Nishina K, Akamatsu H, Mikawa K, Shiga M, Maekawa N, Obara H, Niwa Y
Department of Anaesthesiology and Intensive Care Medicine, Kobe University School of Medicine, Japan.
Anesth Analg. 1999 Feb;88(2):452-8. doi: 10.1097/00000539-199902000-00042.
Neutrophil functions are inhibited by various anesthetics. Clonidine and dexmedetomidine, alpha2-agonists, are often used as adjuncts to anesthesia. Thus, we conducted the current study to determine the effect of clonidine, dexmedetomidine, and xylazine at clinically (or veterinary anesthetically) relevant concentrations (and 10 and 100 times these concentrations) on several aspects of human neutrophil functions using an in vitro system. The three alpha2-agonists had no effects on chemotaxis, phagocytosis, or superoxide anion (O2-) production of neutrophils, except that the highest concentration of clonidine inhibited chemotaxis. Increases in intracellular calcium concentrations in neutrophils stimulated by chemotaxin were not influenced by clonidine, dexmedetomidine, or xylazine. Unchanged calcium concentrations may contribute to failure to modulate the neutrophil functions. In addition, these drugs did not scavenge O2- generated by the cell-free (xanthine-xanthine oxidase) system. This is the first report concerning the effect of clonidine or dexmedetomidine on human neutrophil functions. Our findings suggest that we may not have to take extra precautions in using the alpha2-agonists in patients with infection, but that we cannot expect these drugs to be prophylaxis against autotissue injuries whose pathogenesis includes activation of neutrophils.
Neutrophils are involved in the antibacterial host defense system and autotissue injury. We found that clinically relevant concentrations of clonidine and dexmedetomidine do not affect chemotaxis, phagocytosis, or superoxide production by human neutrophils. These findings indicate that it may not be necessary to take special care in using alpha2-agonists in patients with infection, sepsis, or systemic inflammation.
多种麻醉剂会抑制中性粒细胞的功能。α2 激动剂可乐定和右美托咪定常被用作麻醉辅助药物。因此,我们进行了本研究,以确定可乐定、右美托咪定和赛拉嗪在临床(或兽医麻醉)相关浓度(以及这些浓度的 10 倍和 100 倍)下,使用体外系统对人中性粒细胞功能多个方面的影响。这三种α2 激动剂对中性粒细胞的趋化性、吞噬作用或超氧阴离子(O2-)产生均无影响,不过可乐定的最高浓度抑制了趋化性。趋化因子刺激引起的中性粒细胞内钙浓度升高不受可乐定、右美托咪定或赛拉嗪的影响。钙浓度不变可能导致无法调节中性粒细胞功能。此外,这些药物不会清除无细胞(黄嘌呤 - 黄嘌呤氧化酶)系统产生的 O2-。这是关于可乐定或右美托咪定对人中性粒细胞功能影响的首次报告。我们的研究结果表明,在感染患者中使用α2 激动剂时,可能无需采取额外的预防措施,但我们不能期望这些药物能预防发病机制包括中性粒细胞激活的自身组织损伤。
中性粒细胞参与抗菌宿主防御系统和自身组织损伤。我们发现,临床相关浓度的可乐定和右美托咪定不会影响人中性粒细胞的趋化性、吞噬作用或超氧产生。这些发现表明,在感染、脓毒症或全身炎症患者中使用α2 激动剂时,可能无需特别小心。