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Immunomodulatory effects of anesthetics in obese patients
Anesthesia and surgery have an impact on inflammatory responses, which influences perioperative homeostasis. Inhalational and intravenous anesthesia can alter immune-system homeostasis through multiple processes that include activation of immune cells (such as monocytes, neutrophils, and specific ti...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547428/ https://www.ncbi.nlm.nih.gov/pubmed/28828299 http://dx.doi.org/10.5492/wjccm.v6.i3.140 |
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author | Heil, Luciana Boavista Barros Silva, Pedro Leme Pelosi, Paolo Rocco, Patricia Rieken Macedo |
author_facet | Heil, Luciana Boavista Barros Silva, Pedro Leme Pelosi, Paolo Rocco, Patricia Rieken Macedo |
author_sort | Heil, Luciana Boavista Barros |
collection | PubMed |
description | Anesthesia and surgery have an impact on inflammatory responses, which influences perioperative homeostasis. Inhalational and intravenous anesthesia can alter immune-system homeostasis through multiple processes that include activation of immune cells (such as monocytes, neutrophils, and specific tissue macrophages) with release of pro- or anti-inflammatory interleukins, upregulation of cell adhesion molecules, and overproduction of oxidative radicals. The response depends on the timing of anesthesia, anesthetic agents used, and mechanisms involved in the development of inflammation or immunosuppression. Obese patients are at increased risk for chronic diseases and may have the metabolic syndrome, which features insulin resistance and chronic low-grade inflammation. Evidence has shown that obesity has adverse impacts on surgical outcome, and that immune cells play an important role in this process. Understanding the effects of anesthetics on immune-system cells in obese patients is important to support proper selection of anesthetic agents, which may affect postoperative outcomes. This review article aims to integrate current knowledge regarding the effects of commonly used anesthetic agents on the lungs and immune response with the underlying immunology of obesity. Additionally, it identifies knowledge gaps for future research to guide optimal selection of anesthetic agents for obese patients from an immunomodulatory standpoint. |
format | Online Article Text |
id | pubmed-5547428 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-55474282017-08-21 Immunomodulatory effects of anesthetics in obese patients Heil, Luciana Boavista Barros Silva, Pedro Leme Pelosi, Paolo Rocco, Patricia Rieken Macedo World J Crit Care Med Review Anesthesia and surgery have an impact on inflammatory responses, which influences perioperative homeostasis. Inhalational and intravenous anesthesia can alter immune-system homeostasis through multiple processes that include activation of immune cells (such as monocytes, neutrophils, and specific tissue macrophages) with release of pro- or anti-inflammatory interleukins, upregulation of cell adhesion molecules, and overproduction of oxidative radicals. The response depends on the timing of anesthesia, anesthetic agents used, and mechanisms involved in the development of inflammation or immunosuppression. Obese patients are at increased risk for chronic diseases and may have the metabolic syndrome, which features insulin resistance and chronic low-grade inflammation. Evidence has shown that obesity has adverse impacts on surgical outcome, and that immune cells play an important role in this process. Understanding the effects of anesthetics on immune-system cells in obese patients is important to support proper selection of anesthetic agents, which may affect postoperative outcomes. This review article aims to integrate current knowledge regarding the effects of commonly used anesthetic agents on the lungs and immune response with the underlying immunology of obesity. Additionally, it identifies knowledge gaps for future research to guide optimal selection of anesthetic agents for obese patients from an immunomodulatory standpoint. Baishideng Publishing Group Inc 2017-08-04 /pmc/articles/PMC5547428/ /pubmed/28828299 http://dx.doi.org/10.5492/wjccm.v6.i3.140 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Review Heil, Luciana Boavista Barros Silva, Pedro Leme Pelosi, Paolo Rocco, Patricia Rieken Macedo Immunomodulatory effects of anesthetics in obese patients |
title | Immunomodulatory effects of anesthetics in obese patients |
title_full | Immunomodulatory effects of anesthetics in obese patients |
title_fullStr | Immunomodulatory effects of anesthetics in obese patients |
title_full_unstemmed | Immunomodulatory effects of anesthetics in obese patients |
title_short | Immunomodulatory effects of anesthetics in obese patients |
title_sort | immunomodulatory effects of anesthetics in obese patients |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547428/ https://www.ncbi.nlm.nih.gov/pubmed/28828299 http://dx.doi.org/10.5492/wjccm.v6.i3.140 |
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