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Randomized Controlled Trial
. 2013 Jul;119(1):52-60.
doi: 10.1097/ALN.0b013e31828ce55d.

Effects of anesthetic isoflurane and desflurane on human cerebrospinal fluid Aβ and τ level

Bin Zhang  1 , Ming Tian, Hui Zheng, Yu Zhen, Yun Yue, Tianzuo Li, Shuren Li, Edward R Marcantonio, Zhongcong Xie
Affiliations
Randomized Controlled Trial

Effects of anesthetic isoflurane and desflurane on human cerebrospinal fluid Aβ and τ level

Bin Zhang et al. Anesthesiology. 2013 Jul.

Abstract

Background: Accumulation of β-amyloid protein (Aβ) and tau protein is the main feature of Alzheimer disease neuropathogenesis. Anesthetic isoflurane, but not desflurane, may increase Aβ levels in vitro and in animals. Therefore, we set out to determine the effects of isoflurane and desflurane on cerebrospinal fluid (CSF) levels of Aβ and tau in humans.

Methods: The participants were assigned into spinal anesthesia (N=35), spinal plus desflurane anesthesia (N=33), or spinal plus isoflurane anesthesia (N=38) group by randomization using computer-generated lists. Pre- and postoperative human CSF samples were obtained through an inserted spinal catheter. The levels of Aβ (Aβ40 and Aβ42) and total tau in the CSF were determined.

Results: Here, we show that isoflurane, but not desflurane, was associated with an increase in human CSF Aβ40 levels (from 10.90 to 12.41 ng/ml) 24 h after the surgery under anesthesia compared to spinal anesthesia (from 11.59 to 11.08 ng/ml), P=0.022. Desflurane, but not isoflurane, was associated with a decrease in Aβ42 levels 2 h after the surgery under anesthesia (from 0.39 to 0.35 ng/ml) compared to spinal anesthesia (from 0.43 to 0.44 ng/ml), P=0.006. Isoflurane and desflurane did not significantly affect the tau levels in human CSF.

Conclusions: These studies have established a system to study the effects of anesthetics on human biomarkers associated with Alzheimer disease and cognitive dysfunction. These findings have suggested that isoflurane and desflurane may have different effects on human CSF Aβ levels.

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Figures

Fig. 1
Fig. 1
Surgery under isoflurane anesthesia is associated with increases in human cerebrospinal fluid (CSF) β-amyloid protein (Aβ)40 levels 24 h after the anesthesia. The preoperative baseline, the 2- and 24-h postoperative human CSF Aβ40 levels following spinal (S), spinal plus desflurane (SD), and spinal plus isoflurane (SI) anesthesia are presented. A, The differences between the 2-h postoperative and preoperative baseline human CSF Aβ40 levels are not significantly different among the S, SD, or SI anesthesia group (F = 0.66, P = 0.52, N.S.). B, The differences between the 24-h postoperative and the preoperative baseline human CSF Aβ40 levels are signifi-cantly different among the S, SD, or SI anesthesia group (F = 4.25, * P = 0.02). Specifically, the difference between the 24-h postoperative and the preoperative baseline human CSF Aβ40 levels following SI anesthesia is positively greater than that following S anesthesia, F = 7.62, ** P = 0.006.
Fig. 2
Fig. 2
Surgery under desflurane anesthesia is associated with decreases in human cerebrospinal fluid (CSF) β-amyloid protein (Aβ)42 levels 2 h after the anesthesia. The preop-erative baseline, the 2- and 24-h postoperative human CSF Aβ42 levels following spinal (S), spinal plus desflurane (SD), and spinal plus isoflurane (SI) anesthesia are presented. A, The differences between the 2-h postoperative and the preoperative baseline human CSF Aβ42 levels are significantly different among the S, SD, or SI anesthesia group (F = 4.27, P = 0.01). Specifically, the difference between the 2-h postoperative and the preoperative baseline human CSF Aβ42 levels following SD anesthesia is negatively greater than that following S anesthesia (F = 8.41, ** P = 0.004). B, The differences between the 24-h postoperative and the preoperative baseline human CSF Aβ42 levels are not significantly different among the S, SD, or SI anesthesia group (F = 2.21, P = 0.11).
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