Overdose with the anesthetic propofol causes hematological cytotoxicity and immune cell alteration in an experimental ex vivo whole blood culture model

Chung-Hsi Hsing; Yu-Ping Hung; Ming-Chung Lin; Chia-Ling Chen; Yung-Ting Wang; Po-Chun Tseng; Rahmat Dani Satria; Chiou-Feng Lin

doi:10.1016/j.tiv.2023.105729

Overdose with the anesthetic propofol causes hematological cytotoxicity and immune cell alteration in an experimental ex vivo whole blood culture model

Toxicol In Vitro. 2024 Feb:94:105729. doi: 10.1016/j.tiv.2023.105729. Epub 2023 Nov 5.

Authors

Chung-Hsi Hsing¹, Yu-Ping Hung², Ming-Chung Lin³, Chia-Ling Chen⁴, Yung-Ting Wang², Po-Chun Tseng⁵, Rahmat Dani Satria⁶, Chiou-Feng Lin⁷

Affiliations

¹ Department of Anesthesiology, Chi-Mei Medical Center, Tainan 710, Taiwan; Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan; Department of Anesthesiology, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
² Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
³ Department of Anesthesiology, Chi-Mei Medical Center, Tainan 710, Taiwan; Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan 717, Taiwan.
⁴ School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
⁵ Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Core Laboratory of Immune Monitoring, Office of Research & Development, Taipei Medical University, Taipei 110, Taiwan.
⁶ Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; Clinical Laboratory Installation, Dr. Sardjito Central General Hospital, Yogyakarta 55281, Indonesia.
⁷ Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Core Laboratory of Immune Monitoring, Office of Research & Development, Taipei Medical University, Taipei 110, Taiwan. Electronic address: cflin2014@tmu.edu.tw.

PMID: 37935310
DOI: 10.1016/j.tiv.2023.105729

Abstract

Propofol, an anesthetic characterized by its benefits of rapid induction, maintenance, and recovery times, may cause cytotoxic effects, resulting in propofol infusion syndrome (PRIS). In addition to causing dyslipidemia in PRIS, our previous works showed that propofol overdose induced phagocyte apoptosis. This study, using an experimental ex vivo model of propofol treatment, investigated the possible cytopathology in the blood. A complete blood count examination showed the deregulating effects of propofol overdose 24 h postinoculation, characterized by mononuclear cell increase (lymphocyte and monocyte subsets) and granulocyte decrease. Advanced marker-based flow cytometric analysis confirmed these findings, although there was no change in CD14+ monocytes. Blood smear staining showed the deregulating effects of propofol overdose 24 h postinoculation, characterized by cytosolic vacuolization and cytotoxicity, particularly in neutrophils. Immune cell profiling of caspase-3 activation demonstrated the induction of cell apoptosis following propofol overdose treatment, particularly in granulocytes. Using multiparameter flow cytometry, this study further analyzed the changes in the profile of immune cells, showing a notable increase in CD4 + HLA-DR-CD62L- helper T cells. These studies explored an ex vivo model of cytopathogenic propofol overdose and its special immune-deregulating effects on peripheral blood cells.

Keywords: Blood; Cytotoxicity; Ex vivo; Granulocyte; Lymphocyte; Propofol.

MeSH terms

Anesthetics*
Apoptosis
Blood Culture
Monocytes
Propofol* / toxicity

Substances

Propofol
Anesthetics