Check out the timestamps below to help you navigate through the many topics we discussed.
On This Episode:
In the ever-evolving field of anesthesia, new research constantly reshapes how we approach patient care. In this episode, we explore the compelling findings of a recent systematic review and meta-analysis on the impact of propofol-based total intravenous anesthesia (TIVA) on cancer outcomes.
The implications of this research are far-reaching, touching on everything from survival rates to recurrence risks. We’re going to explore these findings in detail, discuss the biological mechanisms at play, and consider how this might change our approach in the operating room.
Here’s some of what we discuss in this episode:
- We’ll provide an overview of the study and some of the key findings.
- The biological underpinnings of propofol’s benefits.
- The preservation of immune function could be a key factor in why propofol is associated with better survival outcomes.
- Dissecting the findings on recurrence-free survival.
- A deep dive into propofol’s role in lung cancer.
- Clinical implications and practical considerations.
- The future of anesthesia and cancer research.
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"The implications of this research are far-reaching, touching on everything from survival rates to recurrence risks."
- Garry & Terry
References
Al-Hajj, M., Wicha, M. S., Benito-Hernandez, A., Morrison, S. J., & Clarke, M. F. (2003). Prospective identification of tumorigenic breast cancer cells. Proc Natl Acad Sci U S A, 100, 3983–3988. https://doi.org/10.1073/pnas.0530291100
Amulic, B., Cazalet, C., Hayes, G. L., Metzler, K. D., & Zychlinsky, A. (2012). Neutrophil function: From mechanisms to disease. Annu. Rev. Immunol., 30, 459–489. https://doi.org/10.1146/annurev-immunol-020711-074942
Arneth, B. (2019). Tumor microenvironment. Med. Kaunas, 56(1), E15. https://doi.org/10.3390/medicina56010015
Aston-Jones, G., & Waterhouse, B. (2016). Locus coeruleus: From global projection system to adaptive regulation of behavior. Brain Res., 1645, 75–78. https://doi.org/10.1016/j.brainres.2016.03.001
Bald, T., Krummel, M. F., Smyth, M. J., & Barry, K. C. (2020). The NK cell-cancer cycle: Advances and new challenges in NK cell-based immunotherapies. Nat. Immunol., 21(8), 835–847. https://doi.org/10.1038/s41590-020-0728-z
Bateman, B. T., & Kesselheim, A. S. (2015). Propofol as a transformative drug in anesthesia: insights from key early investigators. Drug Discov Today, 20, 1012–1017.
Benarroch, E. E. (2018). Locus coeruleus. Cell Tissue Res., 373(1), 221–232. https://doi.org/10.1007/s00441-017-2649-1
Bovill, J. G. (2000). Mechanisms of anaesthesia: Time to say farewell to the Meyer-Overton rule. Curr. Opin. Anaesthesiol., 13(4), 433–436. https://doi.org/10.1097/00001503-200008000-00006
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin., 68, 394–424.
Brohan, J., & Goudra, B. G. (2017). The role of GABA receptor agonists in anesthesia and sedation. CNS Drugs, 31(10), 845–856. https://doi.org/10.1007/s40263-017-0463-7
Buddeberg, B. S., & Seeberger, M. D. (2022). Anesthesia and oncology: Friend or foe? Front Oncol., 12, 802210. https://doi.org/10.3389/fonc.2022.802210
Buschmann, D., Brandes, F., Lindemann, A., Maerte, M., Ganschow, P., Chouker, A., Schelling, G., Pfaffl, M. W., & Reithmair, M. (2020). Propofol and sevoflurane differentially impact MicroRNAs in circulating extracellular vesicles during colorectal cancer resection: A pilot study. Anesthesiology, 132, 107–120. https://doi.org/10.1097/ALN.0000000000002986
Chang, C. Y., Wu, M. Y., Chien, Y. J., Su, I. M., Wang, S. C., & Kao, M. C. (2021). Anesthesia and long-term oncological outcomes: A systematic review and meta-analysis. Anesth Analg., 132, 623–634. https://doi.org/10.1213/ANE.0000000000005237
Chen, D. S., & Mellman, I. (2013). Oncology meets immunology: The cancer-immunity cycle. Immunity, 39(1), 1–10. https://doi.org/10.1016/j.immuni.2013.07.012
Chen, D. S., & Mellman, I. (2017). Elements of cancer immunity and the cancer-immune set point. Nature, 541(7637), 321–330. https://doi.org/10.1038/nature21349
Chen, F., Li, M., & Zhu, X. (2019). Propofol suppresses proliferation and migration of papillary thyroid cancer cells by down-regulation of lncRNA ANRIL. Exp. Mol. Pathol., 107, 68–76. https://doi.org/10.1016/j.yexmp.2019.01.011
Chen, L., Wan, Y., Liu, Y., & Li, T. (2020). Propofol inhibits biological functions of leukemia stem and differentiated cells through suppressing Wnt/β-catenin and Akt/mTOR. Clin. Exp. Pharmacol. Physiol., 47(1), 127–134. https://doi.org/10.1111/1440-1681.13167
Chen, P., Hsu, W. H., Han, J., & Xia, Y. (2021). Cancer stemness meets immunity: From mechanism to therapy. Cell Rep., 34, 108597. https://doi.org/10.1016/j.celrep.2020.108597
Chen, R. M., Wu, C. H., Chang, H. C., Wu, G. J., Lin, Y. L., Sheu, J. R., et al. (2003). Propofol suppresses macrophage functions and modulates mitochondrial membrane potential and cellular adenosine triphosphate synthesis. Anesthesiology, 98(5), 1178–1185. https://doi.org/10.1097/00000542-200305000-00021
