Beta-Adrenergic Antagonists: Indications and Potential Immunomodulatory Side Effects in the Critically Ill

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Abstract:

Pharmacologic blockade of β-adrenergic receptors is a frequent therapeutic intervention in critically ill patients. Today's 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; adrenergic antagonist; critical care medicine; critical illness; endocrine-immune interaction; immune system; β-blocker

Document Type: Research Article

DOI: http://dx.doi.org/10.2174/092986709787581770

Affiliations: Department Trauma Surgery, University Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany.

Publication date: March 1, 2009

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  • Current Medicinal Chemistry covers all the latest and outstanding developments in medicinal chemistry and rational drug design. Each issue contains a series of timely in-depth reviews written by leaders in the field covering a range of the current topics in medicinal chemistry. Current Medicinal Chemistry is an essential journal for every medicinal chemist who wishes to be kept informed and up-to-date with the latest and most important developments.
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