Comparison of the expression of cluster of differentiation (CD)39 and CD73 between propofol- and sevoflurane-based anaesthesia during open heart surgery

Abstract

High expression of cluster of differentiation (CD)39 and CD73 has cardio-protective effects. We hypothesised that the expression of CD39 and CD73 would differ between propofol- and volatile anaesthetic-based anaesthesia in patients undergoing open heart surgery (OHS). The objective of this prospective randomized trial was to compare the changes in CD39 and CD73 levels in CD4⁺ T cells between propofol- and sevoflurane-based anaesthesia during OHS. The study randomly allocated 156 patients undergoing OHS to a propofol or sevoflurane group. Blood was obtained preoperatively and up to 48 hours after weaning from cardiopulmonary bypass (CPB). The expression levels of CD39 and CD73 in circulating CD4⁺ T cells, serum cytokines and other laboratory parameters were analysed. The primary outcome was the expression of CD39 and CD73 on CD4⁺ T cells. Demographic data and perioperative haemodynamic changes did not show significant differences between the two groups. The expression of CD39 and CD73 in the sevoflurane group was significantly lower than in the propofol group (P < 0.001). Other laboratory findings including cardiac enzymes and cytokine levels, did not show significant intergroup differences. Propofol attenuated the decrease in CD39 and CD73 in circulating CD4⁺ T cells compared to sevoflurane-based anaesthesia during OHS.

Figure 1

CONSORT diagram.

Figure 2

Comparison of changes in CD39 expression in circulating helper T cells between the propofol- and sevoflurane-based anaesthesia groups during open heart surgery (OHS). The expression of CD39 was significantly lower in the sevoflurane group. ^*An overall significant difference between the propofol and sevoflurane groups. ^†Pairwise comparison (P < 0.05) at each time point with Bonferroni’s correction. Abbreviations: Preop, preoperative time; Weaning, immediate after weaning from cardiopulmonary bypass (CPB); 3 hours, 3 hours after weaning from CPB; 24 hours, 24 hours after weaning from CPB; 48 hours, 48 hours after weaning from CPB.

Figure 3

Comparison of changes in CD73 expression in circulating helper T cells between the propofol- and sevoflurane-based anaesthesia groups during OHS. The expression of CD73 was significantly lower in the sevoflurane group. ^*An overall significant difference between the propofol and sevoflurane groups. ^†Pairwise comparison (P < 0.05) at each time point with Bonferroni’s correction. Abbreviations: Preop, preoperative time; Weaning, immediate after weaning from CPB; 3 hours, 3 hours after weaning from CPB; 24 hours, 24 hours after weaning from CPB; 48 hours, 48 hours after weaning from CPB.