Effects of sevoflurane on biological behavior of tumor cells and postoperative immune function of patients_West China Medical Journal

Authors：

XU Jian , WU Changshuai , ZHANG Baohui ,  WANG Kun

Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P. R. China;

Corresponding author：

WANG Kun, Email: hydwangkun@sina.com

Keywords：

Sevoflurane; Tumour; Cancer; Anesthesia

DOI：

10.7507/1002-0179.202001192

Video：

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Surgery is an important method for the treatment of malignant tumors. Sevoflurane is one of the most common general anesthetics, which can directly or indirectly affect the biological behavior of cells and the immune function of tumor patients, thereby affecting the recurrence and metastasis of tumor patients after surgery. From the aspects of microRNA, matrix metalloproteinase, phosphatidylinositol-3-kinase/Akt signaling pathway and hypoxia-inducible factor-1α, this article summarizes the molecular mechanisms of sevoflurane affecting the biological behavior of tumor cells, and clarifies the regulation mechanism of sevoflurane on the immune function of tumor patients. It is expected to provide a theoretical basis for precise anesthesia for tumor patients, and to provide medication basis for reducing postoperative recurrence and metastasis of tumor patients.

Citation： XU Jian, WU Changshuai, ZHANG Baohui, WANG Kun. Effects of sevoflurane on biological behavior of tumor cells and postoperative immune function of patients. West China Medical Journal, 2021, 36(12): 1783-1787. doi: 10.7507/1002-0179.202001192 Copy