Chen, X., Sun, K., Jiao, S., Cai, N., Zhao, X., Zou, H., et al. (2014). High levels of SIRT1 expression enhance tumorigenesis and associate with a poor prognosis of colorectal carcinoma patients. Sci Rep., 4, 7481. https://doi.org/10.1038/srep07481
Chen, X., Wu, Q., Sun, P., Zhao, Y., Zhu, M., & Miao, C. (2018). Propofol disrupts aerobic glycolysis in colorectal cancer cells via inactivation of the NMDAR-CAMKII-ERK pathway. Cell. Physiol. Biochem., 46(2), 492–504. https://doi.org/10.1159/000488617
Chen, Y., Liang, M., Zhu, Y., & Zhou, D. (2015). The effect of propofol and sevoflurane on the perioperative immunity in patients under laparoscopic radical resection of colorectal cancer. Zhonghua yi xue za zhi, 95(42), 3440–3444. https://doi.org/10.1097/MD.0000000000005479
Chen, Z., Zhang, P., Xu, Y., Yan, J., Liu, Z., Lau, W. B., et al. (2019). Surgical stress and cancer progression: The twisted tango. Mol. Cancer, 18(1), 132. https://doi.org/10.1186/s12943-019-1058-3
Cheng, F., Su, L., Yao, C., Liu, L., Shen, J., Liu, C., et al. (2016). SIRT1 promotes epithelial-mesenchymal transition and metastasis in colorectal cancer by regulating Fra-1 expression. Cancer Lett., 375, 274–283. https://doi.org/10.1016/j.canlet.2016.03.010
Choupani, J., Mansoori Derakhshan, S., Bayat, S., Alivand, M. R., & Shekari Khaniani, M. (2018). Narrower insight to SIRT1 role in cancer: A potential therapeutic target to control epithelial-mesenchymal transition in cancer cells. J. Cell Physiol., 233, 4443–4457. https://doi.org/10.1002/jcp.26302
Cho, J. S., Lee, M. H., Kim, S. I., Park, S., Park, H. S., Oh, E., et al. (2017). The effects of perioperative anesthesia and analgesia on immune function in patients undergoing breast cancer resection: A prospective randomized study. Int. J. Med. Sci., 14(10), 970–976. https://doi.org/10.7150/ijms.20064
Clara, J. A., Monge, C., Yang, Y., & Takebe, N. (2020). Targeting signalling pathways and the immune microenvironment of cancer stem cells—a clinical update. Nat Rev Clin Oncol., 17, 204–232. https://doi.org/10.1038/s41571-019-0293-2
Deng, F., Ouyang, M., Wang, X., Yao, X., Chen, Y., Tao, T., et al. (2016). Differential role of intravenous anesthetics in colorectal cancer progression: Implications for clinical application. Oncotarget, 7, 77087–77095. https://doi.org/10.18632/oncotarget.12800
Deegan, C. A., Murray, D., Doran, P., Moriarty, D. C., Sessler, D. I., Mascha, E., et al. (2010). Anesthetic technique and the cytokine and matrix metalloproteinase response to primary breast cancer surgery. Reg. Anesth. Pain Med., 35(6), 490–495. https://doi.org/10.1097/AAP.0b013e3181ef4d05
Devlin, E. G., Clarke, R. S., Mirakhur, R. K., & McNeill, T. A. (1994). Effect of four i.v. induction agents on T-lymphocyte proliferations to PHA in vitro. Br. J. Anaesth., 73(3), 315–317. https://doi.org/10.1093/bja/73.3.315
Drula, R., Braicu, C., Harangus, A., Nabavi, S. M., Trif, M., Slaby, O., et al. (2020). Critical function of circular RNAs in lung cancer. WIREs RNA, 11, e1592.
Du, Q., Liu, J., Zhang, X., Zhang, X., Zhu, H., Wei, M., et al. (2018). Propofol inhibits proliferation, migration, and invasion but promotes apoptosis by regulation of Sox4 in endometrial cancer cells. Braz J. Med. Biol. Res., 51(4), e6803. https://doi.org/10.1590/1414-431x20176803
Efremov, S. M., Kozireva, V. S., Moroz, G. B., Abubakirov, M. N., Shkoda, O. S., Shilova, A. N., et al. (2020). The immunosuppressive effects of volatile versus intravenous anesthesia combined with epidural analgesia on kidney cancer: A pilot randomized controlled trial. Korean J. Anesthesiol., 73(6), 525–533. https://doi.org/10.4097/kja.19461
Gardner, A., & Ruffell, B. (2016). Dendritic cells and cancer immunity. Trends Immunol., 37(12), 855–865. https://doi.org/10.1016/j.it.2016.09.006
Ghahhari, N. M., & Babashah, S. (2015). Interplay between microRNAs and Wnt/β-catenin signalling pathway regulates epithelial-mesenchymal transition in cancer. Eur J Cancer., 51, 1638–1649. https://doi.org/10.1016/j.ejca.2015.04.021
Gong, T., Ning, X., & Deng, Z. (2019). Propofol-induced miR-219-5p inhibits growth and invasion of hepatocellular carcinoma through suppression of GPC3-mediated Wnt/β-catenin signalling activation. J Cell Biochem., 120, 16934–16945. https://doi.org/10.1002/jcb.28952
Goldman, M. J., Craft, B., Hastie, M., Repečka, K., McDade, F., Kamath, A., et al. (2020). Visualizing and interpreting cancer genomics data via the Xena platform. Nat Biotechnol., 38, 675–678. https://doi.org/10.1038/s41587-020-0546-8
Gropper, M. (2019). Miller’s Anesthesia (9th ed.). Gursoy, A., Candas, B., Guner, S., & Yilmaz, S. (2016). Preoperative stress: An operating room nurse intervention assessment. J. Perianesth. Nurs., 31(6), 495–503. https://doi.org/10.1016/j.jopan.2015.08.011
Gyorfi, M. J., & Kim, P. Y. (2020). Halothane toxicity, StatPearls, treasure. Island (FL).
