体外膜肺氧合对重症冠状病毒感染宿主转录组反应的影响
Extracorporeal Membrane Oxygenation Impact on Host Transcriptomic Response in Severe Coronavirus.
作者信息
Smith Deane E, Goparaju Chandra M, Pass Harvey I, James Les, Alimi Marjan, Chang Stephanie, Grossi Eugene A, Moazami Nader, Galloway Aubrey C
机构信息
Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York.
出版信息
Ann Thorac Surg Short Rep. 2023 Apr 14;1(3):533-6. doi: 10.1016/j.atssr.2023.04.003.
BACKGROUND
Evidence suggests that patients critically ill with COVID-19 have a dysregulated host immune response that contributes to end-organ damage. Extracorporeal membrane oxygenation (ECMO) has been used in this population with varying degrees of success. This study was performed to evaluate the impact of ECMO on the host immunotranscriptomic response in these patients.
METHODS
Eleven patients critically ill with COVID-19 requiring ECMO underwent an analysis of cytokines and immunotranscriptomic pathways before ECMO (T1), after ECMO for 24 hours (T2), and 2 hours after ECMO decannulation (T3). A Multiplex Human Cytokine panel was used to identify cytokine changes, and immunotranscriptomic changes in peripheral leukocytes were evaluated by PAXgene and NanoString nCounter.
RESULTS
Differential gene expression of 11 host immune genes was noted at T2 compared with T1. The most significant genes were and , which code for binding ligands for the activation of toll-like receptors 2 and 4. Reactome analyses of differential gene expression demonstrated an impact on many of the body's most important immune inflammatory pathways.
CONCLUSIONS
These findings suggest a temporal impact of ECMO on the host immunotranscriptomic response in patients critically ill with COVID-19.
背景
有证据表明，新冠肺炎重症患者存在宿主免疫反应失调，这会导致终末器官损伤。体外膜肺氧合（ECMO）已应用于这一人群，取得了不同程度的成功。本研究旨在评估ECMO对这些患者宿主免疫转录组反应的影响。
方法
11例需要ECMO的新冠肺炎重症患者在ECMO治疗前（T1）、ECMO治疗24小时后（T2）以及ECMO撤管2小时后（T3）接受了细胞因子和免疫转录组通路分析。使用多重人细胞因子检测板来识别细胞因子变化，并通过PAXgene和NanoString nCounter评估外周血白细胞中的免疫转录组变化。
结果
与T1相比，T2时发现11个宿主免疫基因存在差异基因表达。最显著的基因是 和 ，它们编码用于激活Toll样受体2和4的结合配体。差异基因表达的Reactome分析表明，对人体许多最重要的免疫炎症通路有影响。
结论
这些发现表明ECMO对新冠肺炎重症患者的宿主免疫转录组反应有暂时影响。
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