1.	Yap A, Lopez-Olivo MA, Dubowitz J, et al. Anesthetic technique and cancer outcomes: a meta-analysis of total intravenous versus volatile anesthesia. Can J Anaesth, 2019, 66(5): 546-561.
2.	Lee BM, Cata JP. Impact of anesthesia on cancer recurrence. Rev Esp Anestesiol Reanim, 2015, 62(10): 570-575.
3.	Bajwa SJ, Anand S, Kaur G. Anesthesia and cancer recurrences: the current knowledge and evidence. J Cancer Res Ther, 2015, 11(3): 528-534.
4.	Kim R. Effects of surgery and anesthetic choice on immunosuppression and cancer recurrence. J Transl Med, 2018, 16(1): 8.
5.	Evans DR, Fowler-Williams C, Ma D. Is volatile anesthesia during cancer surgery likely to increase the metastatic risk?. Int Anesthesiol Clin, 2016, 54(4): 92-107.
6.	Liang H, Yang CX, Zhang B, et al. Sevoflurane attenuates platelets activation of patients undergoing lung cancer surgery and suppresses platelets-induced invasion of lung cancer cells. J Clin Anesth, 2016, 35: 304-312.
7.	Ding J, Zhang L, Zeng S, et al. Clinically relevant concentration of sevoflurane suppresses cervical cancer growth and migration through targeting multiple oncogenic pathways. Biochem Biophys Res Commun, 2019, 514(4): 1179-1184.
8.	Zhang B, Pan X, Cobb GP, et al. microRNAs as oncogenes and tumor suppressors. Dev Biol, 2007, 302(1): 1-12.
9.	Di Leva G, Garofalo M, Croce CM. MicroRNAs in cancer. Annu Rev Pathol. 2014, 9: 287-314.
10.	Hirai T, Konishi Y, Mizuno S, et al. Correction to: differential effects of sevoflurane on the growth and apoptosis of human cancer cell lines. J Anesth, 2020, 34(1): 58.
11.	Ciechanowicz S, Zhao H, Chen Q, et al. Differential effects of sevoflurane on the metastatic potential and chemosensitivity of non-small-cell lung adenocarcinoma and renal cell carcinoma in vitro. Br J Anaesth, 2018, 120(2): 368-375.
12.	Wang L, Wang T, Gu JQ, et al. Volatile anesthetic sevoflurane suppresses lung cancer cells and miRNA interference in lung cancer cells. Onco Targets Ther, 2018, 11: 5689-5693.
13.	Seifoleslami M, Khameneie MK, Mashayekhi F, et al. Retracted article: identification of microRNAs (miR-203/miR-7) as potential markers for the early detection of lymph node metastases in patients with cervical cancer. Tumour Biol, 2015: 22.
14.	Wan D, Shen S, Fu S, et al. miR-203 suppresses the proliferation and metastasis of hepatocellular carcinoma by targeting oncogene ADAM9 and oncogenic long non-coding RNA HULC. Anticancer Agents Med Chem, 2016, 16(4): 414-423.
15.	Fan L, Wu Y, Wang J, et al. Sevoflurane inhibits the migration and invasion of colorectal cancer cells through regulating ERK/MMP-9 pathway by up-regulating miR-203. Eur J Pharmacol, 2019, 850: 43-52.
16.	Liu J, Yang L, Guo X, et al. Sevoflurane suppresses proliferation by upregulating microRNA-203 in breast cancer cells. Mol Med Rep, 2018, 18(1): 455-460.
17.	Jaura AI, Flood G, Gallagher HC, et al. Differential effects of serum from patients administered distinct anaesthetic techniques on apoptosis in breast cancer cells in vitro: a pilot study. Br J Anaesth, 2014, 113(Suppl 1): i63-i67.
18.	Ecimovic P, McHugh B, Murray D, et al. Effects of sevoflurane on breast cancer cell function in vitro. Anticancer Res, 2013, 33(10): 4255-4260.
19.	Hu W, Dooley J, Chung SS, et al. miR-29a maintains mouse hematopoietic stem cell self-renewal by regulating Dnmt3a. Blood, 2015, 125(14): 2206-2216.
20.	Song G, Tian L, Cheng Y, et al. Antitumor activity of sevoflurane in HCC cell line is mediated by miR-29a-induced suppression of Dnmt3a. J Cell Biochem, 2019, 120(10): 18152-18161.
21.	Nishiwada T, Kawaraguchi Y, Uemura K, et al. Effect of sevoflurane on human hepatocellular carcinoma HepG2 cells under conditions of high glucose and insulin. J Anesth, 2015, 29(5): 805-808.
22.	Zhang Q, Wang J, Li N, et al. miR-34a increases the sensitivity of colorectal cancer cells to 5-fluorouracil in vitro and in vivo. Am J Cancer Res, 2018, 8(2): 280-290.