Halasi, M., & Gartel, A. L. (2013). FOX(M1) news–it is cancer. Mol Cancer Ther., 12, 245–254. https://doi.org/10.1158/1535-7163.MCT-12-0545
Heaney, A., & Buggy, D. J. (2012). Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis? Br J Anaesth., 109(Suppl 1):i17-i28.
Hemmings, H. C., Adamo, A. I., & Hoffman, M. M. (1995). Biochemical characterization of the stimulatory effects of halothane and propofol on purified brain protein kinase C. Anesth. Analg., 81(6), 1216–1222. https://doi.org/10.1097/00000539-199512000-00017
Hirsch, F. R., Scagliotti, G. V., Mulshine, J. L., Kwon, R., Curran, W. J., Wu, Y. L., et al. (2017). Lung cancer: Current therapies and new targeted treatments. Lancet, 389, 299–311.
Hung, Y. P., & Chirieac, L. R. (2020). How should molecular findings be integrated in the classification for lung cancer? Transl Lung Cancer Res., 9, 2245–2254.
Irwin, M. G., Chung, C. K. E., Ip, K. Y., & Wiles, M. D. (2020). Influence of propofol-based total intravenous anaesthesia on peri-operative outcome measures: A narrative review. Anaesthesia, 75(Suppl 1), e90–e100.
Inada, T., Kubo, K., Kambara, T., & Shingu, K. (2009). Propofol inhibits cyclo-oxygenase activity in human monocytic THP-1 cells. Can. J. Anaesth., 56(3), 222–229. https://doi.org/10.1007/s12630-008-9035-0
Inada, T., Kubo, K., & Shingu, K. (2009). Vaccines using dendritic cells, differentiated with propofol, enhance antitumor immunity in mice. Immunopharmacol. Immunotoxicol., 31(1), 150–157. https://doi.org/10.1080/08923970802590415
Inada, T., Kubo, K., & Shingu, K. (2010). Promotion of interferon-gamma production by natural killer cells via suppression of murine peritoneal macrophage prostaglandin E₂ production using intravenous anesthetic propofol. Int. Immunopharmacol., 10(10), 1200–1208. https://doi.org/10.1016/j.intimp.2010.06.027
Inada, T., Kubo, K., Ueshima, H., & Shingu, K. (2011). Intravenous anesthetic propofol suppresses prostaglandin E2 production in murine dendritic cells. J. Immunotoxicol., 8(4), 359–366. https://doi.org/10.3109/1547691X.2011.620036
Inada, T., Ueshima, H., & Shingu, K. (2013). Intravenous anesthetic propofol suppresses leukotriene production in murine dendritic cells. J. Immunotoxicol., 10(3), 262–269. https://doi.org/10.3109/1547691X.2012.712066
Irwin, M. G., Chung, C. K. E., Ip, K. Y., & Wiles, M. D. (2020). Influence of propofol-based total intravenous anaesthesia on peri-operative outcome measures: A narrative review. Anaesthesia, 75(Suppl 1), e90–e100. https://doi.org/10.1016/j.jbc.2020.05.006
Janig, W. (2014). Sympathetic nervous system and inflammation: A conceptual view. Auton. Neurosci., 182, 4–14. https://doi.org/10.1016/j.autneu.2014.01.004
Jiang, S., Liu, Y., Huang, L., Zhang, F., & Kang, R. (2018). Effects of propofol on cancer development and chemotherapy: Potential mechanisms. Eur. J. Pharmacol., 831, 46–51. https://doi.org/10.1016/j.ejphar.2018.04.009
Jiao, B., Yang, C., Huang, N. N., Yang, N., Wei, J., & Xu, H. (2018). Relationship between volatile anesthetics and tumor progression: Unveiling the mystery. Curr. Med. Sci., 38(6), 962–967. https://doi.org/10.1007/s11596-018-1970-6
Ji, X., Guo, Y., Qiu, Q., Wang, Z., Wang, Y., Ji, J., et al. (2020). Molecular mechanism underlying the inhibitory effect of propofol on lipopolysaccharide-induced pyroptosis of mouse bone marrow-derived macrophages. Nan fang yi ke da xue xue bao, 40(4), 525–530. https://doi.org/10.12122/j.issn.1673-4254.2020.04.12
Kambara, T., Inada, T., Kubo, K., & Shingu, K. (2009). Propofol suppresses prostaglandin E(2) production in human peripheral monocytes. Immunopharmacol. Immunotoxicol., 31(1), 117–126. https://doi.org/10.1080/08923970802452046
Kang, F. C., Wang, S. C., So, E. C., Chang, M. M., Wong, K. L., Cheng, K. S., et al. (2019). Propofol may increase PASE and MAPK pathways, and suppress the Akt pathway to induce apoptosis in MA10 mouse Leydig tumor cells. Oncol. Rep., 41(6), 3565–3574. https://doi.org/10.3892/or.2019.7129
