Influence of sevoflurane on neutrophils in patients with sepsis

Objective. To study the anti-inflammatory properties of sevoflurane via exposure of neutrophils in patients with sepsis in vitro. Material and methods. Intact neutrophils harvested from venous blood of donor volunteers were used. The study enrolled men aged 25—34 years. Intact neutrophils were activated using serum from patients with sepsis. After that, we analyzed their activity using fluorescent antibodies to CD11b and CD66b degranulation markers. Neutrophil apoptosis was estimated after 22 hours. Quantitative assessment was carried out using annexin V and propidium iodide on flow cytofluorimeter. Intact and activated neutrophils were exposed to sevoflurane 0.5 MAC (1 vol.%), 1 MAC (2 vol.%) and 1.5 MAC (3 vol.%) for 30 minutes. Results. Spontaneous apoptosis of intact neutrophils after 22-hour incubation was 57.5 [55.3—59.2]%. Incubation of neutrophils with serum of patients with sepsis significantly (p<0.001) reduced apoptosis by 1.96 times (29.3 [25.25—33.5]%). Sevoflurane exposure ex vivo at a dose of 1.5 MAC (3 vol. %) significantly (p=0.027) reduces anti-inflammatory activation of neutrophils exposed to serum of patients with sepsis. Conclusion. Sevoflurane exposure ex vivo at a dose of 1.5 MAC (3 vol. %) significantly (p=0.027) reduces activation of neutrophils preliminary activated by serum of septic patients. Sevoflurane exposure also reduces expression of CD11b and CD66b molecules on the surface of intact neutrophils and inhibits degranulation process. Sevoflurane exposure significantly reduces anti-inflammatory activation of intact neutrophils and induced spontaneous apoptosis of neutrophils exposed to activation by serum of septic patients.