| Background Effects of anesthesia and surgery on the immune response are well documented. Although the magnitude of changes in the immune response is mainly related to the severity of surgical trauma, anesthesia has a modifying effect. Human helper T cells are important immunocompetent cells, which can differ to Th1 or Th2. And the ratio of the Th1 to Th2 can impact the immune function. It has been known that Morphine promotes the differentiation of Th0 to Th2, but we know little about effects of many other anesthetics on Th0 cells, such as Propofol, Thiopental and Midazolam.Objective To investigate Propofol, Thiopental and Midazolam, from the point of Th0 cell differentiation, to study their direct effects on the immune system, hoping to provide some reference datas in the clinical use. Methods The peripheral blood samples were collected from 60 healthy volunteers. With a randomized block design, the blood was pretreated with different concentrations of Propofol, Thiopental or Midazolam. Intralipid was tested to exclude the influence of vehicle of Propofol. Three methods were employed in this study. The stimulators (PMA+Ionomycin) and the inhibitor of intracellular transport (GlogiStop) were added into the pretreated whole blood, and 4 h later, the trace whole blood technology of flow cytometry detecting was performed for detecting the intracellular cytokines. After pretreated with the anesthetics, the peripheral blood mononuclear cells (PBMCs) were stimulated with PHA for 48 h, then detected by flow cytometry for detecting the chemokine receptors (CCRS/CCR3). And cytometric beads assay were utilized to measure the levels of Th1 (IFN-γ, TNF-α, IL-2) and Th2 (IL-4, IL-6, IL-10) cytokines. All datas were expressed as mean±SEM. Comparisons among experimental groups were performed with ANOVA of randomized block design (SPSS 11.0 software). The P value of less than 0.05 was considered significant.Results Compared with control group, in Propofol 16μg/ml group, the percentage of Thl cells, the ratio of Th1/Th2 were significantly increased (P＜0.05), while in Intralipid 1.6μl/ml group, the percentage of Th1 cells, the percentage of Th2 cells were significantly decreased (P＜0.05). Compared different concentrations in Propofol group, between the low and high dose, the percentage of Thl cells, the ratio of Th1/Th2 were significantly increased (P＜0.05). Compared different concentrations in Intralipid group, between the low and high dose, the percentage of Th1 cells was significantly decreased (P＜0.05). Compared propofol 16μg/ml group with intralipid 1.6μl/ml group, the percentage of Thl cells, the percentage of Th2 cells, the ratio of Thl/Th2 were significantly increased (P＜0.05). Compared with control group, in Thiopental 20μg/ml, 40μg/ml group, the percentage of Thl cells, the ratio of Th1/Th2 were significantly decreased (P＜0.05). Compared different concentrations in Thiopental group, between the low and high dose, between the low and middle dose, the percentage of Thl cells were significantly decreased (P＜0.05). Between the low and high dose, the percentage of Th2 cells were significantly decreased (P＜0.05). In Midazolam group, there were no significant changes.For Propofol group, the levels of Th1 and Th2 cytokines in 16μg/ml group were significantly increased (P＜0.05), compared with the other three groups. In Propofol 1μg/ml, 4μg/ml groups, the levels of IFN-γwere significantly increased (P＜0.05), compared with control group. While for Intralipid group, the level of IL-2 in 1.6μl/ml group was significantly increased (P＜0.05), compared with the other three groups. Compared propofol 16μg/ml group with intralipid 1.6μl/ml group, except the level of IL-2, the levels of Th1 and Th2 cytokines were significantly increased (P＜0.05). For Thiopental group, compared with control group, the level of TNF-αin 4μg/ml group, the levels of TNF-α, IL-2, IL-10 in 20μg/ml group, as well as the levels of IFN-γ, TNF-α, IL-2, IL-10 in 40μg/ml group were significantly decreased (P＜0.05). And the levels of TNF-α, IL-2, IL-10 were significantly decreased in a dose dependent manner (P＜0.05). For Midazolam group, the levels of TNF-αand IL-2 were first significantly increased (P＜0.05),and then decreased in a dose dependent manner (P＜0.05). In 500 ng/ml, the levels of IL-4,IL-6 were significantly increased (P＜0.05), compared with the other three groups, meanwhile the level of IL-10 was significantly increased (P＜0.05), compared with the 50 ng/ml group.Conclusion Propofol can promote Th cells toward Thl differentiation and promote Th cells activity in vitro in high dose. Thiopental can inhibit Th cells activity and shift the balance towards predominantly immunosuppressive Th2-1ike responses. Midazolam has no effect in Th cells differentiation, and can promote the cell-mediated immunity in low dose.
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