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Effekte von Dopamin auf die zelluläre und humorale Immunantwort von Patienten mit Sepsis

Effects of dopamine on cellular and humoral immune responses in septic patients

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Zusammenfassung

Zahlreiche In-vitro- und In-vivo-Studien belegen, dass Dopamin neben seinen hämodynamischen Effekten eine Reihe immunmodulatorischer Wirkungen induziert. Dopamin reduziert die Synthese proinflammatorischer und induziert die Synthese antiinflammatorischer Mediatoren. Dopamin hemmt die Synthese neurohypophysärer Hormone und hemmt die Zellproliferation sowie die Thrombozytenaggregation. Es reduziert die Phagozytoseaktivität neutrophiler Granulozyten und induziert Apoptose. Bei hohen Dopaminserumkonzentrationen, wie sie bei einer Sepsis durch vermehrte endogene Synthese, zusätzliche exogene Applikation und verringerte Clearance erreicht werden, könnten diese Effekte zu relevanten Veränderungen pathophysiologischer Abläufe führen. Um die Bedeutung von Dopamin für die zelluläre und humorale Immunantwort von Patienten mit Sepsis hervorzuheben, sind in dieser Übersicht die speziellen Wirkungen von Dopamin zusammengefasst und die zugrunde liegenden Mechanismen dargestellt.

Abstract

In vitro and in vivo studies have demonstrated that apart from its hemodynamic action dopamine can modulate immune responses. Dopamine reduces the synthesis of proinflammatory and induces the synthesis of anti-inflammatory mediators. Dopamine inhibits neurohormone synthesis, lymphocyte proliferation and platelet aggregation. It reduces the phagocytic activity of neutrophils and induces apoptosis. Particularly with regard to sepsis, where high serum dopamine levels are reached by enhanced endogeneous production, exogeneous application and impaired clearance, this immunomodulation may have a clinical impact. This review summarizes dopamine-mediated immunomodulating effects to advance the knowledge regarding dopamine as an immune regulator under septic conditions.

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Abbreviations

ADP::

Adenosindiphosphat,

cAMP::

zyklisches Adenosinmonophosphat,

C/EBP::

„CCAAT/enhancing binding protein“,

CBP::

„CREB-binding-Protein“,

CREB::

„cAMP-responsive-element-binding-Protein“,

DOPA::

Dihydroxyphenylalanin,

ENA-78::

„epithelial neutrophile-activating-protein“,

Gro-α::

„growth-related-oncogene“,

HO-1::

Hämoxygenase-1,

H2O2::

Wasserstoffperoxid,

HUVEC::

humane Nabelschnurendothelzellen,

ICAM-1::

„intercellular adhesion molecule-1“,

IFNγ::

Interferon-γ,

IL-1::

Interleukin-1,

LPS::

Lipopolysaccharid,

NAC::

N-Acetylcystein,

MAO::

Monoaminooxidase,

NO::

Stickstoffmonoxid,

NOS::

NO-Synthase,

NF-κB::

„nuclear factor-κ B“,

PKA::

Proteinkinase A,

PMN::

polymorphkernige neutrophile Granulozyten,

ROS::

reaktive Sauerstoffprodukte,

SIRS::

„systemic inflammatory response syndrome“,

SOD::

Superoxiddismutase,

TNF-α::

„tumor necrosis factor-α“,

TSH::

Thyreoidea-stimulierendes Hormon

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  1. Institut für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum, Mannheim

    G. Beck, C. Hanusch, N. Rafat & K. van Ackern

  2. V. Medizinische Klinik (Nephrologie), Universitätsklinikum, Mannheim

    P. Brinkkoetter, J. Schulte & B. Yard

  3. Institut für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum, Theodor-Kutzer Ufer 1–3, 68167, Mannheim

    G. Beck

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Beck, G., Hanusch, C., Brinkkoetter, P. et al. Effekte von Dopamin auf die zelluläre und humorale Immunantwort von Patienten mit Sepsis. Anaesthesist 54, 1012–1020 (2005). https://doi.org/10.1007/s00101-005-0887-1

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