LAUSR

Different pathways have been proposed to explain the apoptotic effects of local anaesthetics, such as extracellular signalling-regulated mitogen-activated protein kinase and protein kinase B-mediated processes [9, 10]. Earlier reports from our team have shown that in HaCaT cells, ROP induced apoptosis through the cleavage of PARP caspase substrate, and the downregulation of clusterin/apoliporotein J, a cell survival protein [7]. Nevertheless, in distinct settings, the cytotoxicity of local anaesthetics may theoretically be beneficial, for example, by clearing up ectopic epithelial cells which have been relocated during skin surgery, thus supporting wound site remodelling. Also, apoptotic in situ effects of LEV and ROP might also compromise the viability of malignant cells during skin cancer surgery. In conclusion, compared to ROP, LEV exerted greater acute cytotoxicity on HaCaT cells, regarding particularly apoptosis at lower drug concentrations (0.4 mg/mL), whereas colony forming efficiency and size of HaCaT cells (indicators of cell population recovery capacity) were better preserved with LEV. Although conclusions based on studies on cell lines may not be directly applicable to clinical practice, the results presented here may be considered during the planning of future trials.