Perioperative Anesthesia Management: The Role of MicroRNAs.

MicroRNA (miRNA) is a small RNA molecule that does not code for proteins, and organ- and disease-specific miRNAs are being investigated as diagnostic tools and therapeutic targets, particularly for cardiovascular disease and cancer. Much remains unknown about how anesthetics, other drugs, and perioperative management affect miRNAs, but miRNA-targeted drugs might eventually be used perioperatively. This review examines changes in miRNA expression related to anesthesia management. Sevoflurane results in gene expression patterns that differ by organ. The author investigated changes in miRNA expression induced by anesthetics in the brain, lungs, and liver and found that changes in miRNA expression differ by drug and organ. Since miRNA does not have a one-to-one correspondence with its target mRNA and exhibits complex effects within and between cells, as well as remotely, drug- and organ-specific changes in mRNA expression caused by anesthetics likely involve complex alterations. Cardiovascular disease and cancer are related to perioperative management via miRNAs. Inhalational anesthetics may exacerbate or suppress cellular activity, depending on the type of cancer, and the mechanisms of action differ depending on the inhalational anesthetic. These findings suggest that propofol is more likely to contribute to suppression of cancer cells through intercellular communication. The role of miRNA in perioperative management remains unclear. In the future, it is expected that changes in miRNA expression will be considered when selecting and administering anesthetic drugs perioperatively.