Özet:
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 a2-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 mg.kg 1 and 30 mg.kg 1
) during inflammatory bowel disease by using
an experimental model, which resembles both systemic and local inflammation.
Methods: The effect of dexmedetomidine on the course of inflammatory bowel disease was
investigated by measuring macroscopic and microscopic parameters. We investigated proinflammatory
Th1, Th2, and Th17 cytokine levels in serum samples to analyze systemic
immune response. Following this, local immune response was investigated by measuring
cytokine levels in the presence of dexmedetomidine in spleen cell culture.
Results: Dexmedetomidine administration led to amelioration of all disease associated
pathological manifestations. According to our in vitro and in vivo results, dexmedetomidine
shows anti-inflammatory effect by increasing IL-4 and IL-10 levels responsible from antiinflammatory
response via Th2 pathway. Moreover, we showed for the first time in the
study that dexmedetomidine administration reduces IL-23, which is responsible from
initiation of inflammatory response via Th17 pathway.
Conclusions: Dexmedetomidine can have beneficial effect on preoperative or postoperative
inflammatory bowel disease patients in intensive care units by down-regulating inflammatory
immune response not only in systemic circulation but also in tissue-specific manner.
