Roles of anesthetics in modulating neutrophil extracellular traps formation: a review of current literature

Neutrophil extracellular traps (NETs) represent a critical defensive mechanism against pathogens. However, dysregulated NETs have been implicated in a range of pathological conditions. More recently, increasing attention has been given to its implications in perioperative settings. This has led to increasing interest in how common anesthetics would modulate the neutrophil ability to form NETs. Although their ability to modulate the immune system has long been recognized, a better understanding of the impact of common anesthetics on NETs release is still needed. This may reveal considerations for optimizing immune function and personalizing anesthetic techniques, especially for vulnerable perioperative and intensive care unit patients. In this review, we comprehensively discuss recent advancements in understanding the role of common anesthetics in modulating the capacity of neutrophils to form NETs and the related mechanisms. Gaining insights into the effects of anesthetics on NETs may guide new strategies to reduce complications and improve the recovery and survival of perioperative and ICU patients.