Karami Fath, M., Ebrahimi, M., Nourbakhsh, E., Zia Hazara, A., Mirzaei, A., Shafieyari, S., et al. (2022). PI3K/Akt/mTOR signaling pathway in cancer stem cells. Pathol Res Pract., 237, 154010. https://doi.org/10.1016/j.prp.2022.154010
Kochiyama, T., Li, X., Nakayama, H., Kage, M., Yamane, Y., Takamori, K., et al. (2019). Effect of propofol on the production of inflammatory cytokines by human polarized macrophages. Mediat. Inflamm., 2019, 1919538. https://doi.org/10.1155/2019/1919538
Kolaczkowska, E., & Kubes, P. (2013). Neutrophil recruitment and function in health and inflammation. Nat. Rev. Immunol., 13(3), 159–175. https://doi.org/10.1038/nri3399
Kuprash, D. V., & Nedospasov, S. A. (2016). Molecular and cellular mechanisms of inflammation. Biochemistry, 81(11), 1237–1239. https://doi.org/10.1134/S0006297916110018
Kushida, A., Inada, T., & Shingu, K. (2007). Enhancement of antitumor immunity after propofol treatment in mice. Immunopharmacol. Immunotoxicol., 29(3-4), 477–486. https://doi.org/10.1080/08923970701675085
Li, Q., Zhang, L., Han, Y., Jiang, Z., & Wang, Q. (2012). Propofol reduces MMPs expression by inhibiting NF-κB activity in human MDA-MB-231 cells. Biomed. Pharmacother., 66(1), 52–56. https://doi.org/10.1016/j.biopha.2011.10.006
Li, J., Sun, D., Pu, W., & Wang, J. (2020). Circular RNAs in cancer: Biogenesis, function, and clinical significance. Trends Cancer., 6, 319–336. https://doi.org/10.1016/j.trecan.2020.01.004
Li, G., Zhang, X., Guo, X., Li, Y., & Li, C. (2021). Propofol inhibits the proliferation, migration, and stem-like properties of bladder cancer mainly by suppressing the hedgehog pathway. Cell Transplant., 30, 963689720985113. https://doi.org/10.1177/0963689720985113
Li, X., He, M., Guo, J., & Cao, T. (2019). Upregulation of circular RNA circ-ERBB2 predicts unfavorable prognosis and facilitates the progression of gastric cancer via miR-503/CACUL1 and miR-637/MMP-19 signaling. Biochem Biophys Res Commun., 511, 926–930. https://doi.org/10.1016/j.bbrc.2019.02.076
Liew, P. X., & Kubes, P. (2019). The neutrophil's role during health and disease. Physiol. Rev., 99(2), 1223–1248. https://doi.org/10.1152/physrev.00012.2018
Lin, F. Y., Tsai, Y. T., Lee, C. Y., Lin, C. Y., Lin, Y. W., Li, C. Y., et al. (2011). TNF-α-decreased thrombomodulin expression in monocytes is inhibited by propofol through regulation of tristetraprolin and human antigen R activities. Shock, 36(3), 279–288. https://doi.org/10.1097/SHK.0b013e3182236e7e
Lin, Z., & Fang, D. (2013). The roles of SIRT1 in cancer. Genes Cancer, 4, 97–104. https://doi.org/10.1177/1947601912475079
Liu, F., Qiu, F., Fu, M., Chen, H., & Wang, H. (2020). Propofol reduces epithelial to mesenchymal transition, invasion and migration of gastric cancer cells through the MicroRNA-195–5p/snail axis. Med Sci Monit., 26, e920981.
Liu, Q., Sheng, Z., Cheng, C., Zheng, H., Lanuti, M., Liu, R., et al. (2021). Anesthetic propofol promotes tumor metastasis in lungs via GABAA R-dependent TRIM21 modulation of Src expression. Adv Sci, 8, e2102079. https://doi.org/10.1002/advs.202102079
Liu, S., Gu, X., Zhu, L., Wu, G., Zhou, H., Song, Y., et al. (2016). Effects of propofol and sevoflurane on perioperative immune response in patients undergoing laparoscopic radical hysterectomy for cervical cancer. Medicine, 95(49), e5479. https://doi.org/10.1097/MD.0000000000005479
Liu, S., Sun, J. Y., Ren, L. P., Chen, K., & Xu, B. (2017). Propofol attenuates intermittent hypoxia induced up-regulation of proinflammatory cytokines in microglia through inhibiting the activation of NF-Bκ/p38 MAPK signalling. Folia Neuropathol., 55(2), 124–131. https://doi.org/10.5114/fn.2017.68579
Liu, W. Z., & Liu, N. (2018). Propofol inhibits lung cancer A549 cell growth and epithelial-mesenchymal transition process by upregulation of MicroRNA-1284. Oncol Res., 27, 1–8. https://doi.org/10.3727/096504018x15172738893959
Liu, W. Z., Liu, N., Liu, R., & Liu, Y. (2020). Propofol inhibits lung cancer A549 cell growth and epithelial-mesenchymal transition process by upregulation of MicroRNA-1284. Oncol Res., 27, 1–8.
