Peng Chen, Kun Qian, Kairun Zhu, Lu Xiaoqing, Liu Dajin
{"title":"埃氯胺酮调节腹腔镜结直肠癌手术中氧化应激、炎症和免疫失调的术后生化标志物。","authors":"Peng Chen, Kun Qian, Kairun Zhu, Lu Xiaoqing, Liu Dajin","doi":"10.5937/jomb0-56862","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic colorectal cancer surgery, while minimally invasive, induces systemic oxidative stress, inflammation, and immune dysfunction through surgical trauma and anesthesia-related stress. Esketamine, an NMDA receptor antagonist with antioxidant and anti-inflammatory properties, may mitigate these biochemical perturbations. This study evaluated esketamine's effects on serum biomarkers of oxidative stress (glutathione, catalase, malondialdehyde, superoxide dismutase), inflammatory mediators (TNF-a, CRP IL-6), and T lymphocyte subsets in patients undergoing laparoscopic colorectal cancer resection.</p><p><strong>Methods: </strong>In this randomized controlled trial, 150 stage I-II colorectal cancer patients were allocated to esketamine (0.25 mg/kg bolus + 0.12 mg/kg/h infusion) or control (saline) groups during standardized anesthesia. Preand postoperative serum levels of oxidative stress markers (GSH, CAT, MDA, SOD), inflammatory cytokines (TNF-a, CRP IL-6), and immune cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+ ratio) were quantified via ELISA and flow cytometry. Statistical analysis compared intergroup differences using t-tests and chi-square tests.</p><p><strong>Results: </strong>Postoperatively, the esketamine group exhibited significantly attenuated oxidative stress, with higher GSH (72.43± 6.63 vs. 60 .1 6± 5.57 mg/mL, P < 0.05), CAT (92.56± 8.31 vs. 82.81 ± 7.75 U/mL), and SOD (84.53± 8.02 vs. 69 .93± 7.05 nU/mL), alongside lower MDA (6.41± 0.52 vs. 9.52± 0.63 mmol/L). Pro-inflammatory cytokines were reduced (TNF-a: 4 0 .32 ± 4.84 vs. 54.37± 5.80 pg/mL; IL-6: 50.83± 5.05 vs. 82 .38± 8.46 pg/mL, P < 0.05). Immune function preservation was evident through elevated CD3+ (4 5 .1 8 ± 5 .0 1 % vs. 37 .05 ± 4.92% ) and CD4+ T cells (26.51 ±2.76% vs. 19.78± 2.09%), with a balanced CD4+/CD8+ ratio (1.12± 0.12 vs. 0.72± 0.09).</p><p><strong>Conclusions: </strong>Esketamine-based anesthesia significantly ameliorates postoperative oxidative damage, suppresses inflammatory cytokine release, and preserves cellular immune homeostasis, as evidenced by targeted biochemical and immunological analyses. These findings highlight esketamine's role in modulating perioperative biochemical pathways, potentially enhancing recovery in colorectal cancer surgery.</p>","PeriodicalId":16175,"journal":{"name":"Journal of Medical Biochemistry","volume":"44 5","pages":"1020-1027"},"PeriodicalIF":1.5000,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433307/pdf/","citationCount":"0","resultStr":"{\"title\":\"Esketamine modulates postoperative biochemical markers of oxidative stress, inflammation, and immune dysregulation in laparoscopic colorectal cancer surgery.\",\"authors\":\"Peng Chen, Kun Qian, Kairun Zhu, Lu Xiaoqing, Liu Dajin\",\"doi\":\"10.5937/jomb0-56862\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Laparoscopic colorectal cancer surgery, while minimally invasive, induces systemic oxidative stress, inflammation, and immune dysfunction through surgical trauma and anesthesia-related stress. Esketamine, an NMDA receptor antagonist with antioxidant and anti-inflammatory properties, may mitigate these biochemical perturbations. This study evaluated esketamine's effects on serum biomarkers of oxidative stress (glutathione, catalase, malondialdehyde, superoxide dismutase), inflammatory mediators (TNF-a, CRP IL-6), and T lymphocyte subsets in patients undergoing laparoscopic colorectal cancer resection.