Evidence map›Paper›PMID 40097954›Full record

Trial reportBMC anesthesiology2025

Suppressive effects of deep balanced anesthesia on cellular immunity and protein expression: a randomized-controlled pilot study.

Xuan Duc Nguyen, Audrey Horn, Dania Fischer, Grietje Beck, Cora C Spannenberger, Brice Gaudilliere, Jean-Louis Horn, Hermann-Josef Thierse, Thomas Frietsch

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02794896 (Hypnotic Depth Reduces Lymphocyte Proliferation to Natural Killer Cells, B-cells, Memory T-cells, Depresses Intracellular Oxidative Burst and Changes Protein Expression Pattern of Monocytes), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02794896 nacompletednot on this map

Hypnotic Depth Reduces Lymphocyte Proliferation to Natural Killer Cells, B-cells, Memory T-cells, Depresses Intracellular Oxidative Burst and Changes Protein Expression Pattern of Monocytes

TypeinterventionalSponsorHeidelberg UniversityRan2009 to 2013Enrolled16ConditionsImmunotoxicity, Anesthesia, Inert Gas NarcosisArmsHigh dose propofol, fentanyl and sevoflurane, Low dose propofol, fentanyl and sevoflurane
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Xuan Duc NguyenAmita Lab, Department of Science, Mannheim, 68259, Germany.
Audrey HornDepartment of Anesthesiology Perioperative and Pain Medicine, Stanford University, Stanford, CA, 94305, USA.
Dania FischerDepartment Anesthesiology, Ruprecht Karls University Heidelberg, Heidelberg, 69160, Germany.
Grietje BeckFaculty University Medicine Mannheim, Anesthesia and Critical Care Medicine, Ruprecht Karls University Heidelberg, Theodor-Kutzer Ufer 1-3, Mannheim, 68165, Germany.
Cora C SpannenbergerTÜV, Occupational Health Services Gmbh, Hechingen, 72379, Germany.
Brice GaudilliereDepartment of Anesthesiology Perioperative and Pain Medicine, Stanford University, Stanford, CA, 94305, USA.
Jean-Louis HornDepartment of Anesthesiology Perioperative and Pain Medicine, Stanford University, Stanford, CA, 94305, USA.
Hermann-Josef ThierseLaboratory for Immunology & Proteomics, Department of Dermatology and University Medical Center Mannheim, University of Heidelberg, Mannheim, 68167, Germany.
Thomas FrietschFaculty University Medicine Mannheim, Anesthesia and Critical Care Medicine, Ruprecht Karls University Heidelberg, Theodor-Kutzer Ufer 1-3, Mannheim, 68165, Germany. Thomas.frietsch@umm.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is questionable whether or not a short period of deep anesthesia can have long lasting effects on immune suppression.

methodsTo analyze specific effects of deep anesthesia on immune modulation, a randomized-controlled, single-blinded study, monocentric, pilot-study was conducted at a level 1 orthopedic and trauma center. Inclusion criteria were patients scheduled for extended shoulder surgery with an ASA score between 1 to 3 (n = 186). Patients on immune modulating drugs or with immune deficits were excluded. The remaining patients were enrolled and randomized to either deep or light anesthesia (n = 18). Patient were randomized to receive either deep anesthesia or light anesthesia for 60 min or longer. The primary aim of the study was to compare cellular activity of T-cells, NK-cells and monocytes after anesthesia. Phagocytosis and cellular lysis activity of neutrophils and monocytes were analyzed by flow cytometry. Secondly, we analyzed anesthesia induced protein expresssion pattern in human monocytes by a standardized proteomic approach, implicating quantitative two-dimensional (2D) differential gel electrophoresis and Delta2D software analyses coupled with matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) and Mascot analysis.

resultsAnesthesia duration was 109 min in the deep anesthesia group with 81 ± 17 min of BIS < 45 and a mean BIS of 38 ± 14. The light anesthesia group received anesthesia for 111 min with 13 ± 8 min of BIS < 45 and a mean BIS 56 ± 8. Cytotoxic T-cells decreased fivefold in the light anesthesia group compared to the deep anesthesia group (-28 ± 13% vs. -6 ± 18%, respectively). The number of NK-cells (p = 0.0127) and regulatory T-cells (p = 0.0217) both dropped after deep anesthesia to almost half of the plasma level. Phagocytosis activity of neutrophils and monocytes was constant with a 67% decreased trend of intracellular lysis in monocytes (p = 0.0625). Quantitative proteomic analyses revealed 27 anesthesia-regulated protein spots in human monocytes, 14 of which were significantly identified by MALDI-MS, and were related to processes such as macrophage function and lymphocyte proliferation, tumor progression and apoptosis.

conclusionsDeep anesthesia inhibited immune competent defense cells (killer cells and regulatory T-cells) and had a general suppression on the phagocytic function of all circulating immune competent cells.

trial registrationClinicaltrial.gov identifier: NCT02794896.

Indexed as

Immunity, CellularAdultAgedFemaleHumansKiller Cells, NaturalMaleMiddle AgedMonocytesNeutrophilsPhagocytosisPilot ProjectsProteomicsSingle-Blind MethodT-LymphocytesAnesthesia depthCellular immune responseLymphocyte proliferationMonocyte proteomeNK-cells

Identifiers

PMID40097954
PMCPMC11912595

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.