Abstract
Thrombotic events occurring in either arteries or veins are the primary causes of fatal perioperative cardiovascular events. Risk factors for deep vein thrombosis, several of which are evidently associated with specific surgical procedures, are quite different from those for arterial thrombosis (e.g., aging or atherosclerotic diseases). Thrombus formed in arteries consists mainly of platelets coated with fibrin (i.e., white thrombus), while venous thrombus formed at relatively lower shear stress consists of all blood components including erythrocytes as well as leukocytes infiltrated with fibrin (red thrombus). Clinical evidence indicates beneficial roles of neuraxial anesthesia/ analgesia in the prevention of VTE for patients undergoing high risk surgical procedures. To date, mechanisms of action of drugs used for neuraxial anesthesia/analgesia to prevent venous thrombosis are uncertain. However, accumulation of clinical as well as experimental findings points to the involvement of immune cells (especially monocytes) in red thrombus generation and to the interaction of anesthetics with these cells. We also suggest that adhesion molecules associated with the formation of monocyte platelet aggregates as well as substance P: neurokinin-1 receptor (SP/NK1R) pathway that involves neurogenic inflammation are crucial. Local anesthetics and NK1R antagonists are candidate drugs that may possess the capability to prevent venous thrombotic disorders in perioperative settings.
Keywords: Perioperative thrombosis, neuraxial anesthesia/analgesia, substance P, neurokinin-1 receptor, microparticle, tissue factor, monocyte, local anesthetics.
Current Pharmaceutical Design
Title:Mechanisms of Action of Anesthetics for the Modulation of Perioperative Thrombosis: Evidence for Immune Mechanisms from Basic and Clinical Studies
Volume: 20 Issue: 36
Author(s): Toshiharu Azma, Florin Tuluc, Taishin Ito, Chikako Aoyama-Mani, Shinji Kawahito and Hiroyuki Kinoshita
Affiliation:
Keywords: Perioperative thrombosis, neuraxial anesthesia/analgesia, substance P, neurokinin-1 receptor, microparticle, tissue factor, monocyte, local anesthetics.
Abstract: Thrombotic events occurring in either arteries or veins are the primary causes of fatal perioperative cardiovascular events. Risk factors for deep vein thrombosis, several of which are evidently associated with specific surgical procedures, are quite different from those for arterial thrombosis (e.g., aging or atherosclerotic diseases). Thrombus formed in arteries consists mainly of platelets coated with fibrin (i.e., white thrombus), while venous thrombus formed at relatively lower shear stress consists of all blood components including erythrocytes as well as leukocytes infiltrated with fibrin (red thrombus). Clinical evidence indicates beneficial roles of neuraxial anesthesia/ analgesia in the prevention of VTE for patients undergoing high risk surgical procedures. To date, mechanisms of action of drugs used for neuraxial anesthesia/analgesia to prevent venous thrombosis are uncertain. However, accumulation of clinical as well as experimental findings points to the involvement of immune cells (especially monocytes) in red thrombus generation and to the interaction of anesthetics with these cells. We also suggest that adhesion molecules associated with the formation of monocyte platelet aggregates as well as substance P: neurokinin-1 receptor (SP/NK1R) pathway that involves neurogenic inflammation are crucial. Local anesthetics and NK1R antagonists are candidate drugs that may possess the capability to prevent venous thrombotic disorders in perioperative settings.
Export Options
About this article
Cite this article as:
Azma Toshiharu, Tuluc Florin, Ito Taishin, Aoyama-Mani Chikako, Kawahito Shinji and Kinoshita Hiroyuki, Mechanisms of Action of Anesthetics for the Modulation of Perioperative Thrombosis: Evidence for Immune Mechanisms from Basic and Clinical Studies, Current Pharmaceutical Design 2014; 20 (36) . https://dx.doi.org/10.2174/1381612820666140204102044
DOI https://dx.doi.org/10.2174/1381612820666140204102044 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Heat Shock Proteins - Two Sides of a Coin
Current Cardiology Reviews Therapeutic Strategies in Autoimmune Diseases by Interfering with Leukocyte Endothelium Interaction
Current Pharmaceutical Design Gender Specific Aspects of Cell Death in the Cardiovascular System
Current Pharmaceutical Design Recombinant Activated Factor VII as a General Haemostatic Agent:Evidence-Based Efficacy and Safety
Current Drug Safety Protein O-GlcNAcylation: A Critical Regulator of the Cellular Response to Stress
Current Signal Transduction Therapy Fibroblast Growth Factor-Inducible 14: Multiple Roles in Tumor Metastasis
Current Molecular Medicine Low Radiation Dose with Triple-Rule-Out CT Angiography in Diagnosis of Acute Chest Pain
Current Medical Imaging Lipid Management and Peripheral Arterial Disease
Current Drug Targets Flavonoids and Linderone from Lindera oxyphylla and their Bioactivities
Combinatorial Chemistry & High Throughput Screening Herbal Medicines for Diabetes Management and its Secondary Complications
Current Diabetes Reviews microRNAs: Innovative Targets for Cerebral Ischemia and Stroke
Current Drug Targets The Effect of Anti-B-cell Therapy on the Development of Atherosclerosis in Patients with Rheumatoid Arthritis
Current Pharmaceutical Design Cellular Mechanisms of the Protective Effect of Polyphenols on the Neurovascular Unit in Strokes
Cardiovascular & Hematological Agents in Medicinal Chemistry Apixaban - Metabolism, Pharmacologic Properties and Drug Interactions
Current Drug Metabolism Role of Vascular Progenitor Cells in Cardiovascular Disease
Current Pharmaceutical Design Inflammation Drives Alzheimer's Disease: Emphasis on 5-lipoxygenase Pathways
Current Neuropharmacology Prevention and treatment of atherosclerosis with flaxseed -derived compound secoisolariciresinol diglucoside
Current Pharmaceutical Design A Mitochondrial Approach to Cardiovascular Risk and Disease
Current Pharmaceutical Design Current Scenario of 1,4-Diazepines as Potent Biomolecules-A Mini Review
Mini-Reviews in Medicinal Chemistry A Review on Recent Patents in Digital Processing for Cardiac Electric Signals (II): Advanced Systems and Applications
Recent Patents on Biomedical Engineering (Discontinued)