Table 1.
Immunosuppressive and immunoactivating effects of volatile anesthetics*
| Immune cell type | Effect | Volatile anesthetic |
|---|---|---|
| Neutrophil | Decreased cell number, adhesion | sevoflurane18–22 isoflurane19–21,23 halothane18–21 |
|
| ||
| Increase cell number | desflurane24 | |
|
| ||
| PBMC/Macrophage | Decreased cytokine release (IL-1B, TNF-a, IL-6, IL-8, IL-10) | sevoflurane25,26 isoflurane25,27 |
| Decreased phagocytosis, ROS, chemotaxis | halothane18 | |
| Decreased cell number | sevoflurane28 desflurane28 |
|
|
| ||
| Reversed N2O immune suppression | sevoflurane7 | |
| Enhanced nitrite production | isoflurane27 | |
| Increased cell number, respiratory burst | halothane29 | |
|
| ||
| NK cell | Decreased cytotoxicity | sevoflurane9,30–32 isoflurane9,30–33 halothane9,30–32 |
| Decreased response to IFN-γ | isoflurane25,30,34–36 halothane25,30,34–36 |
|
| Decreased cytokine release | sevoflurane34 | |
|
| ||
| Biphasic (increase then decrease cell number) | desflurane24 | |
|
| ||
| T lymphocyte | Decreased cell number, proliferation, change in Th1/Th2 ratio | isoflurane37,38 |
| Decreased Th1 | sevoflurane31 | |
|
| ||
| Increased Th1 | desflurane24 sevoflurane39 |
|
| Promoted cell-mediated immunity | sevoflurane39 | |
|
| ||
| B lymphocyte | Decreased cell number, increased B cell damage | Sevoflurane40,41 isoflurane40 desflurane40 |
|
| ||
| Other | Increased cortisol | isoflurane37 |
| Decreased platelet-immune cell adhesion | desflurane42 | |
| Decreased microglial cytokine release | isoflurane43 | |
| Decreased monocyte chemoattractant | isoflurane44 halothane44 |
|
|
| ||
| Increased platelet-immune cell adhesion | sevoflurane42 | |
*
Un-shaded and shaded entries are considered immunosuppressive and immunoactivating, respectively.