CD4 + cell population. c The absolute number of white blood cells (left), and the calculated numbers of CD4 + cells (center) and Treg (right), in peripheral blood (details in the Method section). The result showed that the LDKT patients who received desflurane anesthesia, but not sevoflurane, had significantly increased Tregs in the peripheral blood at 24-h post-exposure. All experiments were performed in triplicate. Des, desflurane; NS, not significant; Sevo, sevofluraneCC BY · PubMed Central
Fig. 3 Plasma cytokines were measured by multiplex cytokine immunoassay. Box plots exhibited plasma levels of anti-inflammatory cytokines IL-10 and TGF-β1, and pro-inflammatory cytokines GM-CSF, IFN-γ, IL-2, IL-4, IL-5, IL-12, IL-13 and TNF-α (n = 26; 14 desflurane, 12 sevoflurane). IL-10 showed an increased trend over 24-h period in patients receiving desflurane anesthesia. Des, desflurane; Sevo, sevoflurane
Fig. 3 Plasma cytokines were measured by multiplex cytokine immunoassay. Box plots exhibited plasma levels of anti-inflammatory cytokines IL-10 and TGF-β1, and pro-inflammatory cytokines GM-CSF, IFN-γ, IL-2, IL-4, IL-5, IL-12, IL-13 and TNF-α (n = 26; 14 desflurane, 12 sevoflurane). IL-10 showed an increased trend over 24-h period in patients receiving desflurane anesthesia. Des, desflurane; Sevo, sevofluraneCC BY · PubMed Central
Fig. 4 Matched-pair data analysis of Tregs and IL-10 (n = 26; 14 desflurane, 12 sevoflurane). Fold change was calculated by Tregs (or IL-10) measured at 24-h divided by that of pre-exposure (0-h) in the same patient, in which fold change > 1 indicated upregulation and fold change < 1 was downregulation. a Scatter plot exhibited the positive relationship between Tregs and IL-10 fold changes. b Bar plots showed a higher proportion of co-increased Tregs and IL-10 immunophenotypic response in patients receiving desflurane anesthesia. Des, desflurane; Sevo, sevoflurane
Fig. 4 Matched-pair data analysis of Tregs and IL-10 (n = 26; 14 desflurane, 12 sevoflurane). Fold change was calculated by Tregs (or IL-10) measured at 24-h divided by that of pre-exposure (0-h) in the same patient, in which fold change > 1 indicated upregulation and fold change < 1 was downregulation. a Scatter plot exhibited the positive relationship between Tregs and IL-10 fold changes. b Bar plots showed a higher proportion of co-increased Tregs and IL-10 immunophenotypic response in patients receiving desflurane anesthesia. Des, desflurane; Sevo, sevofluraneCC BY · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 30

  1. Josephson MA. Monitoring and managing graft health in the kidney transplant recipient. Clin J Am Soc Nephrol. 2011;6:1774–80. · DOI
  2. Goldberg RJ, Weng FL, Kandula P. Acute and chronic allograft dysfunction in kidney transplant recipients. Med Clin North Am. 2016;100:487–503. · DOI
  3. Hara S. Banff 2013 update: pearls and pitfalls in transplant renal pathology. Nephrology. 2015;20(Suppl 2):2–8. · DOI
  4. Halloran PF, Reeve JP, Pereira AB, Hidalgo LG, Famulski KS. Antibody-mediated rejection, T cell-mediated rejection, and the injury-repair response: new insights from the Genome Canada studies of kidney transplant biopsies. Kidney Int. 2014;85:258–64. · DOI
  5. Graca L, Cobbold SP, Waldmann H. Identification of regulatory T cells in tolerated allografts. J Exp Med. 2002;195:1641–6. · DOI
