Chiba Yuki, Mizugaki Asumi, Tsuchida Takumi, Kayano Katsuhide, Yamakawa Kazuma, Wada Takeshi
Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
PLoS One. 2025 Jul 31;20(7):e0329069. doi: 10.1371/journal.pone.0329069. eCollection 2025.
The role of extracorporeal membrane oxygenation in the immune response during cardiac arrest, as well as the role of the innate immune system-particularly neutrophils-in the pathophysiology of post-cardiac arrest syndrome, remains underexplored. This study aimed to comprehensively analyze the immune response in the pathology of post-cardiac arrest syndrome. This study included eight patients who experienced cardiogenic cardiopulmonary arrest and were treated for at least 1 week. Blood samples were collected immediately after the return of spontaneous circulation (day 0), as well as on days 1, 3, and 7. These patients formed the post-cardiac arrest syndrome group, and blood samples from five healthy volunteers served as controls. Neutrophil function over time was analyzed using CyTOF® mass cytometry. Furthermore, patients in the post-cardiac arrest syndrome group were divided into extracorporeal membrane oxygenation and non-extracorporeal membrane oxygenation groups according to whether they received extracorporeal membrane oxygenation during resuscitation. Cytokine levels were compared between the two groups using LUMINEX®. Three patients with post-cardiac arrest syndrome underwent extracorporeal membrane oxygenation. Compared with the control group, the post-cardiac arrest syndrome group showed fewer CD177-negative neutrophils and fewer strongly leukotriene B4 receptor 1-positive neutrophils. The extracorporeal membrane oxygenation group had more CD177-negative neutrophils and fewer CD16-seropositive neutrophils than the non-extracorporeal membrane oxygenation group. Differences in serum cytokine levels between the extracorporeal membrane oxygenation and non-extracorporeal membrane oxygenation groups were noted, with certain cytokines, including interleukin-6 and interleukin-8, decreasing over time only in the extracorporeal membrane oxygenation group. As the first in-depth immunological investigation of post-cardiac arrest syndrome, including neutrophil phenotyping, this study may inform clinical practices related to patient management and treatment strategies following cardiac arrest.
体外膜肺氧合在心脏骤停期间免疫反应中的作用，以及先天免疫系统（尤其是中性粒细胞）在心脏骤停后综合征病理生理学中的作用，仍未得到充分研究。本研究旨在全面分析心脏骤停后综合征病理过程中的免疫反应。本研究纳入了8例发生心源性心肺骤停且接受至少1周治疗的患者。在自主循环恢复后即刻（第0天）以及第1、3和7天采集血样。这些患者组成心脏骤停后综合征组，5名健康志愿者的血样作为对照。使用CyTOF®质谱流式细胞术分析中性粒细胞功能随时间的变化。此外，根据心脏骤停后综合征组患者在复苏期间是否接受体外膜肺氧合，将其分为体外膜肺氧合组和非体外膜肺氧合组。使用LUMINEX®比较两组细胞因子水平。3例心脏骤停后综合征患者接受了体外膜肺氧合。与对照组相比，心脏骤停后综合征组CD177阴性中性粒细胞和白三烯B4受体1强阳性中性粒细胞较少。与非体外膜肺氧合组相比，体外膜肺氧合组CD177阴性中性粒细胞较多，CD16血清阳性中性粒细胞较少。注意到体外膜肺氧合组和非体外膜肺氧合组血清细胞因子水平存在差异，某些细胞因子，包括白细胞介素-6和白细胞介素-8，仅在体外膜肺氧合组随时间下降。作为对心脏骤停后综合征的首次深入免疫学研究，包括中性粒细胞表型分析，本研究可能为心脏骤停后患者管理和治疗策略的临床实践提供参考。
