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Enzyme induction by enflurane in man.

M L Berman, O C Green, R K Calverley

    Anesthesiology
    |June 1, 1976
    PubMed
    Summary
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    Enflurane anesthesia may induce liver enzymes, as indicated by a significant increase in the 6-beta-hydroxycortisol (6-OHF) to 17-hydroxycorticosteroids (17-OHCS) ratio in urine post-exposure. This finding suggests potential alterations in drug metabolism pathways.

    Area of Science:

    • Pharmacology and Toxicology
    • Hepatology
    • Anesthesiology

    Background:

    • Cortisol metabolism involves hepatic microsomal enzymes.
    • 6-beta-hydroxycortisol (6-OHF) and 17-hydroxycorticosteroids (17-OHCS) are key urinary cortisol metabolites.
    • Anesthetic agents can potentially induce or inhibit these enzymes.

    Purpose of the Study:

    • To investigate the effect of enflurane anesthesia on hepatic microsomal enzyme activity.
    • To assess whether enflurane induces enzymes involved in cortisol metabolism.
    • To use the ratio of 6-OHF to 17-OHCS as a biomarker for enzyme induction.

    Main Methods:

    • Measurement of urinary 6-OHF and 17-OHCS concentrations in healthy adult males.
    • Comparison of the 6-OHF/17-OHCS ratio in urine collected before and after enflurane anesthesia (9.6 MAC-hours).

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  • Analysis of urine samples collected 5 days pre-anesthesia and 16-18 hours post-anesthesia.

    • Main Results:

    • A marked increase in the 6-OHF/17-OHCS ratio was observed in five out of six volunteers post-anesthesia.
    • One volunteer showed a slight decrease in the ratio.
    • The data suggests a consistent effect of enflurane on cortisol metabolite ratios.

    Conclusions:

    • Enflurane anesthesia appears to induce hepatic microsomal enzymes responsible for cortisol metabolism.
    • The 6-OHF/17-OHCS ratio serves as a sensitive indicator of enflurane-induced enzyme activity.
    • Further research is warranted to elucidate the clinical implications of this enzyme induction.