Opioid−free anesthesia attenuates perioperative immunosuppression by regulating macrophages polarization in gastric cancer patients treated with neoadjuvant PD-1 inhibitor

Bibliographic Details
Title: Opioid−free anesthesia attenuates perioperative immunosuppression by regulating macrophages polarization in gastric cancer patients treated with neoadjuvant PD-1 inhibitor
Authors: Wenjian Liu, Chaopeng Ou, Ruifeng Xue, Xiaohua Yang, Yaqi Ye, Xudong Wang, Jingdun Xie
Source: Frontiers in Immunology, Vol 15 (2024)
Publisher Information: Frontiers Media S.A., 2024.
Publication Year: 2024
Collection: LCC:Immunologic diseases. Allergy
Subject Terms: opioid-based anesthesia, opioid-free anesthesia, macrophages polarization, locally advanced gastric cancer, PD-1 inhibitor, Immunologic diseases. Allergy, RC581-607
More Details: BackgroundOpioid anesthesia can modulate the impaired immune response and opioid-sparing anesthesia may preserve immune functions. This study was performed to assess the effects of opioid-free anesthesia (OFA) and opioid-based anesthesia (OA) on perioperative macrophages differentiation, cytokine changes, and perioperative complications in locally advanced GC (LAGC) patients.MethodsWe used quality of recovery-15 (QoR-15) questionnaire scores and visual analog scale (VAS) scores to compare postoperative quality of recovery and pain level. In addition, the adverse reactions of patients in the two groups were compared. The perioperative serum level of inflammatory cytokines and the ratio of macrophage subtypes were detected.ResultsThe OFA group had significantly longer extubation time and PACU stay, whereas the OA group had significantly higher rate of hypotension, higher doses of norepinephrine, higher PONV and dizziness rate, and delayed flatus passage time. The QoR-15 score on postoperative 24 h was significantly higher in OFA group than in OA group. At the end of or after the surgery, the OFA group had higher levels of interleukin (IL)-12, IL-1β, tumor necrosis factor (TNF)-α, CD68+CD163− macrophage rate, but lower levels of IL-10, transforming growth factor (TGF)-β, and CD68+CD163+ macrophage rate, indicating OFA attenuated perioperative immunosuppression by diminishing M2 and promoting M1 macrophage polarization. And the reversal tendency is more obvious in LAGC patients with neoadjuvant PD-1 inhibitor.ConclusionsThe OFA may attenuate perioperative immunosuppression by diminishing M2 and promoting M1 macrophage polarization in LAGC patients with neoadjuvant PD-1 inhibitor.Clinical trial registrationhttp://gcpgl.sysucc.org.cn, identifier 2022-FXY-001.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1664-3224
Relation: https://www.frontiersin.org/articles/10.3389/fimmu.2024.1438859/full; https://doaj.org/toc/1664-3224
DOI: 10.3389/fimmu.2024.1438859
Access URL: https://doaj.org/article/b75f8a58a0594bc3ab21ac91a45e4b7e
Accession Number: edsdoj.b75f8a58a0594bc3ab21ac91a45e4b7e
Database: Directory of Open Access Journals
More Details
ISSN:16643224
DOI:10.3389/fimmu.2024.1438859
Published in:Frontiers in Immunology
Language:English