Gene expression profiling and oxidative stress in patients undergoing elective surgery and general anesthesia with propofol or isoflurane

Abstract

In a previous study (FAPESP 06/58847-5 and 06/59625-6) we did not detect increased DNA damage or apoptosis in lymphocytes from individuals exposed to isoflurane (ISF), but did find a decrease of DNA damage (oxidized purines) and apoptosis of T helper lymphocytes from patients anesthetized with propofol (PF). Moreover, we observed a significant increase of inflammatory cytokines in response to these anesthetics. Based on these findings, the present study will be conducted in 60 patients of both genders, classified as physical status ASA I, and aged 18 to 50 years. Patients submitted to surgery lasting at least 120 min will be distributed into two groups of 30, differentiated by the anesthetics used (PF or ISF). Venous blood samples will be collected before anesthesia, at 120 min of surgery, and on the day following surgery. The gene expression profiling of blood cells from individuals exposed to anesthetic will be performed using both microarrays and real-time PCR technologies; for oxidative stress, the sensitive methodology of total antioxidant performance (TAP) will be used. The results might provide important information about the complex network of the molecular events related to anesthesia, and also validate the study of transcriptome in blood as a methodology for identifying biomarkers of exposure to compounds with toxic effects. Therefore, the toxicogenomic evaluation and comparison of the two compounds may have relevance not only for early detection of possible adverse effects of the anesthetics, but also for the establishment of strategies for preventive action.