</p><p><strong>Methods: </strong>In this randomized controlled trial, 150 stage I-II colorectal cancer patients were allocated to esketamine (0.25 mg/kg bolus + 0.12 mg/kg/h infusion) or control (saline) groups during standardized anesthesia. Preand postoperative serum levels of oxidative stress markers (GSH, CAT, MDA, SOD), inflammatory cytokines (TNF-a, CRP IL-6), and immune cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+ ratio) were quantified via ELISA and flow cytometry. Statistical analysis compared intergroup differences using t-tests and chi-square tests.</p><p><strong>Results: </strong>Postoperatively, the esketamine group exhibited significantly attenuated oxidative stress, with higher GSH (72.43± 6.63 vs. 60 .1 6± 5.57 mg/mL, P < 0.05), CAT (92.56± 8.31 vs. 82.81 ± 7.75 U/mL), and SOD (84.53± 8.02 vs. 69 .93± 7.05 nU/mL), alongside lower MDA (6.41± 0.52 vs. 9.52± 0.63 mmol/L). Pro-inflammatory cytokines were reduced (TNF-a: 4 0 .32 ± 4.84 vs. 54.37± 5.80 pg/mL; IL-6: 50.83± 5.05 vs. 82 .38± 8.46 pg/mL, P < 0.05). Immune function preservation was evident through elevated CD3+ (4 5 .1 8 ± 5 .0 1 % vs. 37 .05 ± 4.92% ) and CD4+ T cells (26.51 ±2.76% vs. 19.78± 2.09%), with a balanced CD4+/CD8+ ratio (1.12± 0.12 vs. 0.72± 0.09).</p><p><strong>Conclusions: </strong>Esketamine-based anesthesia significantly ameliorates postoperative oxidative damage, suppresses inflammatory cytokine release, and preserves cellular immune homeostasis, as evidenced by targeted biochemical and immunological analyses. These findings highlight esketamine's role in modulating perioperative biochemical pathways, potentially enhancing recovery in colorectal cancer surgery.</p>\",\"PeriodicalId\":16175,\"journal\":{\"name\":\"Journal of Medical Biochemistry\",\"volume\":\"44 5\",\"pages\":\"1020-1027\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-08-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433307/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Biochemistry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5937/jomb0-56862\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"BIOCHEMISTRY & MOLECULAR BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Biochemistry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5937/jomb0-56862","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：腹腔镜结直肠癌手术虽然微创，但通过手术创伤和麻醉相关应激诱导全身氧化应激、炎症和免疫功能障碍。艾氯胺酮，一种具有抗氧化和抗炎特性的NMDA受体拮抗剂，可能减轻这些生化扰动。本研究评估了艾氯胺酮对行腹腔镜结直肠癌切除术患者血清氧化应激生物标志物（谷胱甘肽、过氧化氢酶、丙二醛、超氧化物歧化酶）、炎症介质（TNF-a、CRP IL-6）和T淋巴细胞亚群的影响。方法：在本随机对照试验中，150例I-II期结直肠癌患者在标准化麻醉下被分为艾氯胺酮组（0.25 mg/kg丸+ 0.12 mg/kg/h输注）和对照组（生理盐水）。通过ELISA和流式细胞术定量测定术后前后血清氧化应激标志物（GSH、CAT、MDA、SOD）、炎症因子（TNF-a、CRP - IL-6）和免疫细胞亚群（CD3+、CD4+、CD8+、CD4+/CD8+比值）水平。统计学分析采用t检验和卡方检验比较组间差异。结果：术后艾氯胺酮组氧化应激明显减轻，GSH升高（72.43±6.63 vs. 60）。CAT(92.56±8.31 vs. 82.81±7.75 U/mL)， SOD（84.53±8.02 vs. 69）。（93±7.05 nU/mL）， MDA降低（6.41±0.52 vs. 9.52±0.63 mmol/L）。促炎细胞因子减少（TNF-a: 40）。32±4.84 vs. 54.37±5.80 pg/mL；IL-6: 50.83±5.05 vs. 82。38±8.46 pg/mL, P < 0.05)。免疫功能通过CD3+的升高得以保存。18±5。0.1% vs. 37%。CD4+ T细胞（26.51±2.76%∶19.78±2.09%），CD4+/CD8+比值平衡（1.12±0.12∶0.72±0.09）。结论：靶向生化和免疫学分析表明，艾氯胺酮麻醉可显著改善术后氧化损伤，抑制炎症细胞因子释放，保持细胞免疫稳态。这些发现强调了艾氯胺酮在调节围手术期生化途径中的作用，可能促进结直肠癌手术的恢复。
Esketamine modulates postoperative biochemical markers of oxidative stress, inflammation, and immune dysregulation in laparoscopic colorectal cancer surgery.
