Influence of anesthetic on gene expressoin in colorectal cancer. Anesthetic-specific lncRNA and mRNA profile changes in blood during colorectal cancer resection: A prospective, matched-case pilot study

Prometastatic and antitumor effects of different anesthetics were analyzed in several studies with conflicting results. Underlying perioperative molecular mechanisms mediated by anesthetics potentially affecting tumor phenotype and metastasis are unclear. We hypothesized that anesthetic-specific lncRNA expression changes are induced in the blood circulation and play a role in tumor outcome. We performed high-throughput sequencing and quantitative PCR to identify lncRNA and mRNA expression changes affected by two regimes (total intravenous anesthesia (TIVA) versus volatile anesthetic gas (VAG) in patients undergoing colorectal cancer (CRC) resection. Blood cell-derived total RNA was isolated before and after resection and characterized by RNA sequencing. mRNA-lncRNA interactions and their role in cancer relevant signaling of differentially expressed lncRNAs were identified by bioinformatics analyses. Comparison of these two time points revealed 35 differentially expressed lncRNAs in the TIVA-group, and 25 in the VAG-group with eight shared by both. Two in the TIVA-group, respectively 23 in the VAG-group of in silico identified target-mRNAs were confirmed as differentially regulated in our NGS dataset. Pathway analysis was performed and identified cancer relevant canonical pathways for TIVA. Target-mRNA analysis of VAG showed a markedly worsened immunological response against cancer. In this proof-of-concept study, we were able to identify anesthesic-specific expression changes in lncRNA and mRNA profiles of blood cells. Moreover, our data provide first evidence that anesthesia-induced lncRNA pattern changes may add to the observed differences in CRC outcome after tumor resection.