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Dexmedetomidine AND immunity

F Guo, Q Wang, C Y Yan, H Y Huang, X Yu, L Y Tu
OBJECTIVE: To evaluated the 3 sedation regimen for patients with septic shock. METHODS: The randomized controlled trial wan conducted. Forty-five patients with septic shock were assigned to 3 groups (midazolam group, propofol group, and dexmedetomidine group) randomly. The basic characteristics of patients, the duration of mechanical ventilation, the length of stay in the ICU, the death rate for 28 days and the regulatory cell (Treg) in peripheral blood were observed...
June 14, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
José Manuel Mier-Odriozola
Non-intubated thoracic surgery entails procedures performed through regional anesthesia method in awake or mildly sedated, spontaneously ventilating patients. This method represents advantages for the cardiovascular system, and reduces the orotracheal trauma, postoperative atelectasis, and pneumonia. It also possibly reduces costs. Other theoretical advantages are: easier acceptance of surgery, attenuated stress hormone and immune response, and possibly a better survival in oncological surgery. We show a 34-year-old woman with sever palmar-axillary hyperhidrosis...
March 2016: Gaceta Médica de México
Gong Chen, Yuan Le, Lei Zhou, Li Gong, Xiaoxiao Li, Yunli Li, Qin Liao, Kaiming Duan, Jianbin Tong, Wen Ouyang
AIMS: To investigate the effects and underlying mechanism of dexmedetomidine on the cultured human dendritic cells (DCs). METHODS: Human DCs and cytotoxic T lymphocytes (CTLs) were obtained from human cord blood mononuclear cells by density gradient centrifugation. Cultured DCs were divided into three groups: dexmedetomidine group, dexmedetomidine plus yohimbine (dexmedetomidine inhibitor) group and control group. DCs in the three groups were treated with dexmedetomidine, dexmedetomidine plus yohimbine and culture medium, respectively...
2016: PloS One
N M H Bulow, E Colpo, R P Pereira, E F M Correa, E P Waczuk, M F Duarte, J B T Rocha
Cardiopulmonary bypass (CPB) with extracorporeal circulation produces changes in the immune system accompanied by an increase in proinflammatory cytokines and a decrease in anti-inflammatory cytokines. We hypothesize that dexmedetomidine (DEX) as an anesthetic adjuvant modulates the inflammatory response after coronary artery bypass graft surgery with mini-CPB. In a prospective, randomized, blind study, 12 patients (4 females and 8 males, age range 42-72) were assigned to DEX group and compared with a conventional total intravenous anesthesia (TIVA) group of 11 patients (4 females and 7 males)...
2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Lei Wu, Haoxuan Lv, Wenjie Luo, Shu Jin, Yannan Hang
OBJECTIVE: To study the effects of dexmedetomidine (Dex) on cellular immunity during the perioperative period in children with brain neoplasms. METHODS: Forty children with brain neoplasms scheduled for selective operation were recruited and divided randomly into two groups. The Dex group was given a loading dose of 1 μg*kg(-1) Dex 15 minutes before anesthesia induction followed by a continuous infusion of 0.5 μg × kg(-1) × h(-1) Dex. Patients in control group received a same volume of normal saline for a same time period...
2015: International Journal of Clinical and Experimental Medicine
R M McMurphy, R J Fels, M J Kenney
Sedatives influence the immune system and centrally-acting alpha2-adrenergic receptor agonists, including Dexmedetomidine (Dex), modulate sympathetic nerve discharge (SND). Because sedatives are used under medical conditions that include elderly patients, and because advancing age attenuates SND responsivity to various interventions, we tested the hypothesis that splenic sympathoinhibitory responses to Dex would be attenuated in aged compared with young Fischer 344 rats. Dex-mediated reductions in splenic SND were similar in aged and young baroreceptor-intact and -denervated rats, indicating that SND changes to Dex administration occur in an age-independent manner...
July 2015: Autonomic Neuroscience: Basic & Clinical
Yulan Wang, Xuefeng Xu, Hong Liu, Fuhai Ji
BACKGROUND: Surgical stress may cause immunosuppression especially in patients who have surgery for primary tumor removed. This study aimed to explore the effects of dexmedetomidine on immune and inflammatory response in patients undergoing radical gastrectomy. METHODS: After the institutional review board approval and written informed consent, forty patients undergoing radical gastrectomy were equally randomized to receive dexmedetomidine infusion (Dex group; 0...
