Department of Emergency Med-Cardiopulmonary, The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States.
State University of New York Downstate Medical Center, NY, United States.
Front Immunol. 2024 Mar 13;15:1362858. doi: 10.3389/fimmu.2024.1362858. eCollection 2024.
Cardiac arrest (CA) is a significant public health concern. There is the high imminent mortality and survival in those who are resuscitated is substantively compromised by the post-CA syndrome (PCAS), characterized by multiorgan ischemia-reperfusion injury (IRI). The inflammatory response in PCAS is complex and involves various immune cell types, including lymphocytes and myeloid cells that have been shown to exacerbate organ IRI, such as myocardial infarction. Purinergic signaling, as regulated by CD39 and CD73, has emerged as centrally important in the context of organ-specific IRI. Hence, comprehensive understanding of such purinergic responses may be likewise imperative for improving outcomes in PCAS.
We have investigated alterations of immune cell populations after CA by utilizing rodent models of PCAS. Blood and spleen were collected after CA and resuscitation and underwent flow cytometry analysis to evaluate shifts in CD3CD4 helper T cells, CD3CD8a cytotoxic T cells, and CD4/CD8a ratios. We then examined the expression of CD39 and CD73 across diverse cell types, including myeloid cells, T lymphocytes, and B lymphocytes.
In both rat and mouse models, there were significant increases in the frequency of CD3CD4 T lymphocytes in PCAS (rat, < 0.01; mouse, < 0.001), with consequently elevated CD4/CD8a ratios in whole blood (both, < 0.001). Moreover, CD39 and CD73 expression on blood leukocytes were markedly increased (rat, < 0.05; mouse, < 0.01 at 24h). Further analysis in the experimental mouse model revealed that CD11b myeloid cells, with significant increase in their population ( < 0.01), had high level of CD39 (88.80 ± 2.05 %) and increased expression of CD73 ( < 0.05). CD19 B lymphocytes showed slight increases of CD39 ( < 0.05 at 2h) and CD73 ( < 0.05 at 2h), while, CD3 T lymphocytes had decreased levels of them. These findings suggested a distinct patterns of expression of CD39 and CD73 in these specific immune cell populations after CA.
These data have provided comprehensive insights into the immune response after CA, highlighting high-level expressions of CD39 and CD73 in myeloid cells.
心脏骤停(CA)是一个重大的公共卫生问题。那些复苏后的患者有很高的即时死亡率,而且复苏后综合征(PCAS)会严重影响患者的生存,其特征是多器官缺血再灌注损伤(IRI)。PCAS 中的炎症反应很复杂,涉及多种免疫细胞类型,包括淋巴细胞和髓样细胞,它们已被证明会加重器官 IRI,如心肌梗死。三磷酸腺苷(ATP)信号转导,由 CD39 和 CD73 调节,在器官特异性 IRI 中显得非常重要。因此,全面了解这种嘌呤能反应对于改善 PCAS 的预后可能同样至关重要。
我们通过利用 PCAS 的啮齿动物模型来研究 CA 后免疫细胞群的变化。CA 后和复苏后采集血液和脾脏,并进行流式细胞术分析,以评估 CD3CD4 辅助 T 细胞、CD3CD8a 细胞毒性 T 细胞和 CD4/CD8a 比值的变化。然后,我们检查了包括髓样细胞、T 淋巴细胞和 B 淋巴细胞在内的多种细胞类型中 CD39 和 CD73 的表达。
在大鼠和小鼠模型中,PCAS 中 CD3CD4 T 淋巴细胞的频率显著增加(大鼠, < 0.01;小鼠, < 0.001),全血中的 CD4/CD8a 比值也随之升高(两者均, < 0.001)。此外,血液白细胞上的 CD39 和 CD73 表达明显增加(大鼠, < 0.05;小鼠,24 小时时 < 0.01)。在实验小鼠模型中的进一步分析表明,CD11b 髓样细胞的数量显著增加( < 0.01),其 CD39 水平很高(88.80 ± 2.05%),CD73 的表达增加( < 0.05)。CD19 B 淋巴细胞的 CD39 略有增加(2 小时时 < 0.05),CD73 略有增加(2 小时时 < 0.05),而 CD3 T 淋巴细胞的表达水平则降低。这些发现表明,CA 后这些特定免疫细胞群中 CD39 和 CD73 的表达存在明显的模式。
这些数据全面深入地了解了 CA 后的免疫反应,突出了髓样细胞中 CD39 和 CD73 的高水平表达。