Effects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial

ObjectiveDexmedetomidine has sympatholytic, anti-inflammatory, and analgesic effects and may exert anti-tumor effect by acting on α2A adrenoreceptor. We investigated whether perioperative dexmedetomidine preserves immune function in patients undergoing uterine cancer surgery.MethodsOne hundred patie...

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Autores principales:	Jin Sun Cho, Kieun Seon, Min-Yu Kim, Sang Wun Kim, Young Chul Yoo
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	dexmedetomidine immunity interferon-γ natural killer cell uterine cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/9475d4a8dca44dc28756e38029ca595c
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spelling	oai:doaj.org-article:9475d4a8dca44dc28756e38029ca595c2021-11-16T06:02:54ZEffects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial2234-943X10.3389/fonc.2021.749003https://doaj.org/article/9475d4a8dca44dc28756e38029ca595c2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.749003/fullhttps://doaj.org/toc/2234-943XObjectiveDexmedetomidine has sympatholytic, anti-inflammatory, and analgesic effects and may exert anti-tumor effect by acting on α2A adrenoreceptor. We investigated whether perioperative dexmedetomidine preserves immune function in patients undergoing uterine cancer surgery.MethodsOne hundred patients were randomly assigned to the control or dexmedetomidine groups (50 patients each). Dexmedetomidine was infused at rates of 0.4 μg/kg/h intraoperatively and 0.15 μg/kg/h during the first 24 h postoperatively. The primary outcome was natural killer (NK) cell activity, which was measured preoperatively and 1, 3, and 5 days postoperatively. The inflammatory response was measured by interleukin-6, interferon-γ, and neutrophil/lymphocyte ratio, and pain scores and opioid consumption were assessed. Cancer recurrence or metastasis and death were evaluated 2 years postoperatively.ResultsNK cell activity decreased postoperatively in both groups and changes over time were not different between groups (P=0.496). Interferon-γ increased postoperatively in the dexmedetomidine group, whereas it maintained at the baseline value in the control group. Change in interferon-γ differed significantly between groups (P=0.003). Changes in interleukin-6 and neutrophil-lymphocyte ratio were comparable between groups. Both pain score with activity during the first 1 h and opioid consumption during the first 1–24 h postoperatively were lower in the dexmedetomidine group. Rates of cancer recurrence/metastasis (16.3% vs. 8.7%, P=0.227) and death within 2 years postoperatively (6.7% vs. 2.2%, P=0.318) were not different between groups.ConclusionsPerioperative dexmedetomidine had no favorable impacts on NK cell activity, inflammatory responses, or prognosis, whereas it increased interferon-γ and reduced early postoperative pain severity and opioid consumption in uterine cancer surgery patients.Jin Sun ChoJin Sun ChoKieun SeonMin-Yu KimSang Wun KimYoung Chul YooYoung Chul YooFrontiers Media S.A.articledexmedetomidineimmunityinterferon-γnatural killer celluterine cancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	dexmedetomidine immunity interferon-γ natural killer cell uterine cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	dexmedetomidine immunity interferon-γ natural killer cell uterine cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jin Sun Cho Jin Sun Cho Kieun Seon Min-Yu Kim Sang Wun Kim Young Chul Yoo Young Chul Yoo Effects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial
description	ObjectiveDexmedetomidine has sympatholytic, anti-inflammatory, and analgesic effects and may exert anti-tumor effect by acting on α2A adrenoreceptor. We investigated whether perioperative dexmedetomidine preserves immune function in patients undergoing uterine cancer surgery.MethodsOne hundred patients were randomly assigned to the control or dexmedetomidine groups (50 patients each). Dexmedetomidine was infused at rates of 0.4 μg/kg/h intraoperatively and 0.15 μg/kg/h during the first 24 h postoperatively. The primary outcome was natural killer (NK) cell activity, which was measured preoperatively and 1, 3, and 5 days postoperatively. The inflammatory response was measured by interleukin-6, interferon-γ, and neutrophil/lymphocyte ratio, and pain scores and opioid consumption were assessed. Cancer recurrence or metastasis and death were evaluated 2 years postoperatively.ResultsNK cell activity decreased postoperatively in both groups and changes over time were not different between groups (P=0.496). Interferon-γ increased postoperatively in the dexmedetomidine group, whereas it maintained at the baseline value in the control group. Change in interferon-γ differed significantly between groups (P=0.003). Changes in interleukin-6 and neutrophil-lymphocyte ratio were comparable between groups. Both pain score with activity during the first 1 h and opioid consumption during the first 1–24 h postoperatively were lower in the dexmedetomidine group. Rates of cancer recurrence/metastasis (16.3% vs. 8.7%, P=0.227) and death within 2 years postoperatively (6.7% vs. 2.2%, P=0.318) were not different between groups.ConclusionsPerioperative dexmedetomidine had no favorable impacts on NK cell activity, inflammatory responses, or prognosis, whereas it increased interferon-γ and reduced early postoperative pain severity and opioid consumption in uterine cancer surgery patients.
format	article
author	Jin Sun Cho Jin Sun Cho Kieun Seon Min-Yu Kim Sang Wun Kim Young Chul Yoo Young Chul Yoo
author_facet	Jin Sun Cho Jin Sun Cho Kieun Seon Min-Yu Kim Sang Wun Kim Young Chul Yoo Young Chul Yoo
author_sort	Jin Sun Cho
title	Effects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial
title_short	Effects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial
title_full	Effects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial
title_fullStr	Effects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial
title_full_unstemmed	Effects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial
title_sort	effects of perioperative dexmedetomidine on immunomodulation in uterine cancer surgery: a randomized, controlled trial
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/9475d4a8dca44dc28756e38029ca595c
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Effects of Perioperative Dexmedetomidine on Immunomodulation in Uterine Cancer Surgery: A Randomized, Controlled Trial

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