Immunomodulatory Effects of Perioperative Dexmedetomidine in Ovarian Cancer: An In Vitro and Xenograft Mouse Model Study

Shin, Seokyung; Kim, Ki Jun; Hwang, Hye Jeong; Noh, Sang Ha; Oh, Ju Eun; Yoo, Young Chul

doi:10.3389/fonc.2021.722743

Cited by 9 publications

(8 citation statements)

References 36 publications

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“…For instance, it was suggested that patients who received propofol and sevoflurane in general anesthesia were associated with better overall survival than those who received desflurane alone ( 2 ). Although DEX has been shown to promote tumorigenesis in neurogliomas and lung carcinomas, breast cancer, and colon cancers ( 12 , 27 ), others suggested that DEX could lower the tumor weight and tumor burden in xenograft mice with ovarian cancer ( 28 ), and repressed esophageal cancer cell proliferation in vivo ( 29 ). Despite the controversial in vivo results, the effect of DEX on long-term survival and tumor recurrence after laparoscopic resection of colorectal cancer has not been evaluated in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Association between intraoperative dexmedetomidine and all-cause mortality and recurrence after laparoscopic resection of colorectal cancer: Follow-up analysis of a previous randomized controlled trial

Gong

Xue

et al. 2023

Front. Oncol.

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BackgroundDexmedetomidine (DEX) has been widely applied in the anesthesia and sedation of patients with oncological diseases. However, the potential effect of DEX on tumor metastasis remains contradictory. This study follows up on patients who received intraoperative DEX during laparoscopic resection of colorectal cancer as part of a previous clinical trial, examining their outcomes 5 years later.MethodsBetween June 2015 and December 2015, 60 patients undergoing laparoscopic colorectal resection were randomly assigned to the DEX and control groups. The DEX group received an initial loading dose of 1μ/kg before surgery, followed by a continuous infusion of 0.3μg/kg/h during the operation and the Control group received an equivalent volume of saline. A 5-year follow-up analysis was conducted to evaluate the overall survival, disease-free survival, and tumor recurrence.ResultsThe follow-up analysis included 55 of the 60 patients. The DEX group included 28 patients, while the control group included 27 patients. Baseline characteristics were comparable between the two groups, except for vascular and/or neural invasion of the tumor in the DEX group (9/28 vs. 0/27, p = 0.002). We did not observe a statistically significant benefit but rather a trend toward an increase in overall survival and disease-free survival in the DEX group, 1-year overall survival (96.4% vs. 88.9%, p = 0.282), 2-year overall survival (89.3% vs. 74.1%, p = 0.144), 3-year overall survival (89.3% vs. 70.4%, p = 0.08), and 5-year overall survival (78.6% vs. 59.3%, p = 0.121). The total rates of mortality and recurrence between the two groups were comparable (8/28 vs. 11/27, p = 0.343).ConclusionAdministration of DEX during laparoscopic resection of colorectal cancer had a nonsignificant trend toward improved overall survival and disease-free survival.Clinical Trial Registrationhttp://www.chictr.org.cn/, identifier ChiCTRIOR-15006518.

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Section: Discussionmentioning

confidence: 99%

Association between intraoperative dexmedetomidine and all-cause mortality and recurrence after laparoscopic resection of colorectal cancer: Follow-up analysis of a previous randomized controlled trial

Gong

Xue

et al. 2023

Front. Oncol.

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“…DEX is widely used in the perioperative period and plays a beneficial role in resection of a variety of solid cancers [ 35 ]. A recent animal experiment confirmed its anti-inflammatory effects and showed a lower tumor burden [ 36 ].Clinical researches also shown that application of DEX could reduce serum levels of inflammatory factors in patients receiving carcinoma resection including colon cancer [ 37 ], hysterectomy [ 38 ], and radical gastrectomy [ 39 ]. In addition, immunosuppression attenuated by DEX could also concerned with better outcomes of postoperative cognitive function [ 40 ], effective perioperative analgesia, less use of opioids [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Dexmedetomidine on Systemic Inflammation and Postoperative Complications in Laparoscopic Pancreaticoduodenectomy: A Double‐blind Randomized Controlled Trial

Chen

Wang

et al. 2022

World j. surg.

