Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, People's Republic of China.
Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Drug Des Devel Ther. 2022 Jul 6;16:2161-2175. doi: 10.2147/DDDT.S358042. eCollection 2022.
Dexmedetomidine, a specific α2 adrenergic receptor agonist, is highly frequently used in the perioperatively for its favorable pharmacology, such as mitigating postoperative cognitive dysfunction. Increasing attention has been recently focused on the effect of whether dexmedetomidine influences cancer recurrence, which urges the discussion of the role of dexmedetomidine in tumor-progressive factors. The pharmacologic characteristics of dexmedetomidine, the tumor-progressive factors in the perioperative period, and the relationships between dexmedetomidine and tumor-progressive factors were described in this review. Available evidence suggests that dexmedetomidine could reduce the degree of immune function suppression, such as keeping the number of CD3+ cells, NK cells, CD4+/CD8+ ratio, and Th1/Th2 ratio stable and decreasing the level of proinflammatory cytokine (interleukin 6 and tumor necrosis factor-alpha) during cancer operations. However, dexmedetomidine exhibits different roles in cell biological behavior depending on cancer cell types. The conclusions on whether dexmedetomidine would influence cancer recurrence could not be currently drawn for the lack of strong clinical evidence. Therefore, this is still a new area that needs further exploration.
右美托咪定是一种特异性α2 肾上腺素能受体激动剂，因其具有良好的药理学特性，如减轻术后认知功能障碍，在围手术期被广泛应用。最近，人们越来越关注右美托咪定是否会影响癌症复发，这促使人们讨论右美托咪定在肿瘤进展因素中的作用。本文综述了右美托咪定的药理学特性、围手术期肿瘤进展因素以及右美托咪定与肿瘤进展因素之间的关系。现有证据表明，右美托咪定可降低免疫功能抑制程度，如维持 CD3+细胞、NK 细胞、CD4+/CD8+ 比值和 Th1/Th2 比值稳定，降低促炎细胞因子（白细胞介素 6 和肿瘤坏死因子-α）水平，从而减少癌症手术期间的免疫功能抑制程度。然而，右美托咪定在不同的癌细胞类型中表现出不同的细胞生物学行为作用。由于缺乏强有力的临床证据，目前还不能得出右美托咪定会否影响癌症复发的结论。因此，这仍然是一个需要进一步探索的新领域。