23.	Shi H, Zhou S, Liu J, et al. miR-34a inhibits the in vitro cell proliferation and migration in human esophageal cancer. Pathol Res Pract, 2016, 212(5): 444-449.
24.	Sun SQ, Ren LJ, Liu J, et al. Sevoflurane inhibits migration and invasion of colorectal cancer cells by regulating microRNA-34a/ADAM10 axis. Neoplasma, 2019, 66(6): 887-895.
25.	Gao C, Shen J, Meng ZX, et al. Sevoflurane inhibits glioma cells proliferation and metastasis through miRNA-124-3p/ROCK1 Axis. Pathol Oncol Res, 2020, 26(2): 947-954.
26.	Yi W, Li D, Guo Y, et al. Sevoflurane inhibits the migration and invasion of glioma cells by upregulating microRNA-637. Int J Mol Med, 2016, 38(6): 1857-1863.
27.	Lai RC, Shan WR, Zhou D, et al. Sevoflurane promotes migration, invasion, and colony-forming ability of human glioblastoma cells possibly via increasing the expression of cell surface protein 44. Acta Pharmacol Sin, 2019, 40(11): 1424-1435.
28.	Müller-Edenborn B, Roth-Z’graggen B, Bartnicka K, et al. Volatile anesthetics reduce invasion of colorectal cancer cells through down-regulation of matrix metalloproteinase-9. Anesthesiology, 2012, 117(2): 293-301.
29.	Hurmath FK, Mittal M, Ramaswamy P, et al. Sevoflurane and thiopental preconditioning attenuates the migration and activity of MMP-2 in U87MG glioma cells. Neurochem Int, 2016, 94: 32-38.
30.	Shintani T, Klionsky DJ. Autophagy in health and disease: a double-edged sword. Science, 2004, 306(5698): 990-995.
31.	Gao C, He XF, Xu QR, et al. Sevoflurane downregulates insulin-like growth factor-1 to inhibit cell proliferation, invasion and trigger apoptosis in glioma through the PI3K/AKT signaling pathway. Anticancer Drugs, 2019, 30(7): e0744.
32.	姜虹宇, 徐远志, 赵耀东, 等. 七氟醚与丙泊酚麻醉患者含药血清对人胶质瘤细胞生物学行为的影响及其机制. 山东医药, 2018, 58(44): 38-41.
33.	Gao K, Su Z, Liu H, et al. Anti-proliferation and anti-metastatic effects of sevoflurane on human osteosarcoma U2OS and Saos-2 cells. Exp Mol Pathol, 2019, 108: 121-130.
34.	Kim MS, Kwon HJ, Lee YM, et al. Histone deacetylases induce angiogenesis by negative regulation of tumor suppressor genes. Nat Med, 2001, 7(4): 437-443.
35.	Liang H, Yang CX, Zhang B, et al. Sevoflurane suppresses hypoxia-induced growth and metastasis of lung cancer cells via inhibiting hypoxia-inducible factor-1α. J Anesth, 2015, 29(6): 821-830.
36.	Lu Y, Wang J, Yan J, et al. Sevoflurane attenuate hypoxia-induced VEGF level in tongue squamous cell carcinoma cell by upregulating the DNA methylation states of the promoter region. Biomed Pharmacother, 2015, 71: 139-145.
37.	Liang H, Gu MN, Yang CX, et al. Sevoflurane inhibits proliferation, induces apoptosis, and blocks cell cycle progression of lung carcinoma cells. Asian Pac J Cancer Prev, 2011, 12(12): 3415-3420.
38.	Yuki K, Astrof NS, Bracken C, et al. Sevoflurane binds and allosterically blocks integrin lymphocyte function-associated antigen-1. Anesthesiology, 2010, 113(3): 600-609.
39.	Lim JA, Oh CS, Yoon TG, et al. The effect of propofol and sevoflurane on cancer cell, natural killer cell, and cytotoxic T lymphocyte function in patients undergoing breast cancer surgery: an in vitro analysis. BMC Cancer, 2018, 18(1): 159.
40.	Cho JS, Lee MH, Kim SI, et al. The effects of perioperative anesthesia and analgesia on immune function in patients undergoing breast cancer resection: a prospective randomized study. Int J Med Sci, 2017, 14(10): 970-976.
41.	Yan T, Zhang GH, Wang BN, et al. Effects of propofol/remifentanil-based total intravenous anesthesia versus sevoflurane-based inhalational anesthesia on the release of VEGF-C and TGF-β and prognosis after breast cancer surgery: a prospective, randomized and controlled study. BMC Anesthesiol, 2018, 18(1): 131.
42.	Yan T, Zhang GH, Cheng YZ, et al. Effects of anesthetic technique and surgery on myeloid-derived suppressor cells and prognosis in women who underwent breast cancer surgery: a prospective study. Cancer Manag Res, 2019, 11: 5513-5522.

