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Br J Anaesth. 2014 Jul;113 Suppl 1:i56-62. doi: 10.1093/bja/aeu200. Epub 2014 Jul 9.

Effect of anaesthetic technique on the natural killer cell anti-tumour activity of serum from women undergoing breast cancer surgery: a pilot study.

Author information

1
Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland buckleyaisling@hotmail.com.
2
Department of Immunology, Dublin City University, Dublin, Ireland.
3
Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland School of Medicine & Medical Science, University College Dublin, Dublin, Ireland Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA.

Abstract

BACKGROUND:

Animal models and retrospective clinical data suggest that certain anaesthetic techniques can attenuate immunosuppression and minimize metastasis after cancer surgery. Natural killer (NK) T cells are a critical component of the anti-tumour immune response. We investigated the effect of serum from women undergoing primary breast cancer surgery, randomized to propofol-paravertebral block (PPA) or sevoflurane-opioid (GA) anaesthetic techniques, on healthy human donor NK cell function and cytotoxicity against oestrogen and progesterone receptor-positive breast cancer cells (HCC1500).

METHODS:

Ten subjects who donated serum before operation and 24 h after operation in an ongoing randomized prospective trial (NCT 00418457) were randomly selected. Serum from PPA (n=5) and GA (n=5) subjects was co-cultured with HCC1500 and healthy primary NK cells. NK cell activating receptors (NKp30, NKp44, NKp46, 2b4, CD16, NKG2D), cytokine production, NK CD107a expression, and cytotoxicity towards HCC1500 were examined.

RESULTS:

Serum from PPA subjects did not alter normal NK marker expression or secretion of cytokines. Serum from GA subjects reduced NK cell activating receptor CD16 [from mean (sem), 82 (2)% to 50 (4)%, P=0.001], IL-10 [from 1700 (80) to 1200 (92) pg ml(-1), P=0.001], and IL-1β [from 68 (12) to 19 (4) pg ml(-1), P=0.01]. An increase in NK cell CD107a [23 (2)% to 37(3)%, P=0.007] and apoptosis of HCC1500 [11 (1)% to 21 (2)%, P=0.0001] was observed with PPA serum, but not GA serum, treated NK cells.

CONCLUSION:

Serum from women with breast cancer undergoing surgical excision who were randomized to receive a PPA anaesthetic technique led to greater human donor NK cell cytotoxicity in vitro compared with serum from women who received GA.

CLINICAL TRIAL REGISTRATION:

NCT 041857.

KEYWORDS:

anaesthesia regional; anaesthesia, general; breast neoplasms; immune cells, natural killer cells; immunity, innate

PMID:
25009196
DOI:
10.1093/bja/aeu200
[Indexed for MEDLINE]
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