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@ARTICLE{Nguyen:300109,
      author       = {X. D. Nguyen and A. Horn and D. Fischer and G. Beck and C.
                      C. Spannenberger and B. Gaudilliere and J.-L. Horn and H.-J.
                      Thierse$^*$ and T. Frietsch},
      title        = {{S}uppressive effects of deep balanced anesthesia on
                      cellular immunity and protein expression: a
                      randomized-controlled pilot study.},
      journal      = {BMC anesthesiology},
      volume       = {25},
      number       = {1},
      issn         = {1471-2253},
      address      = {[Erscheinungsort nicht ermittelbar]},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2025-00607},
      pages        = {129},
      year         = {2025},
      note         = {Functional Proteome Analysis, German Cancer Research
                      Center(DKFZ), Heidelberg 69120, Germany},
      abstract     = {It is questionable whether or not a short period of deep
                      anesthesia can have long lasting effects on immune
                      suppression.To 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.Anesthesia 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.Deep 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.Clinicaltrial.gov identifier: NCT02794896.},
      keywords     = {Humans / Pilot Projects / Male / Female / Middle Aged /
                      Single-Blind Method / Immunity, Cellular: drug effects /
                      Adult / Monocytes: metabolism / Monocytes: drug effects /
                      Monocytes: immunology / Killer Cells, Natural: drug effects
                      / Killer Cells, Natural: immunology / Phagocytosis: drug
                      effects / Aged / Proteomics: methods / T-Lymphocytes:
                      immunology / T-Lymphocytes: drug effects / Neutrophils: drug
                      effects / Neutrophils: metabolism / Spectrometry, Mass,
                      Matrix-Assisted Laser Desorption-Ionization: methods /
                      Anesthesia depth (Other) / Cellular immune response (Other)
                      / Lymphocyte proliferation (Other) / Monocyte proteome
                      (Other) / NK-cells (Other)},
      cin          = {B100},
      ddc          = {610},
      cid          = {I:(DE-He78)B100-20160331},
      pnm          = {312 - Funktionelle und strukturelle Genomforschung
                      (POF4-312)},
      pid          = {G:(DE-HGF)POF4-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40097954},
      pmc          = {pmc:PMC11912595},
      doi          = {10.1186/s12871-025-02980-9},
      url          = {https://inrepo02.dkfz.de/record/300109},
}