Fig. 3

The anesthetic effects on cancer cell biology, anti-cancer immunity, and cell-to-cell communication via miRNAs. Anesthetic exposure during cancer surgery can affect normal cells, anti-cancer immune cells and cancer cells directly or indirectly via miRNA expression changes. Mature miRNA induced by anesthesia inhibits its target protein expression in the affected cell and the adjacent cell with gap junction. Also, miRNA with RISC is released as EV from cells by exocytosis or in microvesicles, which enable miRNA to alter the target protein expressions in the distant cells including normal cells, anti-cancer immune cells and other cancer cells: ‘cell-to-cell communication’. miRNA: micro RNA, RISC: RNA-induced silencing complex, EV: extracellular vesicle