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Anesth Analg 2006;103:809-814
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000237308.28739.d8

CARDIOVASCULAR ANESTHESIA

Clonidine Attenuated Early Proinflammatory Response in T-Cell Subsets After Cardiac Surgery

Vera von Dossow, MD*, Nadine Baehr, Cand Med*, Maryam Moshirzadeh, MD*, Christian von Heymann, MD*, Jan P. Braun, MD*, Ortrud V. Hein, MD*, Michael Sander, MD*, Klaus-D Wernecke, PhD{dagger}, Wolfgang Konertz, MD{ddagger}, and Claudia D. Spies, MD*

From the *Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité; {dagger}Institute of Medical Biometry, Campus Charité Mitte, Charité; {ddagger}Department of Cardiovascular Surgery, Campus Charité Mitte, Charité, Universitaetsmedizin Berlin, Berlin, Germany.

Address correspondence and reprint requests to Claudia Spies, MD, Professor of Anesthesiology, Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité, Universitaetsmedizin Berlin, Schumannstr. 20/21, 10117 Berlin, Germany. Address e-mail to claudia.spies{at}charite.de.

T-cells play a central role in the immune response to injury. Cardiac surgery is associated with significant risk of systemic inflammatory response syndrome and subsequent unbalanced induction of proinflammatory cytokines. As clonidine has immunomodulating properties via reducing sympathetic activity, this study involved the analysis of T-cell function in the early postoperative period in patients undergoing coronary artery bypass graft surgery. Forty patients undergoing cardiac surgery were randomly allocated to one of the following groups: clonidine group (n = 20) [clonidine 1 µg kg–1 h–1] and placebo group (n = 20). Study medication was started after induction of anesthesia and maintained until 6 h after surgery. Blood samples to determine Th1 and Th2 cells and cytotoxic lymphocytes (Tc1 and Tc2 cells) were drawn preoperatively, on admission to the intensive care unit, 6 and 12 h postoperatively as well as on the morning of days 1 and 2 after surgery. In the clonidine group significantly lower levels of Th1/Th2 ratios as well as Tc1/Tc2 ratios were found 6 h postoperatively compared to the placebo group (P < 0.05). Clonidine changed the ratio of T-lymphocyte subpopulations in peripheral blood in favor of a proinflammatory response, which might be favorable for maintaining immune balance after surgery.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.