Westermann Timo Michael, Sendas Joe, Koller Alexander Sebastian, Jovanovski Darko, Hüsken Dominik, Lessing Pascal Max Lucien, Weber Birte, Mühling Bernd, Liebold Andreas, Messerer David Alexander Christian, Huber-Lang Markus, Wohlgemuth Lisa
Institute of Clinical and Experimental Trauma Immunology, University Hospital Ulm, Ulm, Germany.
Department of Cardiothoracic and Vascular Surgery, University Hospital Ulm, Ulm, Germany.
Scand J Immunol. 2025 Jul;102(1):e70042. doi: 10.1111/sji.70042.
The lack of diagnostic and monitoring tools for postsurgical immunological complications such as systemic inflammation can contribute to a poor outcome despite modern intensive care. The need for reliable immune monitoring has been emphasised. Polymorphonuclear leukocytes (PMNs) play an important role in postsurgical inflammation. A subgroup of PMNs is particularly interesting, because they are released shortly after (iatrogenic) trauma: immature PMNs, characterised by, for example, their low CD10 expression. Therefore, we investigated the role of CD10 PMNs in a non-interventional exploratory study by including patients undergoing scheduled, highly standardised cardiac surgery with extracorporeal circulation. We were able to demonstrate that the number of CD10 PMNs released shortly after the beginning of surgery correlated with different fluid phase markers of inflammation and organ damage postsurgically. Among these parameters were CRP, IL-6, NGAL, CK-MB, and troponin-T. Noteworthy, the amount of CD10 PMNs increased as early as 24 h before these well-established markers, suggesting superiority of CD10 PMNs as an early diagnostic marker. Comparing CD10 immature PMNs with CD10 mature PMNs revealed potential involved mechanisms, including lower CD11b expression and a significant decrease in the formation of platelet-neutrophil complexes (PNCs) by CD10 PMNs. In conclusion, we propose CD10 PMNs as a potential early cellular biomarker to assess the postsurgical inflammatory response. In comparison to clinically established markers like CRP or IL-6 and scoring systems such as the SOFA-Score, CD10 PMNs reflect a potential candidate for future immune monitoring to determine the risk of excessive inflammation and organ impairment more rapidly.
尽管有现代重症监护，但缺乏针对术后免疫并发症（如全身炎症）的诊断和监测工具可能导致预后不良。人们已经强调了对可靠免疫监测的需求。多形核白细胞（PMN）在术后炎症中起重要作用。PMN的一个亚组特别有趣，因为它们在（医源性）创伤后不久就会释放：未成熟的PMN，例如以其低CD10表达为特征。因此，我们在一项非干预性探索性研究中，纳入了接受计划的、高度标准化的体外循环心脏手术的患者，以研究CD10 PMN的作用。我们能够证明，手术开始后不久释放的CD10 PMN数量与术后炎症和器官损伤的不同液相标志物相关。这些参数包括CRP、IL-6、NGAL、CK-MB和肌钙蛋白-T。值得注意的是，CD10 PMN的数量早在这些成熟标志物出现前24小时就增加了，这表明CD10 PMN作为早期诊断标志物具有优越性。将CD10未成熟PMN与CD10成熟PMN进行比较，揭示了潜在的相关机制，包括较低的CD11b表达以及CD10 PMN形成血小板-中性粒细胞复合物（PNC）的显著减少。总之，我们提出CD10 PMN作为评估术后炎症反应的潜在早期细胞生物标志物。与CRP或IL-6等临床确立的标志物以及SOFA评分等评分系统相比，CD10 PMN反映了一个潜在的候选指标，可用于未来的免疫监测，以更快地确定过度炎症和器官损伤的风险。
