The influence of dexmedetomidine and propofol on circulating cytokine levels in healthy subjects
随机对35名健康年轻男性受试者使用右美托咪定(n = 18)或异丙酚(n = 17)进行麻醉，直到受试者意识消失(LOR)。采用多参数免疫分析法检测48种细胞因子、趋化因子和生长因子水平。每个受试者在基线和最高药物浓度下测定药物浓度。
Minna Kallioinen, Annalotta Scheinin, Mikael Maksimow,et,al. The influence of dexmedetomidine and propofol on circulating cytokine levels in healthy subjects. BMC Anesthesiology 2019;19:222
Background: Surgery and diseases modify inflammatory responses and the immune system. Anesthetic agents also have effects on the human immune system but the responses they induce may be altered or masked by the surgical procedures or underlying illnesses. The aim of this study was to assess how single-drug dexmedetomidine and propofol anesthesia without any surgical intervention alter acute immunological biomarkers in healthy subjects.
Methods: Thirty-five healthy, young male subjects were anesthetized using increasing concentrations of dexmedetomidine (n = 18) or propofol (n = 17) until loss of responsiveness (LOR) was detected. The treatment allocation was randomized. Multi-parametric immunoassays for the detection of 48 cytokines, chemokines and growth factors were used. Concentrations were determined at baseline and at the highest drug concentration for each subject.
Results: The changes in the concentration of eotaxin (decrease after dexmedetomidine) and platelet-derived growth factor (PDGF, increase after propofol) were statistically significantly different between the groups. Significant changes were detected within both groups; the concentrations of monocyte chemotactic protein 1, chemokine ligand 27 and macrophage migration inhibitory factor were lower in both groups after the drug administration.Dexmedetomidine decreased the concentration of eotaxin, interleukin-18, interleukin-2Rα, stem cell factor, stem cell growth factor and vascular endothelial growth factor, and propofol decreased significantly the levels of hepatocyte growth factor, IFN-γ-induced protein 10 and monokine induced by IFN-γ, and increased the levels of interleukin-17,interleukin-5, interleukin-7 and PDGF.
Conclusions: Dexmedetomidine seemed to have an immunosuppressive effect on the immune system whereas propofol seemed to induce mixed pro- and anti-inflammatory effects on the immune system. The choice of anesthetic agent could be relevant when treating patients with compromised immunological defense mechanisms.
翻译：唐剑 编辑：冯玉蓉 审校：王贵龙