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Background Laparoscopic pancreaticoduodenectomy (LPD) may induce intense inflammatory response which might be related to the patient’s outcomes. Clinical dexmedetomidine (DEX) has been widely used for opioid-sparing anesthesia and satisfactory sedation. The objective of this study was to investigate the influence of DEX on inflammatory response and postoperative complications in LPD. Methods Ninety-nine patients undergoing LPD were randomly assigned to two groups: normal saline (NS) and DEX. The primary outcome was the neutrophil-to-lymphocyte ratio (NLR) differences postoperatively within 48 h. Secondary outcomes were postoperative complications, the length of postoperative hospital stay and the incidence of ICU admission. Other outcomes included anesthetics consumption and intraoperative vital signs. Results NLR at postoperative day 2 to baseline ratio decreased significantly in the DEX group (P = 0.032). Less major complications were observed in the DEX group such as pancreatic fistula, delayed gastric emptying and intra-abdominal infection (NS vs. DEX, 21.7% vs. 13.6%, P = 0.315; 10.9% vs. 2.3%, P = 0.226; 17.4% vs. 11.4%, P = 0.416, respectively) though there were no statistical differences. Three patients were transferred to the ICU after surgery in the NS group, while there was none in the DEX group (P = 0.242). The median postoperative hospital stay between groups were similar (P = 0.313). Both intraoperative propofol and opioids were less in the DEX group (P < 0.05). Conclusions Intraoperative DEX reduced the early postoperative inflammatory response in LPD. It also reduced the use of narcotics that may related to reduced major complications, which need additional research further.

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“…DEX can effectively inhibit the activation of IGF2 signal pathway, improve the immune function of ovarian cancer rats, inhibit the invasion and migration of ovarian cancer cells, and significantly increase the percentage of CD4 + , CD8 + and the ratio of CD4+/CD8+ ( Tian et al, 2019 ). The DEX infusion may improve the surgical outcomes of ovarian cancer by inhibiting the surgical stress response and the release of stress mediators ( Shin et al, 2021 ). CD3 + T cells and CD4+/CD8+ in DEX group were significantly higher than that in the control group, which could reduce the perioperative inflammatory response and improve the cellular immune function of patients undergoing thoracoscopic radical resection of lung cancer ( Kong and Lu, 2018 ; Zong et al, 2021 ).…”

Section: Dex's Regulatory Effect On Immune Cells and Inflammationmentioning

confidence: 99%

Effects of Dexmedetomidine on Immune Cells: A Narrative Review

Chen

Sun²,

Lv³

et al. 2022

Front. Pharmacol.

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As we all know, dexmedetomidine (DEX), as a highly selective α2 adrenergic receptor agonist, exerts sedative, anti-anxiety and hypnotic effects by inhibiting the discharge of norepinephrine neurons in locus coeruleus and GABA-related hypnotic pathways. However, the role of DEX in anti-inflammatory and immune regulation has gradually attracted the attention of researchers in recent years. The α2 adrenergic receptor is one of the members of the adrenergic receptor family, which is widely present in a variety of immune cells and mediates the biological behavior of the inflammatory immune system. At present, there have been more and more studies on the effects of DEX on immune cells and inflammatory responses, but few studies have systematically explored the anti-inflammatory and immunomodulatory effects of DEX. Here, we comprehensively review the published human and animal studies related to DEX, summarize the effects of DEX on immune cells and its role in related diseases, and propose potential research direction.

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Immunomodulatory Effects of Perioperative Dexmedetomidine in Ovarian Cancer: An In Vitro and Xenograft Mouse Model Study

Cited by 9 publications

References 36 publications

Association between intraoperative dexmedetomidine and all-cause mortality and recurrence after laparoscopic resection of colorectal cancer: Follow-up analysis of a previous randomized controlled trial

Association between intraoperative dexmedetomidine and all-cause mortality and recurrence after laparoscopic resection of colorectal cancer: Follow-up analysis of a previous randomized controlled trial

Effects of Dexmedetomidine on Systemic Inflammation and Postoperative Complications in Laparoscopic Pancreaticoduodenectomy: A Double‐blind Randomized Controlled Trial

Effects of Dexmedetomidine on Immune Cells: A Narrative Review

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