The effects of general anesthesia and surgery on basal and interferon stimulated natural killer cell activity of humans.

UNLABELLED: Natural killer (NK) cells can lyse certain tumor cells as well as virally infected cells without prior sensitization. Animal studies have shown that general anesthesia (GA) alone or GA followed by surgery decreases both basal NK cytotoxicity and enhancement of NK activity by interferon (IFN). The purpose of this study was to determine whether similar inhibition of NK activity by anesthesia and surgery occurs in humans. Venous blood was drawn 1 h before and 20-24 h after surgery under isoflurane/N2O anesthesia. Peripheral blood mononuclear cells (PBMC) were assayed for basal and IFN-alpha-stimulated NK cytotoxicity using a chromium release assay with K562 cells as targets. Flow cytometry was used to enumerate NK, T-helper, and T-cytotoxic/suppressor cell populations in each sample. Basal NK activity was significantly depressed after GA and GA and surgery. Although the postoperative IFN treatment increased NK activity to the preoperative basal level, the level achieved was significantly lower than the level observed after IFN stimulation of PBMC as evaluated preoperatively. This decreased activity does not seem to be the result of a decrease in the percentage of circulating NK cells. The decrease in NK activity after anesthesia and surgery may lead to increased susceptibility to infection and/or tumor dissemination and thus needs to be explored. IMPLICATIONS: Natural killer cells can kill cancer cells and virally infected cells. This study shows that surgery with general anesthesia leads to decreased natural killer cell activity as assessed int he laboratory. This decreased natural killer cell activity may lead to infection or tumor dissemination. NK activity can be restored to presurgery levels by treating isolated NK cells with interferon-alpha.