Longhini, F., Bruni, A., Garofalo, E., De Sarro, R., Memeo, R., Navalesi, P., et al. (2020). Anesthetic strategies in oncological surgery: Not only a simple sleep, but also impact on immunosuppression and cancer recurrence. Cancer Manag. Res., 12, 931–940. https://doi.org/10.2147/CMAR.S237224
Manou-Stathopoulou, V., Korbonits, M., & Ackland, G. L. (2019). Redefining the perioperative stress response: A narrative review. Br. J. Anaesth., 123(5), 570–583. https://doi.org/10.1016/j.bja.2019.08.011
Madsen, R. R., Erickson, E. C., Rueda, O. M., Robin, X., Caldas, C., Toker, A., Semple, R. K., & Vanhaesebroeck, B. (2021). Positive correlation between transcriptomic stemness and PI3K/AKT/mTOR signaling scores in breast cancer, and a counterintuitive relationship with PIK3CA genotype. PLoS Genet., 17, e1009876. https://doi.org/10.1371/journal.pgen.1009876
Manz, K. M., Baxley, A. G., Zurawski, Z., Hamm, H. E., & Grueter, B. A. (2019). Heterosynaptic GABAB receptor function within feedforward microcircuits gates glutamatergic transmission in the nucleus accumbens core. J. Neurosci., 39(47), 9277–9293. https://doi.org/10.1523/JNEUROSCI.1395-19.2019
Medzhitov, R. (2008). Origin and physiological roles of inflammation. Nature, 454(7203), 428–435. https://doi.org/10.1038/nature07201
Medzhitov, R. (2010). Inflammation 2010: New adventures of an old flame. Cell, 140(6), 771–776. https://doi.org/10.1016/j.cell.2010.03.006
Mikawa, K., Akamatsu, H., Nishina, K., Shiga, M., Maekawa, N., Obara, H., et al. (1998). Propofol inhibits human neutrophil functions. Anesth. Analg., 87(3), 695–700. https://doi.org/10.1097/00000539-199809000-00039
Moradkhani, M. R., & Karimi, A. (2018). Role of drug anesthesia and cancer. Drug Res., 68(3), 125–131. https://doi.org/10.1055/s-0043-119071
Mühling, J., Campos, M. E., Sablotzki, A., Krüll, M., Dehne, M. G., Gonther, J., et al. (2002). Effects of propofol and taurine on intracellular free amino acid profiles and immune function markers in neutrophils in vitro. Clin. Chem. Lab. Med., 40(2), 111–121. https://doi.org/10.1515/CCLM.2002.020
Myers, J. A., & Miller, J. S. (2021). Exploring the NK cell platform for cancer immunotherapy. Nat. Rev. Clin. Oncol., 18(2), 85–100. https://doi.org/10.1038/s41571-020-0426-7
Ng, W. L., Mohd Mohidin, T. B., & Shukla, K. (2018). Functional role of circular RNAs in cancer development and progression. RNA Biol., 15, 995–1005.
Ogawa, K., Hirai, M., Katsube, T., Murayama, M., Hamaguchi, K., Shimakawa, T., et al. (2000). Suppression of cellular immunity by surgical stress. Surgery, 127(3), 329–336. https://doi.org/10.1067/msy.2000.103498
Oh, C. S., Lee, J., Yoon, T. G., Seo, E. H., Park, H. J., Piao, L., et al. (2018). Effect of equipotent doses of propofol versus sevoflurane anesthesia on regulatory T cells after breast cancer surgery. Anesthesiology, 129(5), 921–931. https://doi.org/10.1097/ALN.0000000000002382
Pádua, D., Figueira, P., Ribeiro, I., Almeida, R., Mesquita, P. (2020). The relevance of transcription factors in gastric and colorectal cancer stem cells identification and eradication. Front Cell Dev Biol., 8, 442. https://doi.org/10.3389/fcell.2020.00442
Perouansky, M. (2015). The Overton in Meyer-Overton: A biographical sketch commemorating the 150th anniversary of Charles Ernest Overton's birth. Br. J. Anaesth., 114(4), 537–541. https://doi.org/10.1093/bja/aev069
Pio, R., Ajona, D., Ortiz-Espinosa, S., Mantovani, A., & Lambris, J. D. (2019). Complementing the cancer-immunity cycle. Front. Immunol., 10, 774. https://doi.org/10.3389/fimmu.2019.00774
Prossomariti, A., Piazzi, G., Alquati, C., & Ricciardiello, L. (2020). Are Wnt/β-catenin and PI3K/AKT/mTORC1 distinct pathways in colorectal cancer? Cell Mol Gastroenterol Hepatol., 10, 491–506. https://doi.org/10.1016/j.jcmgh.2020.04.007
