Table 3 Immunomodulatory effects of sedative agents used in ICU patients

Opioids

[55, 56, 99]

Suppression of mitogen-stimulated proliferation of T and B-lymphocytes

[57–59, 97]

Suppression of natural killer, and primary antibody production

[60–62]

Inhibition of phagocytosis by macrophages

[63–70, 101, 102]

Suppression of IL2, IL12, INFγ, and NO production

[77–80, 82, 83, 94, 97–99]

Activation of sympathic nervous system, and the hypothalamic-pituitary-adrenal axis

[84]

Enhancement of Pseudomonas aeruginosa virulence

[85]

Reduction of bacterial clearance via impairment of TLR9-NF-κB signaling

[86]

Enhancement of cellular apoptosis

Benzodiazepines

[105]

Inhibition of IL-1, IL-6, and TNF-α production

[109]

Supression of macrophage migration and phagocytosis

Clonidine and dexmetetomidine

[119]

Reduction of IL-1β, and IL6 production

[121]

Sympatholytic effects

Propofol

[112, 113]

Suppression of H₂O₂, NO, and O* production; improvement of endothelial dysfunction

[113]

Suppression of TNF-α, IL-β, IL-10

[114]

Attenuation of leukosequestration, pulmonary edema, and pulmonary hyperpermeability

Barbiturates

[124]

Suppression of antigen-specific lymphocyte proliferation, and IL-2 production

[125]

Suppression of TNF-α mRNA expression

[126]

Impairment of phagocytosis