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Monocyte subsets predict mortality after cardiac arrest
Journal of Leukocyte Biology ( IF 5.5 ) Pub Date : 2020-10-05 , DOI: 10.1002/jlb.5a0420-231rr
Konstantin A Krychtiuk 1 , Max Lenz 1 , Bernhard Richter 1 , Philipp J Hohensinner 1 , Stefan P Kastl 1 , Andreas Mangold 1 , Kurt Huber 2, 3 , Christian Hengstenberg 1 , Johann Wojta 1, 2, 4 , Gottfried Heinz 1 , Walter S Speidl 1
Affiliation  

After successful cardiopulmonary resuscitation (CPR), many patients show signs of an overactive immune activation. Monocytes are a heterogeneous cell population that can be distinguished into 3 subsets by flow cytometry (classical monocytes [CM: CD14++CD16-], intermediate monocytes [IM: CD14++CD16+CCR2+] and non-classical monocytes [NCM: CD14+CD16++CCR2-]). Fifty-three patients admitted to the medical intensive care unit (ICU) after cardiac arrest were included. Blood was taken on admission and after 72 h. The primary endpoint of this study was survival at 6 months and the secondary endpoint was neurological outcome as determined by cerebral performance category (CPC)-score at 6 months. Median age was 64.5 (49.8-74.3) years and 75.5% were male. Six-month mortality was 50.9% and survival with good neurological outcome was 37.7%. Monocyte subset distribution upon admission to the ICU did not differ according to survival. Seventy-two hours after admission, patients who died within 6 months showed a higher percentage of the pro-inflammatory subset of IM (8.3% [3.8-14.6]% vs. 4.1% [1.5–8.2]%; P = 0.025), and a lower percentage of CM (87.5% [79.9–89.0]% vs. 90.8% [85.9–92.7]%; P = 0.036) as compared to survivors. In addition, IM were predictive of outcome independent of time to ROSC and witnessed cardiac arrest, and correlated with CPC-score at 6 months (R = 0.32; P = 0.043). These findings suggest a possible role of the innate immune system in the pathophysiology of post cardiac arrest syndrome.

中文翻译:

单核细胞亚群可预测心脏骤停后的死亡率

在成功进行心肺复苏 (CPR) 后,许多患者表现出过度活跃的免疫激活迹象。单核细胞是一种异质细胞群,可以通过流式细胞术分为 3 个亚群(经典单核细胞 [CM: CD14 ++ CD16 - ]、中间单核细胞 [IM: CD14 ++ CD16 + CCR2 + ] 和非经典单核细胞 [NCM: CD14 + CD16 ++ CCR2 -])。包括 53 名在心脏骤停后入住医疗重症监护病房 (ICU) 的患者。入院时和72小时后采血。本研究的主要终点是 6 个月时的生存率,次要终点是根据 6 个月脑表现类别 (CPC) 评分确定的神经学结果。中位年龄为 64.5 (49.8-74.3) 岁,75.5% 为男性。6 个月死亡率为 50.9%,神经功能良好的存活率为 37.7%。入住 ICU 时的单核细胞亚群分布不因生存而异。入院后 72 小时内,6 个月内死亡的患者显示出较高比例的 IM 促炎亚群(8.3% [3.8-14.6]% vs. 4.1% [1.5-8.2]%;P = 0.025),并且 与幸存者相比,CM 的百分比较低(87.5% [79.9–89.0]% vs. 90.8% [85.9–92.7]%;P = 0.036)。此外,IM 可预测结果,与 ROSC 和目击心脏骤停的时间无关,并与 6 个月时的 CPC 评分相关(R  = 0.32;P  = 0.043)。这些发现表明先天免疫系统可能在心脏骤停后综合征的病理生理学中发挥作用。
更新日期:2020-10-05
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