Immunomodulatory potential of dexmedetomidine in perioperative pain management for patients with cancer

Abstract

•Dexmedetomidine (DEX) has immunomodulatory effects in perioperative pain management.•DEX can reduce pro-inflammatory cytokines.•DEX has dose-dependent effects on tumor progression.•Optimizing DEX dosing may improve the therapeutic outcomes of cancer surgery.•Further research is needed to clarify DEX's impact on cancer recurrence and survival, as the findings remain mixed.

Figure 1

Effect of DEX on immune cells and inflammatory factors. DEX can regulate immune cell function by acting directly on the α2 adrenergic receptors of immune cells or by acting on the nervous system to cause changes in Catecholamine release and regulation of immune cell function, thus suppressing tumor and virally infected cells. CD4⁺/CD8⁺ T cells: Cluster of differentiation 4⁺ helper T cells/cluster of differentiation 8⁺ helper T cells; DC: Dendritic cell; DEX: Dexmedetomidine; NK cells: Natural killer cells.

Figure 2

Association between DEX and tumors. DEX inhibits tumor growth by modulating immune cells and inflammatory factors but may promote tumor multiplication by activating relevant signaling pathways through direct action on adrenergic receptors in tumor cells. Akt: Protein kinase B; Bcl-2: B-cell lymphoma-2; Bcl-xL: B-cell lymphoma-extra-large; DEX: Dexmedetomidine; ERK: Extracellular regulated protein kinase; +: Promotion.