1. Yap A, Lopez-Olivo MA, Dubowitz J, et al. Anesthetic technique and cancer outcomes: a meta-analysis of total intravenous versus volatile anesthesia. Can J Anaesth, 2019, 66(5): 546-561.
2. Lee BM, Cata JP. Impact of anesthesia on cancer recurrence. Rev Esp Anestesiol Reanim, 2015, 62(10): 570-575.
3. Bajwa SJ, Anand S, Kaur G. Anesthesia and cancer recurrences: the current knowledge and evidence. J Cancer Res Ther, 2015, 11(3): 528-534.
4. Kim R. Effects of surgery and anesthetic choice on immunosuppression and cancer recurrence. J Transl Med, 2018, 16(1): 8.
5. Evans DR, Fowler-Williams C, Ma D. Is volatile anesthesia during cancer surgery likely to increase the metastatic risk?. Int Anesthesiol Clin, 2016, 54(4): 92-107.
6. Liang H, Yang CX, Zhang B, et al. Sevoflurane attenuates platelets activation of patients undergoing lung cancer surgery and suppresses platelets-induced invasion of lung cancer cells. J Clin Anesth, 2016, 35: 304-312.
7. Ding J, Zhang L, Zeng S, et al. Clinically relevant concentration of sevoflurane suppresses cervical cancer growth and migration through targeting multiple oncogenic pathways. Biochem Biophys Res Commun, 2019, 514(4): 1179-1184.
8. Zhang B, Pan X, Cobb GP, et al. microRNAs as oncogenes and tumor suppressors. Dev Biol, 2007, 302(1): 1-12.
9. Di Leva G, Garofalo M, Croce CM. MicroRNAs in cancer. Annu Rev Pathol. 2014, 9: 287-314.
10. Hirai T, Konishi Y, Mizuno S, et al. Correction to: differential effects of sevoflurane on the growth and apoptosis of human cancer cell lines. J Anesth, 2020, 34(1): 58.
11. Ciechanowicz S, Zhao H, Chen Q, et al. Differential effects of sevoflurane on the metastatic potential and chemosensitivity of non-small-cell lung adenocarcinoma and renal cell carcinoma in vitro. Br J Anaesth, 2018, 120(2): 368-375.
12. Wang L, Wang T, Gu JQ, et al. Volatile anesthetic sevoflurane suppresses lung cancer cells and miRNA interference in lung cancer cells. Onco Targets Ther, 2018, 11: 5689-5693.
13. Seifoleslami M, Khameneie MK, Mashayekhi F, et al. Retracted article: identification of microRNAs (miR-203/miR-7) as potential markers for the early detection of lymph node metastases in patients with cervical cancer. Tumour Biol, 2015: 22.
14. Wan D, Shen S, Fu S, et al. miR-203 suppresses the proliferation and metastasis of hepatocellular carcinoma by targeting oncogene ADAM9 and oncogenic long non-coding RNA HULC. Anticancer Agents Med Chem, 2016, 16(4): 414-423.
15. Fan L, Wu Y, Wang J, et al. Sevoflurane inhibits the migration and invasion of colorectal cancer cells through regulating ERK/MMP-9 pathway by up-regulating miR-203. Eur J Pharmacol, 2019, 850: 43-52.
16. Liu J, Yang L, Guo X, et al. Sevoflurane suppresses proliferation by upregulating microRNA-203 in breast cancer cells. Mol Med Rep, 2018, 18(1): 455-460.
17. Jaura AI, Flood G, Gallagher HC, et al. Differential effects of serum from patients administered distinct anaesthetic techniques on apoptosis in breast cancer cells in vitro: a pilot study. Br J Anaesth, 2014, 113(Suppl 1): i63-i67.
18. Ecimovic P, McHugh B, Murray D, et al. Effects of sevoflurane on breast cancer cell function in vitro. Anticancer Res, 2013, 33(10): 4255-4260.
19. Hu W, Dooley J, Chung SS, et al. miR-29a maintains mouse hematopoietic stem cell self-renewal by regulating Dnmt3a. Blood, 2015, 125(14): 2206-2216.
20. Song G, Tian L, Cheng Y, et al. Antitumor activity of sevoflurane in HCC cell line is mediated by miR-29a-induced suppression of Dnmt3a. J Cell Biochem, 2019, 120(10): 18152-18161.
21. Nishiwada T, Kawaraguchi Y, Uemura K, et al. Effect of sevoflurane on human hepatocellular carcinoma HepG2 cells under conditions of high glucose and insulin. J Anesth, 2015, 29(5): 805-808.
22. Zhang Q, Wang J, Li N, et al. miR-34a increases the sensitivity of colorectal cancer cells to 5-fluorouracil in vitro and in vivo. Am J Cancer Res, 2018, 8(2): 280-290.