Ratnakumari, L., & Hemmings, H. C. (1997). Effects of propofol on sodium channel-dependent sodium influx and glutamate release in rat cerebrocortical synaptosomes. Anesthesiology, 86(2), 428–439. https://doi.org/10.1097/00000542-199702000-00018
Redegeld, F. A., Yu, Y., Kumari, S., Charles, N., & Blank, U. (2018). Non-IgE mediated mast cell activation. Immunol. Rev., 282(1), 87–113. https://doi.org/10.1111/imr.12629
Ren, X. F., Li, W. Z., Meng, F. Y., & Lin, C. F. (2010). Differential effects of propofol and isoflurane on the activation of T-helper cells in lung cancer patients. Anaesthesia, 65(5), 478–482. https://doi.org/10.1111/j.1365-2044.2010.06304.x
Romano, S., Tufano, M., D’Arrigo, P., Vigorito, V., Russo, S., & Romano, M. F. (2020). Cell stemness, epithelial-to-mesenchymal transition, and immunoevasion: Intertwined aspects in cancer metastasis. Semin Cancer Biol., 60, 181–190. https://doi.org/10.1016/j.semcancer.2019.08.015
Rossano, F., Tufano, R., Cipollaro de L'Ero, G., Servillo, G., Baroni, A., & Tufano, M. (1992). Anesthetic agents induce human mononuclear leucocytes to release cytokines. Immunopharmacol. Immunotoxicol., 14(3), 439–450. https://doi.org/10.3109/08923979209005403
Salo, M., Pirttikangas, C. O., & Pulkki, K. (1997). Effects of propofol emulsion and thiopentone on T helper cell type-1/type-2 balance in vitro. Anaesthesia, 52(4), 341–344. https://doi.org/10.1111/j.1365-2044.1997.95-pz0084.x
Sanders, M. A., & Majumdar, A. P. N. (2014). Colon cancer stem cells: Implications in carcinogenesis. Front Biosci (Landmark Ed)., 16, 1651–1662.
Sanders, R. D., Hussell, T., & Maze, M. (2011). Sedation & immunomodulation. Anesthesiol. Clin., 29(4), 687–706. https://doi.org/10.1016/j.anclin.2011.09.008
Sethi, G., Shanmugam, M. K., Ramachandran, L., Kumar, A. P., & Tergaonkar, V. (2012). Multifaceted link between cancer and inflammation. Biosci. Rep., 32(1), 1–15. https://doi.org/10.1042/BSR20100136
Shaukat, A., & Levin, T. R. (2022). Current and future colorectal cancer screening strategies. Nat Rev Gastroenterol Hepatol., https://doi.org/10.1038/s41575-022-00612-y.
Sharif, K., Watad, A., Coplan, L., Lichtbroun, B., Krosser, A., Lichtbroun, M., et al. (2018). The role of stress in the mosaic of autoimmunity: An overlooked association. Autoimmun. Rev., 17(10), 967–983. https://doi.org/10.1016/j.autrev.2018.04.005
Shiratsuchi, H., Kouatli, Y., Yu, G. X., Marsh, H. M., & Basson, M. D. (2009). Propofol inhibits pressure-stimulated macrophage phagocytosis via the GABAA receptor and dysregulation of p130 phosphorylation. Am. J. Physiol. Cell Physiol., 296(6), C1400–C1410. https://doi.org/10.1152/ajpcell.00345.2008
Siegel, R. L., Miller, K. D., Fuchs, H. E., & Jemal, A. (2022). Cancer statistics. CA Cancer J Clin., 72(1), 7–30. https://doi.org/10.3322/caac.21332
Song, T., Zhou, H., Wei, X., Meng, Y., & Guo, Q. (2020). Downregulation of microRNA-324-3p inhibits lung cancer by blocking the NCAM1-MAPK axis through ALX4. Cancer Gene Ther. https://doi.org/10.1038/s41419-019-1761-4
Stadtfeld, M., & Hochedlinger, K. (2010). Induced pluripotency: History, mechanisms, and applications. Genes Dev., 24, 2239–2263. https://doi.org/10.1101/gad.1963910
Stambrook, P. J., Maher, J., & Farzaneh, F. (2017). Cancer immunotherapy: Whence and whither. Mol. Cancer Res., 15(6), 635–650. https://doi.org/10.1158/1541-7786.MCR-16-0427
Su, Z., Liu, H. L., Qi, B., & Liu, Y. (2020). Effects of propofol on proliferation and apoptosis of cardia cancer cells via MAPK/ERK signaling pathway. Eur. Rev. Med. Pharmacol. Sci., 24(1), 428–433. https://doi.org/10.26355/eurrev_202001_19942
Sun, H., Gao, D. (2018). Propofol suppresses growth, migration and invasion of A549 cells by down-regulation of miR-372. BMC Cancer., 18, 1252.