  6. Edozie FC, Nova-Lamperti EA, Povoleri GA, Scottà C, John S, Lombardi G, et al. Regulatory T-cell therapy in the induction of transplant tolerance: the issue of subpopulations. Transplantation. 2014;98:370–9. · DOI
  7. Hu M, Wang YM, Wang Y, Zhang GY, Zheng G, Yi S, et al. Regulatory T cells in kidney disease and transplantation. Kidney Int. 2016;90:502–14. · DOI
  8. Tang Q, Vincenti F. Transplant trials with Tregs: perils and promises. J Clin Invest. 2017;127:2505–12. · DOI
  9. de St Groth BF. Regulatory T-cell abnormalities and the global epidemic of immuno-inflammatory disease. Immunol Cell Biol. 2012;90:256–9. · DOI
  10. Stelmaszczyk-Emmel A, Zawadzka-Krajewska A, Szypowska A, Kulus M, Demkow U. Frequency and activation of CD4+CD25 FoxP3+ regulatory T cells in peripheral blood from children with atopic allergy. Int Arch Allergy Immunol. 2013;162:16–24. · DOI
  11. Srisala S, Pongsakul N, Sahakijpicharn T, Hongeng S, Chutipongtanate S, Apiwattanakul N. Capillary blood as an alternative specimen for enumeration of percentages of lymphocyte subsets. BMC Res Notes. 2019;12:633. https://doi.org/10.1186/s13104-019-4659-4. · DOI
  12. Shan J, Guo Y, Luo L, Lu J, Li C, Zhang C, et al. Do CD4+ Foxp3+ Treg cells correlate with transplant outcomes: a systematic review on recipients of solid organ transplantation. Cell Immunol. 2011;270:5–12. · DOI
  13. Karczewski M, Karczewski J, Kostrzewa A, Wiktorowicz K, Glyda M. The role of Foxp3+ regulatory T cells in kidney transplantation. Transplant Proc. 2009;41:1527–9. · DOI
  14. San Segundo D, Fernández-Fresnedo G, Rodrigo E, Ruiz JC, González M, Gómez-Alamillo C, et al. High regulatory T-cell levels at 1 year posttransplantation predict long-term graft survival among kidney transplant recipients. Transplant Proc. 2012;44:2538–41. · DOI
  15. Liu L, Deng S, Teng L, Fu Q, Wang C, He X. Absolute of CD4(+)CD25(+)FOXP3(+) regulatory T-cell count rather than its ratio in peripheral blood is related to long-term survival of renal allografts. Transplant Proc. 2012;44:284–6. · DOI
  16. Ma L, Zhang H, Hu K, Lv G, Fu Y, Ayana DA, et al. The imbalance between Tregs, Th17 cells and inflammatory cytokines among renal transplant recipients. BMC Immunol. 2015;16:56. https://doi.org/10.1186/s12865-015-0118-8. · DOI
  17. Carmona-Escamilla MA, Queipo G, García-Mosqueda LA, García-Covarrubias L, Fonseca-Sánchez MA, Villanueva-Ortega E, et al. Peripheral blood regulatory T cells are diminished in kidney transplant patients with chronic allograft nephropathy. Transplant Proc. 2018;50:444–8. · DOI
  18. Hutchinson JA, Geissler EK. Now or never? The case for cell-based immunosuppression in kidney transplantation. Kidney Int. 2015;87:1116–24. · DOI
  19. Zwang NA, Leventhal JR. Cell therapy in kidney transplantation: focus on regulatory T cells. J Am Soc Nephrol. 2017;28:1960–72. · DOI
  20. Schneemilch CE, Hachenberg T, Ansorge S, Ittenson A, Bank U. Effects of different anaesthetic agents on immune cell function in vitro. Eur J Anaesthesiol. 2005;22:616–23. · DOI
  21. Pirbudak Cocelli L, Ugur MG, Karadasli H. Comparison of effects of low-flow sevoflurane and desflurane anesthesia on neutrophil and T-cell populations. Curr Ther Res Clin Exp. 2012;73:41–51. · DOI
  22. Koksoy S, Sahin Z, Karsli B. Comparison of the effects of desflurane and bupivacaine on Th1 and Th2 responses. Clin Lab. 2013;59:1215–20. · DOI