23. Shi H, Zhou S, Liu J, et al. miR-34a inhibits the in vitro cell proliferation and migration in human esophageal cancer. Pathol Res Pract, 2016, 212(5): 444-449.
24. Sun SQ, Ren LJ, Liu J, et al. Sevoflurane inhibits migration and invasion of colorectal cancer cells by regulating microRNA-34a/ADAM10 axis. Neoplasma, 2019, 66(6): 887-895.
25. Gao C, Shen J, Meng ZX, et al. Sevoflurane inhibits glioma cells proliferation and metastasis through miRNA-124-3p/ROCK1 Axis. Pathol Oncol Res, 2020, 26(2): 947-954.
26. Yi W, Li D, Guo Y, et al. Sevoflurane inhibits the migration and invasion of glioma cells by upregulating microRNA-637. Int J Mol Med, 2016, 38(6): 1857-1863.
27. Lai RC, Shan WR, Zhou D, et al. Sevoflurane promotes migration, invasion, and colony-forming ability of human glioblastoma cells possibly via increasing the expression of cell surface protein 44. Acta Pharmacol Sin, 2019, 40(11): 1424-1435.
28. Müller-Edenborn B, Roth-Z’graggen B, Bartnicka K, et al. Volatile anesthetics reduce invasion of colorectal cancer cells through down-regulation of matrix metalloproteinase-9. Anesthesiology, 2012, 117(2): 293-301.
29. Hurmath FK, Mittal M, Ramaswamy P, et al. Sevoflurane and thiopental preconditioning attenuates the migration and activity of MMP-2 in U87MG glioma cells. Neurochem Int, 2016, 94: 32-38.
30. Shintani T, Klionsky DJ. Autophagy in health and disease: a double-edged sword. Science, 2004, 306(5698): 990-995.
31. Gao C, He XF, Xu QR, et al. Sevoflurane downregulates insulin-like growth factor-1 to inhibit cell proliferation, invasion and trigger apoptosis in glioma through the PI3K/AKT signaling pathway. Anticancer Drugs, 2019, 30(7): e0744.
32. 姜虹宇, 徐远志, 赵耀东, 等. 七氟醚与丙泊酚麻醉患者含药血清对人胶质瘤细胞生物学行为的影响及其机制. 山东医药, 2018, 58(44): 38-41.
33. Gao K, Su Z, Liu H, et al. Anti-proliferation and anti-metastatic effects of sevoflurane on human osteosarcoma U2OS and Saos-2 cells. Exp Mol Pathol, 2019, 108: 121-130.
34. Kim MS, Kwon HJ, Lee YM, et al. Histone deacetylases induce angiogenesis by negative regulation of tumor suppressor genes. Nat Med, 2001, 7(4): 437-443.
35. Liang H, Yang CX, Zhang B, et al. Sevoflurane suppresses hypoxia-induced growth and metastasis of lung cancer cells via inhibiting hypoxia-inducible factor-1α. J Anesth, 2015, 29(6): 821-830.
36. Lu Y, Wang J, Yan J, et al. Sevoflurane attenuate hypoxia-induced VEGF level in tongue squamous cell carcinoma cell by upregulating the DNA methylation states of the promoter region. Biomed Pharmacother, 2015, 71: 139-145.
37. Liang H, Gu MN, Yang CX, et al. Sevoflurane inhibits proliferation, induces apoptosis, and blocks cell cycle progression of lung carcinoma cells. Asian Pac J Cancer Prev, 2011, 12(12): 3415-3420.
38. Yuki K, Astrof NS, Bracken C, et al. Sevoflurane binds and allosterically blocks integrin lymphocyte function-associated antigen-1. Anesthesiology, 2010, 113(3): 600-609.
39. Lim JA, Oh CS, Yoon TG, et al. The effect of propofol and sevoflurane on cancer cell, natural killer cell, and cytotoxic T lymphocyte function in patients undergoing breast cancer surgery: an in vitro analysis. BMC Cancer, 2018, 18(1): 159.
40. Cho JS, Lee MH, Kim SI, et al. The effects of perioperative anesthesia and analgesia on immune function in patients undergoing breast cancer resection: a prospective randomized study. Int J Med Sci, 2017, 14(10): 970-976.
41. Yan T, Zhang GH, Wang BN, et al. Effects of propofol/remifentanil-based total intravenous anesthesia versus sevoflurane-based inhalational anesthesia on the release of VEGF-C and TGF-β and prognosis after breast cancer surgery: a prospective, randomized and controlled study. BMC Anesthesiol, 2018, 18(1): 131.
42. Yan T, Zhang GH, Cheng YZ, et al. Effects of anesthetic technique and surgery on myeloid-derived suppressor cells and prognosis in women who underwent breast cancer surgery: a prospective study. Cancer Manag Res, 2019, 11: 5513-5522.

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