Abstract
Pharmacologic blockade of β-adrenergic receptors is a frequent therapeutic intervention in critically ill patients. Todays strategies predominantly include the treatment of cardiovascular diseases like hypertension and cardiac arrhythmias. Furthermore, β-adrenergic antagonists are routinely used to prevent the catecholamine-induced hypermetabolism in critically ill patients suffering from severe burn injury. In addition to these well known beneficial effects of β-adrenoceptor blocking agents it has been demonstrated, that the adrenergic system is involved in the modulation of cellular immune functions. Therefore, the immunomodulatory properties of β-adrenergic antagonists have been established during the last years and the scientific focus was addressed on the proposed immunologic side effects of a β-adrenergic blockade and its potential effect on the clinical course of critical illness. This manuscript reviews the rational and the effect of the therapeutic use of β-adrenergic antagonists in critically ill patients on the base of the current literature and further emphasizes on potential immunologic side effects.
Keywords: Propranolol, β-blocker, adrenergic antagonist, immune system, critical illness, endocrine-immune interaction, critical care medicine
Current Medicinal Chemistry
Title: Beta-Adrenergic Antagonists: Indications and Potential Immunomodulatory Side Effects in the Critically Ill
Volume: 16 Issue: 9
Author(s): Reiner Oberbeck and Philipp Kobbe
Affiliation:
Keywords: Propranolol, β-blocker, adrenergic antagonist, immune system, critical illness, endocrine-immune interaction, critical care medicine
Abstract: Pharmacologic blockade of β-adrenergic receptors is a frequent therapeutic intervention in critically ill patients. Todays strategies predominantly include the treatment of cardiovascular diseases like hypertension and cardiac arrhythmias. Furthermore, β-adrenergic antagonists are routinely used to prevent the catecholamine-induced hypermetabolism in critically ill patients suffering from severe burn injury. In addition to these well known beneficial effects of β-adrenoceptor blocking agents it has been demonstrated, that the adrenergic system is involved in the modulation of cellular immune functions. Therefore, the immunomodulatory properties of β-adrenergic antagonists have been established during the last years and the scientific focus was addressed on the proposed immunologic side effects of a β-adrenergic blockade and its potential effect on the clinical course of critical illness. This manuscript reviews the rational and the effect of the therapeutic use of β-adrenergic antagonists in critically ill patients on the base of the current literature and further emphasizes on potential immunologic side effects.
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Cite this article as:
Oberbeck Reiner and Kobbe Philipp, Beta-Adrenergic Antagonists: Indications and Potential Immunomodulatory Side Effects in the Critically Ill, Current Medicinal Chemistry 2009; 16 (9) . https://dx.doi.org/10.2174/092986709787581770
DOI https://dx.doi.org/10.2174/092986709787581770 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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