Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients
| Autor: | Kaoru Ikejiri, Asami Ito-Masui, Motomu Shimaoka, Yuichi Akama, Eun Jeong Park, Eiji Kawamoto, Ryo Esumi, Miho Sumiyoshi, Arong Gaowa, Hiroshi Imai, Toru Shinkai, Yuki Nakamori |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
PD-L1
lymphocytes post-cardiac arrest syndrome medicine.medical_specialty Lymphocyte medicine.medical_treatment Ischemia Inflammation Article Sepsis Pathogenesis Immune system Internal medicine PD-1 mental disorders medicine Cardiopulmonary resuscitation immunosuppression business.industry Immunosuppression General Medicine medicine.disease medicine.anatomical_structure inflammation Cardiology Medicine medicine.symptom business |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 18 Journal of Clinical Medicine, Vol 10, Iss 4188, p 4188 (2021) |
| ISSN: | 2077-0383 |
| Popis: | Background: A deregulated immune system has been implicated in the pathogenesis of post-cardiac arrest syndrome (PCAS). A soluble form of programmed cell death-1 (PD-1) ligand (sPD-L1) has been found at increased levels in cancer and sustained inflammation, thereby deregulating immune functions. Here, we aim to study the possible involvement of sPD-L1 in PCAS. Methods: Thirty out-of-hospital cardiac arrest (OHCA) patients consecutively admitted to the ER of Mie University Hospital were prospectively enrolled. Plasma concentrations of sPD-L1 were measured by an enzyme-linked immunosorbent assay in blood samples of all 30 OHCA patients obtained during cardiopulmonary resuscitation (CPR). In 13 patients who achieved return-of-spontaneous-circulation (ROSC), sPD-L1 levels were also measured daily in the ICU. Results: The plasma concentrations of sPD-L1 in OHCA were significantly increased in fact, to levels as high as those observed in sepsis. sPD-L1 levels during CPR correlated with reduced peripheral lymphocyte counts and increased C-reactive protein levels. Of 13 ROSC patients, 7 cases survived in the ICU for more than 4 days. A longitudinal analysis of sPD-L1 levels in the 7 ROSC cases revealed that sPD-L1 levels occurred in parallel with organ failure. Conclusions: This study suggests that ischemia- reperfusion during CPR may aberrantly activate immune and endothelial cells to release sPD-L1 into circulation, which may play a role in the pathogenesis of immune exhaustion and organ failures associated with PCAS. |
| Databáze: | OpenAIRE |
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