Sun, L., Ma, W., Gao, W., Xing, Y., Chen, L., Xia, Z., et al. (2019). Propofol directly induces pase-1-dependent macrophage pyroptosis through the NLRP3-ASC inflammasome. Cell Death Dis., 10(8), 542. https://doi.org/10.1038/s41419-019-1761-4
Tanaka, T., Kai, S., Matsuyama, T., Adachi, T., Fukuda, K., & Hirota, K. (2013). General anesthetics inhibit LPS-induced IL-1β expression in glial cells. PloS One, 8(12), e82930. https://doi.org/10.1371/journal.pone.0082930
Tokunaga, R., Naseem, M., Lo, J. H., Battaglin, F., Soni, S., Puccini, A., et al. (2019). B cell and B cell-related pathways for novel cancer treatments. Cancer Treat. Rev., 73, 10–19. https://doi.org/10.1016/j.ctrv.2018.12.001
Vandewalle, J., Luypaert, A., De Bosscher, K., & Libert, C. (2018). Therapeutic mechanisms of glucocorticoids. Trends Endocrinol. Metab., 29(1), 42–54. https://doi.org/10.1016/j.tem.2017.10.010
Walker, W., & Rotondo, D. (2004). Prostaglandin E2 is a potent regulator of interleukin-12- and interleukin-18-induced natural killer cell interferon-gamma synthesis. Immunology, 111(3), 298–305. https://doi.org/10.1111/j.1365-2567.2004.01810.x
Walsh, C. T. (2018). Propofol: Milk of amnesia. Cell, 175(1), 10–13. https://doi.org/10.1016/j.cell.2018.08.031
Wang, D., Yang, T., Liu, J., Liu, Y., Xing, N., He, J., et al. (2020). Propofol inhibits the migration and invasion of glioma cells by blocking the PI3K/AKT pathway through miR-206/ROCK1 Axis. Onco Targets Ther., 13, 361–370. https://doi.org/10.2147/ott.S232601
Wang, H., Jiao, H., Jiang, Z., & Chen, R. (2020). Propofol inhibits migration and induces apoptosis of pancreatic cancer PANC-1 cells through miR-34a-mediated E-cadherin and LOC285194 signals. Bioengineered., 11, 510–521. https://doi.org/10.1080/21655979.2020.1754038
Wang, M. J., Chen, J. J., Song, S. H., Su, J., Zhao, L. H., Liu, Q. G., et al. (2021). Inhibition of SIRT1 limits self-renewal and oncogenesis by inducing senescence of liver cancer stem cells. J Hepatocell Carcinoma., 8, 685–699. https://doi.org/10.2147/JHC.S296234
Wang, T. W., Chern, E., Hsu, C. W., Tseng, K. C., & Chao, H. M. (2020). SIRT1-mediated expression of CD24 and epigenetic suppression of novel tumor suppressor miR-1185-1 increases colorectal cancer stemness. Cancer Res., 80, 5257–5269. https://doi.org/10.1158/0008-5472.Can-19-3188
Weir, C. J., Mitchell, S. J., & Lambert, J. J. (2017). Role of GABAA receptor subtypes in the behavioural effects of intravenous general anaesthetics. Br. J. Anaesth., 119(1), i167–i175. https://doi.org/10.1093/bja/aex369
Wilson, M. M., Weinberg, R. A., Lees, J. A., & Guen, V. J. (2020). Emerging mechanisms by which EMT programs control stemness. Trends Cancer., 6, 775–780. https://doi.org/10.1016/j.trecan.2020.03.011
Woo, J. H., Baik, H. J., Kim, C. H., Chung, R. K., Kim, D. Y., Lee, G. Y., et al. (2015). Effect of propofol and desflurane on immune cell populations in breast cancer patients: A randomized trial. J. Korean Med. Sci., 30(10), 1503–1508. https://doi.org/10.3346/jkms.2015.30.10.1503
Wu, T., & Dai, Y. (2017). Tumor microenvironment and therapeutic response. Cancer Lett., 387, 61–68. https://doi.org/10.1016/j.canlet.2016.01.043
Wu, X., Li, X., & Xu, G. (2020). Propofol suppresses the progression of nonsmall cell lung cancer via downregulation of the miR-215p/MAPK10 axis. Oncol Rep., 44, 487–498. https://doi.org/10.3892/or.2020.7619
Xiao, H. (2019). MiR-7-5p suppresses tumor metastasis of non-small cell lung cancer by targeting NOVA2. Cell Mol Biol Lett., 24, 60.
Xing, S. G., Zhang, K. J., Qu, J. H., Ren, Y. D., & Luan, Q. (2018). Propofol induces apoptosis of non-small cell lung cancer cells via ERK1/2-dependent upregulation of PUMA. Eur. Rev. Med. Pharmacol. Sci., 22(13), 4341–4349. https://doi.org/10.26355/eurrev_201807_15431
Xu, W., Zhou, B., Wu, J., Jiang, P., Chen, H., & Yan, F. (2020). Circular RNA hsa-circ-0007766 modulates the progression of gastric carcinoma via miR-1233-3p/GDF15 axis. Int J Med Sci., 17, 1569–1583.
Xu, W., Zheng, J., Bie, S., Kang, L., Mao, Q., Liu, W., et al. (2018). Propofol inhibits Wnt signaling and exerts anticancer activity in glioma cells. Oncol. Lett., 16(1), 402–408. https://doi.org/10.3892/ol.2018.8606
Xu, Y., Pan, S., Jiang, W., Xue, F., & Zhu, X. (2020). Effects of propofol on the development of cancer in humans. Cell Prolif., 53(8), e12867. https://doi.org/10.1111/cpr.12867
Xu, Y., Sun, Y., Chen, H., Wang, Y., & Wang, G. N. (2016). Effects of two different anesthetic methods on cellular immunity of patients after liver cancer resection. J. Biol. Regul. Homeost. Agents., 30(4), 1099–1106.
