The immunomodulatory mechanism of dexmedetomidine

Int Immunopharmacol. 2021 Aug;97:107709. doi: 10.1016/j.intimp.2021.107709. Epub 2021 Apr 29.


Dexmedetomidine has been increasingly introduced into the perioperative care of surgical patients. Because a subset of anesthetics/sedatives are immunomodulatory, it is critical to understand the role of dexmedetomidine in our host immune functions. Here we reviewed the role of dexmedetomidine in different immune cells. We also reviewed published clinical articles that described the role of dexmedetomidine in organ injury, cancer surgery, and infection. In animal studies, dexmedetomidine attenuated organ injury. In clinical studies, dexmedetomidine was associated with an improvement in outcomes in cardiac surgery and transplant surgery. However, there is a paucity in research examining how dexmedetomidine is associated with these outcomes. Further studies are needed to understand its clinical application from immunological standpoints.

Keywords: Dexmedetomidine; Leukocyte; Outcome.

Publication types

  • Review

MeSH terms

  • Adrenergic alpha-2 Receptor Agonists / pharmacology*
  • Adrenergic alpha-2 Receptor Agonists / therapeutic use
  • Animals
  • Dexmedetomidine / pharmacology*
  • Dexmedetomidine / therapeutic use
  • Disease Models, Animal
  • Humans
  • Immunologic Factors / pharmacology*
  • Immunologic Factors / therapeutic use
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / metabolism
  • Leukocytes / drug effects*
  • Leukocytes / immunology
  • Leukocytes / metabolism
  • Perioperative Period
  • Receptors, Adrenergic, alpha-2 / metabolism
  • Stress, Physiological / drug effects
  • Stress, Physiological / immunology
  • Surgical Procedures, Operative / adverse effects


  • Adrenergic alpha-2 Receptor Agonists
  • Immunologic Factors
  • Inflammation Mediators
  • Receptors, Adrenergic, alpha-2
  • Dexmedetomidine