Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 7 2023 07 15 1378 1389 Yang Liu The Second Affiliated Hospital of Qiqihar Medical University Shuyue Wang Department of Anesthesiology, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, China Weining Yang Operating Room, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, China 2023 02 10 2023 07 15 Background: We aimed to explore the mechanism of the effect of remimazolam (Rem) on the proliferation of colorectal cancer (CRC) cells with CRC as a disease context. Methods: Translocation protein (TSPO) expression in CRC was determined by Western blotting and qRT-PCR in the Second Affiliated Hospital of Qiqihar Medical University from March 2019 to February 2022. TSPO-interacting proteins were predicted through string database. The proliferation was measured by CCK-8 and 5-ethynyl-2-deoxyuridine (EDU). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) and clonal colony on cells were formed to screen for the optimal concentration of Rem and to detect the viability. The expression of apoptosis-related proteins, Bcl-2 and P53, was determined by qRT-PCR and Western blotting. The effect of Rem on the expression of tumor markers, CEA and CA19-9, in CRC was examined through ELISA. Results: TSPO expression in CRC tissues and cells was higher than that in ANT samples and normal intestinal epithelial cells. Over-expression of TSPO promoted the proliferation of HCT116 and the expression of tumor markers CEA and CA19-9 and inhibited the apoptosis of HCT116. Interference with TSPO inhibited the proliferation of HCT116 and the expression of CEA and CA19-9 and promoted the apoptosis of HCT116. 1 μg/mL Rem could inhibit the viability of HCT116, the proliferation of HCT116 and the expression of CEA and CA19-9, and improve the apoptosis of HCT116. TSPO could interact with VDAC and affect its protein expression, and Rem could inhibit the proliferation and the expression of CEA and CA19-9 through the TSPO/VDAC pathway, to promote its apoptosis. Conclusion: Rem affects the proliferation of CRC cells by inhibiting the TSPO/VDAC pathway. https://ijph.tums.ac.ir/index.php/ijph/article/view/31193 https://ijph.tums.ac.ir/index.php/ijph/article/download/31193/7980