Possible pathogenic mechanism of propofol infusion syndrome involves coenzyme Q
| Autor: | Joél Smet, Arnaud Vanlander, Birgitte Wuyts, Boel De Paepe, Elien De Latter, Rudy Van Coster, Juergen G. Okun, Bert Vanheel, Peter De Paepe, Georges A. Dacremont, Annick de Jaeger, Philippe G. Jorens, Niels Van Regenmortel |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
Ubiquinone Citric Acid Cycle Respiratory chain Mitochondrion Pharmacology Electron Transport medicine Citrate synthase Animals Rats Wistar Muscle Skeletal Propofol biology business.industry Cytochrome c Skeletal muscle Syndrome medicine.disease Respiration Artificial Rats Anesthesiology and Pain Medicine medicine.anatomical_structure Propofol infusion syndrome Anesthesia Coenzyme Q – cytochrome c reductase biology.protein Human medicine business Anesthetics Intravenous medicine.drug |
| Zdroj: | Anesthesiology |
| ISSN: | 0003-3022 |
| Popis: | Background: Propofol is a short-acting intravenous anesthetic agent. In rare conditions, a life-threatening complication known as propofol infusion syndrome can occur. The pathophysiologic mechanism is still unknown. Some studies suggested that propofol acts as uncoupling agent, others suggested that it inhibits complex I or complex IV, or causes increased oxidation of cytochrome c and cytochrome aa3, or inhibits mitochondrial fatty acid metabolism. Although the exact site of interaction is not known, most hypotheses point to the direction of the mitochondria. Methods: Eight rats were ventilated and sedated with propofol up to 20 h. Sequential biopsy specimens were taken from liver and skeletal muscle and used for determination of respiratory chain activities and propofol concentration. Activities were also measured in skeletal muscle from a patient who died of propofol infusion syndrome. Results: In rats, authors detected a decrease in complex II+III activity starting at low tissue concentration of propofol (20 to 25 µM), further declining at higher concentrations. Before starting anesthesia, the complex II+III/citrate synthase activity ratio in liver was 0.46 (0.25) and in skeletal muscle 0.23 (0.05) (mean [SD]). After 20 h of anesthesia, the ratios declined to 0.17 (0.03) and 0.12 (0.02), respectively. When measured individually, the activities of complexes II and III remained normal. Skeletal muscle from one patient taken in the acute phase of propofol infusion syndrome also shows a selective decrease in complex II+III activity (z-score: −2.96). Conclusion: Propofol impedes the electron flow through the respiratory chain and coenzyme Q is the main site of interaction with propofol. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|