Immunomodulatory Potential of Diuretics

SIMPLE SUMMARY: In the elderly population, it is important to find the right anti-inflammatory and pro-inflammatory balance to avoid the impairment of the immune system, which becomes weaker with age. This age-dependent weakness of the immune system can increase the risk of serious infections and premature death. This review describes diuretics (substances that promote urination) and their effect on the immune system. The effect on the immune system of this group of drugs was noted in patients suffering from hypertension, observed under experimental conditions with laboratory animals. The cause of hypertension is strongly connected to chronic inflammation. Most diuretics are anti-inflammatory, but depending on the drug, the effects may vary. This topic is highly significant in medical practice regarding the treatment of patients with associated diseases with chronic inflammatory etiology, including arterial hypertension or chronic heart failure. In obese patients and patients with allergies, the anti-inflammatory effect is beneficial because the immune system is too strongly activated. In this article, we try to provide doctors practical advice regarding the type of diuretic that should be used in patients with specific clinical problems and additional diseases. ABSTRACT: In this review, diuretics and their immunomodulatory functions are described. The effects on the immune response of this group of drugs are reported in patients suffering from hypertension and under experimental conditions involving animal models and cell line studies. The pathogenesis of hypertension is strongly connected to chronic inflammation. The vast majority of diuretics modulate the immune response, changing it in favor of the anti-inflammatory response, but depending on the drug, these effects may differ. This topic is significantly important in medical practice regarding the treatment of patients who have coexisting diseases with chronic inflammatory pathogenesis, including hypertension or chronic heart failure. In patients with metabolic syndrome, allergies, or autoimmune disorders, the anti-inflammatory effect is favorable, because of the overstimulation of their immune system. Otherwise, in the geriatric population, it is important to find the proper anti- and pro-inflammatory balance to avoid an enhancement of immune response suppression, which can result in reducing the risk of serious infections that can occur due to the age-diminished function of the immune system. This article is intended to facilitate the selection of an antihypertensive drug that depends on the patient’s immune situation.