Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Anti-inflammatory effect of remifentanil in lipopolysaccharide-stimulated amniotic epithelial cells

  • Kim, Cheul-Hong (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Jeong, Seong Soon (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Park, Soon Ji (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Choi, Eun-Ji (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Kim, Yeon Ha (Department of Integrated Biological Science, Pusan National University) ;
  • Ahn, Ji-Hye (Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute)
  • Received : 2019.10.15
  • Accepted : 2019.10.22
  • Published : 2019.10.31
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Abstract

Background: Sometimes general anesthesia is required for dental surgery in pregnant women. Facial bone fractures or neck abscess should be treated immediately. Dental surgery, however, creates a stressful situation that can cause inflammation. Inflammatory responses are a well-known major cause of preterm labor and preterm birth. Here we demonstrate the effects of remifentanil on the factors related to preterm labor and its mechanism of action on amniotic-derived epithelial cells (WISH cells). Methods: WISH cells were exposed to lipopolysaccharide (LPS) for 24 h and co-treated with various concentrations of remifentanil. MTT assays were performed to measure cell viability. To explain the effects of remifentanil on the factors related to inflammation in WISH cells, activation of nuclear factor kappa B ($NF-{\kappa}B$) and p38 and the expression of interleukin $(IL)-1{\beta}$, tumor necrosis factor $(TNF)-{\alpha}$, cyclooxygenase (COX)2, and prostaglandin E $(PGE)_2$ were quantified using western blotting and RT-PCR, respectively. Results: Remifentanil did not affect WISH cell viability. In western blot analysis, co-treatment with remifentanil resulted in decreased phosphorylation of $NF-{\kappa}B$, and expression of COX2 and $PGE_2$ in LPS-induced inflammation, but the results were statistically significant only at low concentrations. Reduction of $IL-1{\beta}$ and $TNF-{\alpha}$ expression was also observed with RT-PCR. Conclusion: Co-treatment with remifentanil does not affect the viability of WISH cells, but reduces the expression of the factors related to inflammation, which can induce uterine contraction and preterm labor. These findings provide evidence that remifentanil may inhibit uterine contraction and preterm labor in clinical settings.

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References

  1. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371: 75-84. https://doi.org/10.1016/S0140-6736(08)60074-4
  2. Romero R, Espinoza J, Kusanovic JP, Gotsch F, Hassan S, Erez O, et al. The preterm parturition syndrome. BJOG 2006, 113: 17-42.
  3. Bobitt JR, Ledger WJ. Unrecognized amnionitis and prematurity: a preliminary report. J Reprod Med 1977; 19: 8-12.
  4. Reitman E, Flood P. Anaesthetic considerations for non-obstetric surgery during pregnancy. Br J Anaesth 2011; 107: i72-8. https://doi.org/10.1093/bja/aer343
  5. Hofbauer R, Frass M, Gmeiner B, Sandor N, Schumann R, Wagner O, et al. Effects of remifentanil on neutrophil adhesion, transmigration, and intercellular adhesion molecule expression. Acta Anaesthesiol Scand 2000; 44: 1232-7. https://doi.org/10.1034/j.1399-6576.2000.441008.x
  6. Sacerdote P, Gaspani L, Rossoni G, Panerai AE, Bianchi M. Effect of the opioid remifentanil on cellular immune response in the rat. Int Immunopharmacol 2001; 1: 713-9. https://doi.org/10.1016/S1567-5769(01)00005-4
  7. Zhang Y, Du Z, Zhou Q, Wang Y, Li J. Remifentanil attenuates lipopolysaccharide-induced acute lung injury by downregulating the NF-kappaB signaling pathway. Inflammation 2014; 37: 1654-60. https://doi.org/10.1007/s10753-014-9893-2
  8. Christian F, Smith EL, Carmody RJ. The regulation of NF-kappaB subunits by phosphorylation. Cells 2016; 5: 12. https://doi.org/10.3390/cells5010012
  9. Mertens MJ, Olofsen E, Engbers FH, Burm AG, Bovill JG, Vuyk J. Propofol reduces perioperative remifentanil requirements in a synergistic manner: response surface modeling of perioperative remifentanil-propofol interactions. Anesthesiology 2003; 99: 347-59. https://doi.org/10.1097/00000542-200308000-00016
  10. Komatsu R, Turan AM, Orhan-Sungur M, McGuire J, Radke OC, Apfel CC. Remifentanil for general anaesthesia: a systematic review. Anaesthesia 2007; 62: 1266-80. https://doi.org/10.1111/j.1365-2044.2007.05221.x
  11. Sweet MJ, Hume DA. Endotoxin signal transduction in macrophages. J Leukoc Biol 1996; 60: 8-26. https://doi.org/10.1002/jlb.60.1.8
  12. Romero R, Mazor M. Infection and preterm labor. Clin Obstet Gynecol 1988; 31: 553-84. https://doi.org/10.1097/00003081-198809000-00006
  13. Pasare C, Medzhitov R. Toll-like receptors: linking innate and adaptive immunity. Microbes Infect 2004; 6: 1382-7. https://doi.org/10.1016/j.micinf.2004.08.018
  14. Baeuerle PA, Henkel T. Function and activation of NF-kappa B in the immune system. Annu Rev Immunol 1994; 12: 141-79. https://doi.org/10.1146/annurev.iy.12.040194.001041
  15. Sun SC. Non-canonical NF-kappaB signaling pathway. Cell Res 2011; 21: 71-85. https://doi.org/10.1038/cr.2010.177
  16. Romero R, Brody DT, Oyarzun E, Mazor M, Wu YK, Hobbins JC, et al. Infection and labor. III. Interleukin-1: a signal for the onset of parturition. Am J Obstet Gynecol 1989; 160: 1117-23. https://doi.org/10.1016/0002-9378(89)90172-5
  17. Challis JR, Lye SJ, Gibb W, Whittle W, Patel F, Alfaidy N. Understanding preterm labor. Ann N Y Acad Sci 2001; 943: 225-34. https://doi.org/10.1111/j.1749-6632.2001.tb03804.x
  18. Keelan JA, Blumenstein M, Helliwell RJ, Sato TA, Marvin KW, Mitchell MD. Cytokines, prostaglandins and parturition--a review. Placenta 2003; 24: 33-46.
  19. Romero R, Durum S, Dinarello CA, Oyarzun E, Hobbins JC, Mitchell MD. Interleukin-1 stimulates prostaglandin biosynthesis by human amnion. Prostaglandins 1989; 37: 13-22. https://doi.org/10.1016/0090-6980(89)90028-2
  20. Sadowsky DW, Novy MJ, Witkin SS, Gravett MG. Dexamethasone or interleukin-10 blocks interleukin-1beta-induced uterine contractions in pregnant rhesus monkeys. Am J Obstet Gynecol 2003; 188: 252-63. https://doi.org/10.1067/mob.2003.70
  21. Romero R, Manogue KR, Mitchell MD, Wu YK, Oyarzun E, Hobbins JC, et al. Infection and labor. IV. Cachectintumor necrosis factor in the amniotic fluid of women with intraamniotic infection and preterm labor. Am J Obstet Gynecol 1989; 161: 336-41. https://doi.org/10.1016/0002-9378(89)90515-2