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Inhibitory effects of S-(-) and R-(+) bupivacaine on neutrophil function

I D Welters1, A Menzebach, T W Langefeld

  • 1Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-Universität, Rudolf-Buchheim-Str. 7, 35385 Giessen, Germany. Ingeborg.D.Welters@chiru.med.uni-giessen.de

Abstract

Insights

Bupivacaine, a local anesthetic, was found to inhibit neutrophil functions like phagocytosis and oxidative burst. While enantiomers showed some differences, racemic bupivacaine

Area of Science:

  • Immunology
  • Pharmacology
  • Cell Biology

Background:

  • Polymorphonuclear leukocytes (PMN) are crucial for bacterial defense via phagocytosis.
  • Local anesthetics are known to affect PMN functions, including migration and oxidative burst.
  • This study investigates the impact of bupivacaine and its enantiomers on neutrophil immune functions.

Purpose of the Study:

  • To determine the influence of racemic bupivacaine and its enantiomers (R-(+) and S-(-)) on neutrophil phagocytic activity.
  • To assess the effects on oxidative burst and surface expression of complement and Fcgamma receptors.
  • To elucidate potential enantiomer-specific effects on these leukocyte functions.

Main Methods:

  • Neutrophil function assays were performed on venous blood pre-incubated with varying concentrations of bupivacaine enantiomers.
  • Surface receptor expression (CD16, CD35, CD11b) was measured using FITC-labeled antibodies and flow cytometry.
  • Phagocytic activity and oxidative burst were quantified by measuring the ingestion of Staphylococcus aureus and the conversion of dihydrorhodamine 123, respectively.

Main Results:

  • Racemic bupivacaine demonstrated a time- and concentration-dependent inhibition of neutrophil surface receptor expression, phagocytosis, and oxidative burst.
  • The S-(-) bupivacaine enantiomer exhibited less inhibitory action compared to R-(+) and racemic bupivacaine.
  • However, the observed enantiomer-specific effects were minor in the context of the overall functional changes.

Conclusions:

  • Bupivacaine impairs neutrophil surface receptor expression, potentially leading to reduced phagocytic activity and oxidative burst.
  • These findings suggest a mechanism by which local anesthetics can modulate innate immune responses.
  • Enantiomer-specific effects of bupivacaine on leukocyte functions appear to play a limited role.

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