Background: Laparoscopic colorectal cancer surgery, while minimally invasive, induces systemic oxidative stress, inflammation, and immune dysfunction through surgical trauma and anesthesia-related stress. Esketamine, an NMDA receptor antagonist with antioxidant and anti-inflammatory properties, may mitigate these biochemical perturbations. This study evaluated esketamine's effects on serum biomarkers of oxidative stress (glutathione, catalase, malondialdehyde, superoxide dismutase), inflammatory mediators (TNF-a, CRP IL-6), and T lymphocyte subsets in patients undergoing laparoscopic colorectal cancer resection.
Methods: In this randomized controlled trial, 150 stage I-II colorectal cancer patients were allocated to esketamine (0.25 mg/kg bolus + 0.12 mg/kg/h infusion) or control (saline) groups during standardized anesthesia. Preand postoperative serum levels of oxidative stress markers (GSH, CAT, MDA, SOD), inflammatory cytokines (TNF-a, CRP IL-6), and immune cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+ ratio) were quantified via ELISA and flow cytometry. Statistical analysis compared intergroup differences using t-tests and chi-square tests.
Results: Postoperatively, the esketamine group exhibited significantly attenuated oxidative stress, with higher GSH (72.43± 6.63 vs. 60 .1 6± 5.57 mg/mL, P < 0.05), CAT (92.56± 8.31 vs. 82.81 ± 7.75 U/mL), and SOD (84.53± 8.02 vs. 69 .93± 7.05 nU/mL), alongside lower MDA (6.41± 0.52 vs. 9.52± 0.63 mmol/L). Pro-inflammatory cytokines were reduced (TNF-a: 4 0 .32 ± 4.84 vs. 54.37± 5.80 pg/mL; IL-6: 50.83± 5.05 vs. 82 .38± 8.46 pg/mL, P < 0.05). Immune function preservation was evident through elevated CD3+ (4 5 .1 8 ± 5 .0 1 % vs. 37 .05 ± 4.92% ) and CD4+ T cells (26.51 ±2.76% vs. 19.78± 2.09%), with a balanced CD4+/CD8+ ratio (1.12± 0.12 vs. 0.72± 0.09).
Conclusions: Esketamine-based anesthesia significantly ameliorates postoperative oxidative damage, suppresses inflammatory cytokine release, and preserves cellular immune homeostasis, as evidenced by targeted biochemical and immunological analyses. These findings highlight esketamine's role in modulating perioperative biochemical pathways, potentially enhancing recovery in colorectal cancer surgery.
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The JOURNAL OF MEDICAL BIOCHEMISTRY (J MED BIOCHEM) is the official journal of the Society of Medical Biochemists of Serbia with international peer-review. Papers are independently reviewed by at least two reviewers selected by the Editors as Blind Peer Reviews. The Journal of Medical Biochemistry is published quarterly.
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