title: β-Blockade use for Traumatic Injuries and Immunomodulation: A Review of Proposed Mechanisms and Clinical Evidence.
abstract: Sympathetic nervous system activation and catecholamine release are important events following injury and infection. The nature and timing of different pathophysiologic insults have significant effects on adrenergic pathways, inflammatory mediators, and the host response. Beta adrenergic receptor blockers (β-blockers) are commonly used for treatment of cardiovascular disease, and recent data suggests that the metabolic and immunomodulatory effects of β-blockers can expand their use. β-blocker therapy can reduce sympathetic activation and hypermetabolism as well as modify glucose homeostasis and cytokine expression. It is the purpose of this review to examine either the biologic basis for proposed mechanisms or to describe current available clinical evidence for the use of β-blockers in traumatic brain injury, spinal cord injury, hemorrhagic shock, acute traumatic coagulopathy, erythropoietic dysfunction, metabolic dysfunction, pulmonary dysfunction, burns, immunomodulation, and sepsis.
authors.affiliation: Department of Surgery and Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Loftus
authors.forename: Philip A
authors.initials: PA
authors.lastname: Efron
authors.forename: Lyle L
authors.initials: LL
authors.lastname: Moldawer
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Mohr
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000818:Animals; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D056747:Immunomodulation / Q000187:drug effects; D014947:Wounds and Injuries / Q000188:drug therapy* / Q000276:immunology* / Q000378:metabolism
chemical_list: D000319:Adrenergic beta-Antagonists; D016207:Cytokines