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

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

Volume: 16 Issue: 9

Author(s): Reiner Oberbeck and Philipp Kobbe

Affiliation:

Keywords: Propranolol, β-blocker, adrenergic antagonist, immune system, critical illness, endocrine-immune interaction, critical care medicine

Abstract: Pharmacologic blockade of β-adrenergic receptors is a frequent therapeutic intervention in critically ill patients. Todays 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.

Cite this article as:

Oberbeck Reiner and Kobbe Philipp, Beta-Adrenergic Antagonists: Indications and Potential Immunomodulatory Side Effects in the Critically Ill, Current Medicinal Chemistry 2009; 16 (9) . https://dx.doi.org/10.2174/092986709787581770