Isoflurane but not Fentanyl Causes Apoptosis in Immature Primary Neuronal Cells

Monika Berns1, *, Anna Christine Wolter1, Christoph Bührer1, Stefanie Endesfelder1, Thoralf Kerner2
1 Klinik für Neonatologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
2 Abteilung für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Asklepios Klinikum Harburg, Hamburg, Germany

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© 2017 Shah et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Charité - Universitätsmedizin Berlin, Klinik für Neonatologie D-13344 Berlin, Germany; Tel: +49-30-450566122; Fax: +49-30-450566922; E-mail:



Anaesthetics are widely used in new-borns and preterm infants, although it is known that they may adversely affect the developing brain.


We assessed the impact of the volatile anaesthetic, isoflurane, and the intravenous analgesic, fentanyl, on immature and mature embryonic neuronal cells.


Primary neuronal cultures from embryonic rats (E18) cultured for 5 (immature) or 15 days (mature) in vitro (DIV), respectively, were exposed to isoflurane (1.5 Vol.%) or fentanyl (0.8 - 200 ng/ml) for 24 hours. Experiments were repeated in the presence of the γ-amino butyric acid-A (GABAA) receptor antagonists, bicuculline or picrotoxin (0.1 mmol/l), or the pancaspase inhibitor zVAD-fmk (20 nmol/l). Cell viability was assessed by methyltetrazolium (MTT) metabolism or lactate dehydrogenase (LDH) release.


Isoflurane reduced cell viability significantly in primary neuronal cells cultured for 5 DIV (Δ MTT -28 ±13%, Δ LDH +143 ±15%). Incubation with bicuculline, picrotoxin or zVAD-fmk protected the cells mostly from isoflurane toxicity. After 15 DIV, cell viability was not reduced by isoflurane. Viability of primary neurons cultured for 5 DIV did not change with fentanyl over the wide range of concentrations tested.


Immature primary neurons may undergo apoptosis following exposure to isoflurane but are unaffected by fentanyl. Mature primary neurons were not affected by isoflurane exposure.

Keywords: Apoptosis, Developing brain, Fentanyl, Isoflurane, Immature, Mature, Neuronal cells.