Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients
<b>Background:</b> A deregulated immune system has been implicated in the pathogenesis of post-cardiac arrest syndrome (PCAS). A soluble form of programmed cell death-1 (PD-1) ligand (sPD-L1) has been found at increased levels in cancer and sustained inflammation, thereby deregulating im...
Main Authors: | , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-09-01
|
Series: | Journal of Clinical Medicine |
Subjects: | |
Online Access: | https://www.mdpi.com/2077-0383/10/18/4188 |
id |
doaj-33c17408e8764f35b0ef6de9bb04efb3 |
---|---|
record_format |
Article |
spelling |
doaj-33c17408e8764f35b0ef6de9bb04efb32021-09-26T00:28:29ZengMDPI AGJournal of Clinical Medicine2077-03832021-09-01104188418810.3390/jcm10184188Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest PatientsMiho Sumiyoshi0Eiji Kawamoto1Yuki Nakamori2Ryo Esumi3Kaoru Ikejiri4Toru Shinkai5Yuichi Akama6Asami Ito-Masui7Hiroshi Imai8Arong Gaowa9Eun Jeong Park10Motomu Shimaoka11Department of Anesthesia, Mie Prefectural General Medical Center, 5450-132 Hinaga, Yokkaichi 510-0885, Mie, JapanDepartment of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Disaster and Emergency Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Disaster and Emergency Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Disaster and Emergency Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, JapanDepartment of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City 514-8507, Mie, Japan<b>Background:</b> A deregulated immune system has been implicated in the pathogenesis of post-cardiac arrest syndrome (PCAS). A soluble form of programmed cell death-1 (PD-1) ligand (sPD-L1) has been found at increased levels in cancer and sustained inflammation, thereby deregulating immune functions. Here, we aim to study the possible involvement of sPD-L1 in PCAS. <b>Methods:</b> Thirty out-of-hospital cardiac arrest (OHCA) patients consecutively admitted to the ER of Mie University Hospital were prospectively enrolled. Plasma concentrations of sPD-L1 were measured by an enzyme-linked immunosorbent assay in blood samples of all 30 OHCA patients obtained during cardiopulmonary resuscitation (CPR). In 13 patients who achieved return-of-spontaneous-circulation (ROSC), sPD-L1 levels were also measured daily in the ICU. <b>Results:</b> The plasma concentrations of sPD-L1 in OHCA were significantly increased; in fact, to levels as high as those observed in sepsis. sPD-L1 levels during CPR correlated with reduced peripheral lymphocyte counts and increased C-reactive protein levels. Of 13 ROSC patients, 7 cases survived in the ICU for more than 4 days. A longitudinal analysis of sPD-L1 levels in the 7 ROSC cases revealed that sPD-L1 levels occurred in parallel with organ failure. <b>Conclusions:</b> This study suggests that ischemia- reperfusion during CPR may aberrantly activate immune and endothelial cells to release sPD-L1 into circulation, which may play a role in the pathogenesis of immune exhaustion and organ failures associated with PCAS.https://www.mdpi.com/2077-0383/10/18/4188post-cardiac arrest syndromeimmunosuppressioninflammationPD-1PD-L1lymphocytes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Miho Sumiyoshi Eiji Kawamoto Yuki Nakamori Ryo Esumi Kaoru Ikejiri Toru Shinkai Yuichi Akama Asami Ito-Masui Hiroshi Imai Arong Gaowa Eun Jeong Park Motomu Shimaoka |
spellingShingle |
Miho Sumiyoshi Eiji Kawamoto Yuki Nakamori Ryo Esumi Kaoru Ikejiri Toru Shinkai Yuichi Akama Asami Ito-Masui Hiroshi Imai Arong Gaowa Eun Jeong Park Motomu Shimaoka Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients Journal of Clinical Medicine post-cardiac arrest syndrome immunosuppression inflammation PD-1 PD-L1 lymphocytes |
author_facet |
Miho Sumiyoshi Eiji Kawamoto Yuki Nakamori Ryo Esumi Kaoru Ikejiri Toru Shinkai Yuichi Akama Asami Ito-Masui Hiroshi Imai Arong Gaowa Eun Jeong Park Motomu Shimaoka |
author_sort |
Miho Sumiyoshi |
title |
Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients |
title_short |
Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients |
title_full |
Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients |
title_fullStr |
Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients |
title_full_unstemmed |
Elevated Plasma Soluble PD-L1 Levels in Out-of-Hospital Cardiac Arrest Patients |
title_sort |
elevated plasma soluble pd-l1 levels in out-of-hospital cardiac arrest patients |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-09-01 |
description |
<b>Background:</b> A deregulated immune system has been implicated in the pathogenesis of post-cardiac arrest syndrome (PCAS). A soluble form of programmed cell death-1 (PD-1) ligand (sPD-L1) has been found at increased levels in cancer and sustained inflammation, thereby deregulating immune functions. Here, we aim to study the possible involvement of sPD-L1 in PCAS. <b>Methods:</b> Thirty out-of-hospital cardiac arrest (OHCA) patients consecutively admitted to the ER of Mie University Hospital were prospectively enrolled. Plasma concentrations of sPD-L1 were measured by an enzyme-linked immunosorbent assay in blood samples of all 30 OHCA patients obtained during cardiopulmonary resuscitation (CPR). In 13 patients who achieved return-of-spontaneous-circulation (ROSC), sPD-L1 levels were also measured daily in the ICU. <b>Results:</b> The plasma concentrations of sPD-L1 in OHCA were significantly increased; in fact, to levels as high as those observed in sepsis. sPD-L1 levels during CPR correlated with reduced peripheral lymphocyte counts and increased C-reactive protein levels. Of 13 ROSC patients, 7 cases survived in the ICU for more than 4 days. A longitudinal analysis of sPD-L1 levels in the 7 ROSC cases revealed that sPD-L1 levels occurred in parallel with organ failure. <b>Conclusions:</b> This study suggests that ischemia- reperfusion during CPR may aberrantly activate immune and endothelial cells to release sPD-L1 into circulation, which may play a role in the pathogenesis of immune exhaustion and organ failures associated with PCAS. |
topic |
post-cardiac arrest syndrome immunosuppression inflammation PD-1 PD-L1 lymphocytes |
url |
https://www.mdpi.com/2077-0383/10/18/4188 |
work_keys_str_mv |
AT mihosumiyoshi elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT eijikawamoto elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT yukinakamori elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT ryoesumi elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT kaoruikejiri elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT torushinkai elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT yuichiakama elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT asamiitomasui elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT hiroshiimai elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT aronggaowa elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT eunjeongpark elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients AT motomushimaoka elevatedplasmasolublepdl1levelsinoutofhospitalcardiacarrestpatients |
_version_ |
1717366052320444416 |