  23. Zhang T, Fan Y, Liu K, Wang Y. Effects of different general anaesthetic techniques on immune responses in patients undergoing surgery for tongue cancer. Anaesth Intensive Care. 2014;42:220–7. · DOI
  24. Liu S, Gu X, Zhu L, et al. Effects of propofol and sevoflurane on perioperative immune response in patients undergoing laparoscopic radical hysterectomy for cervical cancer. Medicine. 2016;95:e5479. https://doi.org/10.1097/MD.0000000000005479. · DOI
  25. Stollings LM, Jia LJ, Tang P, Dou H, Lu B, Xu Y. Immune modulation by volatile anesthetics. Anesthesiology. 2016;125:399–411. · DOI
  26. Yuki K, Eckenhoff RG. Mechanisms of the immunological effects of volatile anesthetics: a review. Anesth Analg. 2016;123:326–35. · DOI
  27. Alberu J, Vargas-Rojas MI, Morales-Buenrostro LE, Crispin JC, Rodríguez-Romo R, Uribe-Uribe NO, et al. De novo donor-specific HLA antibody development and peripheral CD4(+)CD25(high) cells in kidney transplant recipients: a place for interaction? J Transp Secur. 2012;2012:302539. https://doi.org/10.1155/2012/302539. · DOI
  28. Vignali DA, Collison LW, Workman CJ. How regulatory T cells work. Nat Rev Immunol. 2008;8:523–32. · DOI · Paper page
  29. Gianchecchi E, Fierabracci A. Inhibitory receptors and pathways of lymphocytes: the role of PD-1 in Treg development and their involvement in autoimmunity onset and cancer progression. Front Immunol. 2018;9:2374. https://doi.org/10.3389/fimmu.2018.02374. · DOI
  30. Vanichapol T, Pongsakul N, Srisala S, Apiwattanakul N, Chutipongtanate S, Hongeng S. Suppressive characteristics of umbilical cord blood-derived regulatory T cells after ex vivo expansion on autologous and allogeneic T effectors and various lymphoblastic cells. J Immunother. 2019;42:110–8. · DOI

Metadata

Authors
Chutipongtanate, A., Prukviwat, S., Pongsakul, N., Srisala, S., Kamanee, N., Arpornsujaritkun, N., Gesprasert, G., Apiwattanakul, N., Hongeng, S., Ittichaikulthol, W., Sumethkul, V., & Chutipongtanate, S.
Affiliations
Mahidol University (TH)
Corresponding author
Chutipongtanate, Somchai
ORCID
Venue
BMC Anesthesiology
Publisher
Springer Science and Business Media LLC
Published
2020-08-27
Volume
20
Issue
1
Pages
215-215
ISSN
1471-2253 (ISSN-L)
DOI
10.1186/s12871-020-01130-7
PMC
PMC7450591
OpenAlex
W3080813876
Cited by
11
References
2
Citations by year
2026: 1 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 2
FWCI
1.09
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Anesthesiology (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Talent Management Program of Mahidol University (TM:CP131)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Stress, Anesthesia, and Immune Response
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
  • Life Sciences › Neuroscience › Developmental Neuroscience › Anesthesia and Neurotoxicity Research
Keywords
sevoflurane, regulatory T cells, living donor kidney transplantation, volatile anesthetics, immunomodulation, transplantation tolerance, Foxp3, CD4+CD25+ T cells, kidney graft function, transplant rejection risk
MeSH terms
Sevoflurane, Desflurane, Adult, Double-Blind Method, Female, Humans, Male, Middle Aged, Prospective Studies, Kidney Transplantation, Anesthetics, Inhalation, Living Donors, T-Lymphocytes, Regulatory

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review