TECHNOLOGY, EDUCATION AND SAFETY: Edited by Stephan A. LoerAnesthesia-induced immune modulationRossaint, Jan; Zarbock, AlexanderAuthor Information Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany Correspondence to Alexander Zarbock, Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149 Münster, Germany. Tel: +49 251 83 47252; fax: +49 251 88704; e-mail: [email protected] Current Opinion in Anaesthesiology: December 2019 - Volume 32 - Issue 6 - p 799-805 doi: 10.1097/ACO.0000000000000790 Buy Metrics Abstract Purpose of review Surgery, invasive procedures and anesthesia itself may induce an inflammatory response in the patient. This represents an evolutionary inherited and conserved response of the host to environmental stimuli and may lead to both beneficial and potentially harmful effects. This review highlights the mechanisms of anesthesia-induced and perioperative immune modulation. Recent findings The innate and adaptive immune system serve the host in protection against invading pathogens. Yet, an inflammatory immune response may also be induced by different noninfectious stimuli, for example invasive perioperative procedures and the surgical trauma itself. These stimuli may lead to the activation of the immune system with the consequence of perturbation of cell, tissue of even organ functions in cases of an overshooting immune response. Several perioperative factors have been identified that modulate the immune response, for example different anesthetic drugs and surgical tissue injury, but their impact on immune system modulation may also vary with respect to the procedural context and include both pro-inflammatory and anti-inflammatory effects. Summary The current review will highlight the current knowledge on the perioperative anesthesia-induced and surgery-induced modulation of the immune response and also address possible intervention strategies for the development of future therapeutic approaches. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.