Yang, C., Gao, J., Yan, N., Wu, B., Ren, Y., Li, H., et al. (2017). Propofol inhibits the growth and survival of gastric cancer cells in vitro through the upregulation of ING3. Oncol. Rep., 37(1), 587–593. https://doi.org/10.3892/or.2016.5218
Yang, J., Antin, P., Berx, G., Blanpain, C., Brabletz, T., Bronner, M., et al. (2020). Guidelines and definitions for research on epithelial-mesenchymal transition. Nat Rev Mol Cell Biol., 21, 341–352. https://doi.org/10.1038/s41580-020-0237-9
Yang, S. C., Chung, P. J., Ho, C. M., Kuo, C. Y., Hung, M. F., & Huang, Y. T. (2013). Propofol inhibits superoxide production, elastase release, and chemotaxis in formyl peptide-activated human neutrophils by blocking formyl peptide receptor 1. J. Immunol., 190, 6511–6519. https://doi.org/10.4049/jimmunol.1202215
Yang, T., Shu, X., Zhang, H. W., Sun, L. X., Yu, L., Liu, J., et al. (2020). Enolase 1 regulates stem cell-like properties in gastric cancer cells by stimulating glycolysis. Cell Death Dis., 11, 870. https://doi.org/10.1038/s41419-020-03087-4
Yu, G., Dymond, M., Yuan, L., Chaturvedi, L. S., Shiratsuchi, H., Durairaj, S., et al. (2011). Propofol's effects on phagocytosis, proliferation, nitrate production, and cytokine secretion in pressure-stimulated microglial cells. Surgery, 150(5), 887–896. https://doi
Yu, J., Han, M., & Geng, J. (2019). Influence of propofol intravenous anesthesia on hemorheology, haemodynamics and immune function of colorectal carcinoma patients undergoing radical resection. Pak. J. Med. Sci., 35(3), 780–785. https://doi.org/10.12669/pjms.35.3.590
Zagryazhskaya, A., & Zhivotovsky, B. (2014). miRNAs in lung cancer: A link to aging. Ageing Res Rev., 17, 54–67. https://doi.org/10.1016/j.arr.2014.03.006
Zha, H., Matsunami, E., Blazon-Brown, N., Koutsogiannaki, S., Hou, L., Bu, W., et al. (2019). Volatile anesthetics affect macrophage phagocytosis. PloS One, 14(5), e0216163. https://doi.org/10.1371/journal.pone.0216163
Zhang, C., Ma, L., Niu, Y., Wang, Z., Xu, X., Li, Y., et al. (2020). Circular RNA in lung cancer research: Biogenesis, functions, and roles. Int J Biol Sci., 16, 803–814. https://doi.org/10.7150/ijbs.40262
Zhang, D., Zhou, X. H., Zhang, J., Zhou, Y. X., Ying, J., Wu, G. Q., et al. (2015). Propofol promotes cell apoptosis via inhibiting HOTAIR mediated mTOR pathway in cervical cancer. Biochem. Biophys. Res. Commun., 468(4), 561–567. https://doi.org/10.1016/j.bbrc.2015.10.129
Zhang, T., Fan, Y., Liu, K., & Wang, Y. (2014). Effects of different general anaesthetic techniques on immune responses in patients undergoing surgery for tongue cancer. Anaesth. Intensive Care, 42(2), 220–227. https://doi.org/10.1177/0310057X1404200209
Zhang, X., Li, F., Zheng, Y., Wang, X., Wang, K., Yu, Y., et al. (2019). Propofol reduced mammosphere formation of breast cancer stem cells via PD-L1/Nanog in vitro. Oxid Med Cell Longev., 2019, 9078209. https://doi.org/10.1155/2019/9078209
Zhang, Y. F., Li, C. S., Zhou, Y., & Lu, X. H. (2020). Effects of propofol on colon cancer metastasis through STAT3/HOTAIR axis by activating WIF-1 and suppressing Wnt pathway. Cancer Med., 9, 1842–1854. https://doi.org/10.1002/cam4.2840
Zhao, H., Wei, H., He, J., Wang, D., Li, W., Wang, Y., et al. (2020). Propofol disrupts cell carcinogenesis and aerobic glycolysis by regulating circTADA2A/miR-455-3p/FOXM1 axis in lung cancer. Cell Cycle., 19, 2538–2552. https://doi.org/10.1080/21655979.2020.1754038
Zheng, R., Zhang, S., Zeng, H., Wang, S., Sun, K., Chen, R., et al. (2022). Cancer incidence and mortality in China, 2016. J Natl Cancer Center., https://doi.org/10.1016/j.jncc.2022.02.002
Zhou, M., Dai, J., Zhou, Y., Wu, J., Xu, T., Zhou, D., et al. (2018). Propofol improves the function of natural killer cells from the peripheral blood of patients with esophageal squamous cell carcinoma. Exp. Ther. Med., 16(1), 83–92. https://doi.org/10.3892/etm.2018.6140
Zindel, J., & Kubes, P. (2020). DAMPs, PAMPs, and LAMPs in immunity and sterile inflammation. Annu. Rev. Pathol., 15, 493–518. https://doi.org/10.1146/annurev-pathmechdis-012419-032847
