Table 3.
Immunomodulatory effects of sedative agents used in ICU patients
| Sedative agent | References | Main results |
|---|---|---|
| Opioids | [55,56,99] | Suppression of mitogen-stimulated proliferation of T and B-lymphocytes |
| [57-59,97] | Suppression of natural killer, and primary antibody production | |
| [60-62] | Inhibition of phagocytosis by macrophages | |
| [63-70,101,102] | Suppression of IL2, IL12, INFγ, and NO production | |
| [77-80,82,83,94,97-99] | Activation of sympathic nervous system, and the hypothalamic-pituitary-adrenal axis | |
| [84] | Enhancement of Pseudomonas aeruginosa virulence | |
| [85] | Reduction of bacterial clearance via impairment of TLR9-NF-κB signaling | |
| [86] | Enhancement of cellular apoptosis | |
| Benzodiazepines | [105] | Inhibition of IL-1, IL-6, and TNF-α production |
| [109] | Supression of macrophage migration and phagocytosis | |
| Clonidine and dexmetetomidine | [119] | Reduction of IL-1β, and IL6 production |
| [121] | Sympatholytic effects | |
| Propofol | [112,113] | Suppression of H2O2, NO, and O* production; improvement of endothelial dysfunction |
| [113] | Suppression of TNF-α, IL-β, IL-10 | |
| [114] | Attenuation of leukosequestration, pulmonary edema, and pulmonary hyperpermeability | |
| Barbiturates | [124] | Suppression of antigen-specific lymphocyte proliferation, and IL-2 production |
| [125] | Suppression of TNF-α mRNA expression | |
| [126] | Impairment of phagocytosis |
ICU: intensive care unit; IL: interleukin; INF: interferon; NO: nitric oxide; TNF: tumor necrosis factor.