J Dent Anesth Pain Med.  2019 Dec;19(6):343-351. 10.17245/jdapm.2019.19.6.343.

Effects of remifentanil preconditioning on factors related to uterine contraction in WISH cells

Affiliations
  • 1Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea. uzleen@me.com
  • 2Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea.

Abstract

BACKGROUND
Preterm labor and miscarriage may occur in stressful situations, such as a surgical operation or infection during pregnancy. Pharyngeal and buccal abscess and facial bone fractures are inevitable dental surgeries in pregnant patients. Remifentanil is an opioid analgesic that is commonly used for general anesthesia and sedation. Nonetheless, no study has investigated the effects of remifentanil on amniotic epithelial cells. This study evaluated the effects of remifentanil on the factors related to uterine contraction and its mechanism of action on amniotic epithelial cells.
METHODS
Amniotic epithelial cells were preconditioned at various concentrations of remifentanil for 1 h, followed by 24-h lipopolysaccharide (LPS) exposure. MTT assays were performed to assess the cell viability in each group. The effects of remifentanil on factors related to uterine contractions in amniotic epithelial cells were assessed using a nitric oxide (NO) assay, western blot examinations of the expression of nuclear factor-kappa B (NF-κB), cyclooxygenase 2 (COX2), and prostaglandin E2 (PGE₂), and RT-PCR examinations of the expression of the proinflammatory cytokines interleukin (IL)-1β and tumor necrosis factor-alpha (TNF-α).
RESULTS
Remifentanil did not affect viability and nitric oxide production of amniotic epithelial cells. Western blot analysis revealed that remifentanil preconditioning resulted in decreased expressions of NF-κB and PGE2 in the cells in LPS-induced inflammation, and a tendency of decreased COX2 expression. The results were statistically significant only at high concentration. RT-PCR revealed reduced expressions of IL-1β and TNF-α.
CONCLUSION
Preconditioning with remifentanil does not affect the viability of amniotic epithelial cells but reduces the expression of factors related to uterine contractions in situations where cell inflammation is induced by LPS, which is an important inducer of preterm labor. These findings provide evidence that remifentanil may inhibit preterm labor in clinical settings.

Keyword

Amniotic Epithelial Cells; Lipopolysaccharides; NF-kappa B; Preterm Labor; Remifentanil; Uterine Contraction

MeSH Terms

Abortion, Spontaneous
Abscess
Anesthesia, General
Blotting, Western
Cell Survival
Cyclooxygenase 2
Cytokines
Dinoprostone
Epithelial Cells
Facial Bones
Female
Humans
Inflammation
Interleukins
Lipopolysaccharides
NF-kappa B
Nitric Oxide
Obstetric Labor, Premature
Pregnancy
Tumor Necrosis Factor-alpha
Uterine Contraction*
Cyclooxygenase 2
Cytokines
Dinoprostone
Interleukins
Lipopolysaccharides
NF-kappa B
Nitric Oxide
Tumor Necrosis Factor-alpha

Figure

  • Fig. 1 MTT assays showed that the viability of amniotic epithelial cells was not affected by different concentrations of remifentanil

  • Fig. 2 NO production in amniotic epithelial cells was not affected by remifentanil.

  • Fig. 3 Preconditioning with remifentanil reduced NF-κB expression after inducing inflammation in cells using with lipopolysaccharide (LPS) in the cells. ##P < 0.01, ###P < 0.001 versus control group; *P < 0.05, **P < 0.01, ***P < 0.001 versus LPS group.

  • Fig. 4 RT-PCR analysis showed that preconditioning with remifentanil reduced IL-1β and TNF-α expression after inducing inflammation in cells using lipopolysaccharide (LPS). ##P < 0.01, ###P < 0.001 versus control group; *P < 0.05, **P < 0.01, ***P < 0.001 versus LPS group.

  • Fig. 5 Preconditioning with remifentanil reduced PGE2 expression after inducing inflammation in cells using lipopolysaccharide (LPS). The expression of COX2 tended to decrease non-significantly at low concentrations and was statistically significant at the highest concentration of remifentanil (1 µg). ##P < 0.01, ###P < 0.001 versus control group; *P < 0.05, **P < 0.01, ***P < 0.001 versus LPS group.


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