March 2015: Journal of Surgical Research
I Grosu, P Lavand'homme
Inflammation can be defined as the host response when confronted with an aggression. The purpose of the inflammatory reaction is the defense of the host for re-establishing the baseline homeostasis of the organism. Compared to the neuroendocrine changes associated to the stress response to injury, the inflammatory reaction is the major determinant of patient's recovery in the perioperative period. Perioperative inflammation is involved in the occurrence of various postoperative adverse outcomes other than only acute pain...
September 2015: Minerva Anestesiologica
Kumiko Tanabe, Rie Matsushima-Nishiwaki, Osamu Kozawa, Hiroki Iida
Dexmedetomidine, an α2-adrenoceptor agonist, is used as a sedative medication for criticalyl ill patients and is known to exert neuroprotective effects by direct action on neurons and indirect action on neurons through astrocytes. Interleukin (IL)-6 plays a key role in neuroinflammation, which accompanies infection, traumatic brain injury, ischemia, neurodegenerative disorders, as both a pro-inflammatory cytokine and an anti-inflammatory cytokine. Dexmedetomidine suppresses immune function. However, the effects of dexmedetomidine on cytokine synthesis in the central nervous system (CNS) remain elusive...
October 2014: International Journal of Molecular Medicine
Rick Sai-Chuen Wu, King-Chuen Wu, Chiu-Chen Huang, Yi-Ying Chiang, Chia-Chen Chen, Ching-Lung Liao, Chin-Nan Chu, Jing-Gung Chung
Various sedative agents, including dexmedetomidine (dex), induce immunosuppression, and enhance infection progression. However, there was no information on how anesthetic affects local and systemic cellular immune function. We conducted this study to examine the impact of dex on the differentiation and function of immune cells at site of inflammation and in peripheral blood during endotoxemia of mice. In BALB/c mice with and without endotoxemia, we evaluated the influence of two dosages of 5 and 50 mcg/kg/h intravenous dex on immune cells: including number of T cells (CD3), B cells (CD19), natural killer cells (CD8a), monocytes (CD11b), and macrophages (Mac-3) in peripheral blood, the activities of macrophages in peripheral blood and in peritoneal lavage, and proliferation of B and T cells and of natural killer cells activity in the spleen...
December 2015: Environmental Toxicology
M J Kenney, B T Larsen, R M McMurphy, D Mason, R J Fels
Recent lines of inquiry indicate that sedatives can influence the immune system, leading to the concept of sedative-induced immunomodulation. It has been hypothesized that sedatives may alter immune responses by modulating the sympathetic nervous system, however, little information is known regarding the effects of sedatives on regulation of splenic sympathetic nerve discharge (SND), a significant omission based on the functional role that changes in splenic SND exert on splenic cytokine gene expression. The present investigation determined the effect of systemic Dexmedetomidine (Dex) administration on the level of directly-recorded splenic SND and tested the hypothesis that the intravenous administration of Dex would inhibit splenic SND in anesthetized rats...
July 2014: Autonomic Neuroscience: Basic & Clinical
Yeon Jang, Mi-Young Yeom, Eun-Sun Kang, Ji-Won Kang, Ho-Kyung Song
BACKGROUND: Pain plays roles in both the nervous system and immune system. Changes in the neuroendocrine pathway under pain conditions give rise to sympathetic outflow with increased plasma catecholamines and activate immune reactions. Dexmedetomidine exerts sedative, analgesic, and anesthetic-sparing effects and is known to diminish pro-inflammatory processes by central sympatholytic effects. To investigate the influence of the analgesic effect of dexmedetomidine on immunomodulation under pain conditions, splenic natural killer (NK) tumoricidal cytotoxic activity, proliferative ability of T lymphocytes, and cytokine changes were assessed...
2014: International Journal of Medical Sciences
Xiaobao Zhang, Jun Wang, Wenyi Qian, Jingjing Zhao, Li Sun, Yanning Qian, Hang Xiao
Astrocytes play an important role in immune regulation in the central nervous system (CNS). Dexmedetomidine (DEX) has been reported to exert anti-inflammatory effects on astrocytes stimulated by lipopolysaccharide (LPS) both in vitro and in vivo studies. However, the underlying molecular mechanisms remain poorly understood. This study was designed to evaluate the effects of DEX on tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) gene expressions in LPS-challenged astrocytes. Moreover, c-Jun N-terminal kinases (JNKs) and p38 mitogen-activated protein kinase (MAPK) pathways in LPS-challenged astrocytes were also investigated...
