Sugammadex reverses vecuronium-mediated inhibition of reactive oxygen species production in endothelial cells and vascular smooth muscle cells

Abstract

Neuromuscular blockers, including vecuronium and rocuronium, have been widely used during various operations. Sugammadex, a gamma-cyclodextrin with a high binding capacity for neuromuscular blockers, has been widely used for the rapid and complete reversal of induced neuromuscular blockade via encapsulation. However, the effects of sugammadex on neuromuscular blocker-induced changes in reactive oxygen species (ROS) production remain largely unknown. The present in vitro study was conducted, aiming to bridge this gap in knowledge. The effects of neuromuscular blockers vecuronium or rocuronium (alone) and neuromuscular blockers combined with sugammadex, and sugammadex (alone) on ROS production, induced by various stimuli, were examined using 2',7'-di-chlorodihydrofluorescein diacetate staining. The aim was to measure intracellular ROS. Sugammadex attenuated vecuronium-mediated inhibition of ROS production induced by angiotensin II. It also oxidized low-density lipoprotein in vascular smooth muscle cells and endothelial cells, respectively. However, these effects were not observed with rocuronium. Sugammadex did not significantly change vecuronium - and rocuronium-mediated inhibition of ROS production induced by lipopolysaccharides in macrophage cell RAW264.7. Sugammadex, alone, did not significantly alter ROS production. Present results suggest that sugammadex reverses vecuronium-mediated inhibition of ROS production induced by oxidized low-density lipoprotein and angiotensin II in endothelial and vascular smooth muscle cells. This may be due to the encapsulation of vecuronium by sugammadex.