June 2014: Inflammation
Michael A Smith, Maho Hibino, Bonnie A Falcione, Katherine M Eichinger, Ravi Patel, Kerry M Empey
OBJECTIVE: To evaluate the evidence describing the immunosuppressive and pharmacokinetic properties of commonly used analgesic and sedation agents in critically ill patients. DATA SOURCES: MEDLINE (January 1980-September 2013) was searched. STUDY SELECTION AND DATA EXTRACTION: All in vitro and in vivo studies that evaluated the immune-modulating properties of analgesic and sedation agents commonly used in the critically ill were included. Full-text and abstract-only articles (noted) were included in this review...
January 2014: Annals of Pharmacotherapy
Hironobu Ueshima, Takefumi Inada, Koh Shingu
Dexmedetomidine is a highly-selective α2-adrenergic receptor agonist used for sedation of critically ill patients in an intensive care setting. Dendritic cells (DCs) in peripheral tissues sense certain foreign antigens and ingest and process them, while migrating to the regional lymph node. Then, DCs present the processed antigen on their surface to stimulate the clonal proliferation of cognitive lymphocytes, leading to the establishment of adaptive immunity. In murine bone marrow-derived DCs, dexmedetomidine significantly delayed the intracellular proteolytic degradation of ovalbumin, while it did not affect phagocytosis, decreased the expression of the surface molecules I-A(b) and CD86, and suppressed cognitive helper T-cell proliferation...
October 2013: Immunopharmacology and Immunotoxicology
Gulay Erdogan Kayhan, Mehmet Gul, Basak Kayhan, Ender Gedik, Ulku Ozgul, Elcin Latife Kurtoglu, Mahmut Durmus, Mehmet Özcan Ersoy
BACKGROUND: Since sedatives are often administered to immune-compromised and critically ill patients, our understanding of immunomodulation by sedation will be critical. Dexmedetomidine, a selective α2-adrenergic receptor agonist, is often used for sedation and analgesia especially in intensive care units. There are conflicting and little data concerning both the effect and the mechanism of dexmedetomidine on immune response. In our study, we aimed to investigate the effect of dexmedetomidine on immune system at two different doses (5 μg...
August 2013: Journal of Surgical Research
Alex Bekker, Michael Haile, Richard Kline, Sorosch Didehvar, Ramesh Babu, Frank Martiniuk, Michael Urban
BACKGROUND: Surgery induces a variety of metabolic, endocrine, and immune changes collectively known as the "stress response," which may often lead to prolonged postoperative convalescence. Anesthetic management may modulate this physiological response, thus affecting the postoperative course. We hypothesized that the intraoperative administration of dexmedetomidine (DEX), a sympatholytic agent, would reduce the stress response and improve the quality of recovery in patients undergoing major surgery...
January 2013: Journal of Neurosurgical Anesthesiology
Robert D Sanders, Tracy Hussell, Mervyn Maze
As the armamentarium for sedation in the critically ill expands, opportunities will develop to modulate the immune responses of patients by way of the direct immune and neural-immune interactions of the sedatives. Control of autonomic activity through the use of appropriate sedation may be critical in this matter. Likewise analgesic-based sedation, with increased opioid dosage, may not prove beneficial in the setting of infection; whether avoidance of morphine in preference for a fentanyl derivative will help is unclear...
December 2011: Anesthesiology Clinics
Koichi Yuki, Sulpicio G Soriano, Motomu Shimaoka
BACKGROUND: Sedative drugs modify immune cell functions via several mechanisms. However, the effects of sedatives on immune function have been primarily investigated in neutrophils and macrophages, and to the lesser extent lymphocytes. Lymphocyte function-associated antigen-1 (LFA-1) is an adhesion molecule that has a central role in regulating immune function of lymphocytes including interleukin-2 (IL-2) production and lymphocyte proliferation. Previous clinical studies reported that propofol and isoflurane reduced IL-2 level in patients, but midazolam did not...
April 2011: Anesthesia and Analgesia
Pratik P Pandharipande, Robert D Sanders, Timothy D Girard, Stuart McGrane, Jennifer L Thompson, Ayumi K Shintani, Daniel L Herr, Mervyn Maze, E Wesley Ely
INTRODUCTION: Benzodiazepines and alpha2 adrenoceptor agonists exert opposing effects on innate immunity and mortality in animal models of infection. We hypothesized that sedation with dexmedetomidine (an alpha2 adrenoceptor agonist), as compared with lorazepam (a benzodiazepine), would provide greater improvements in clinical outcomes among septic patients than among non-septic patients. METHODS: In this a priori-determined subgroup analysis of septic vs non-septic patients from the MENDS double-blind randomized controlled trial, adult medical/surgical mechanically ventilated patients were randomized to receive dexmedetomidine-based or lorazepam-based sedation for up to 5 days...
2010: Critical Care: the Official Journal of the Critical Care Forum
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