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Role of T lymphocytes apoptosis in immunosuppression and prognosis of cardiac arrest |
Wang Yan-juan, Zhang Jun-li, Gu Wei |
General Ward, Beijing Shunyi Hospital, Beijing 101300, China |
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Abstract Objective To observe the change rule of T lymphocyte subsets and cell apoptosis in patients with cardiac arrest (CA), so as to explore the clinical significance of the related immune assessment and prognosis prediction. Methods A total of 43 patients with CA who have been treated in the emergency department of Beijing Chaoyang Hospital from January 2014 to February 2018 were selected. By taking the survival rate on the 28 day of hospitalization as the end of observation, the patients were divided into the survival group and the death group. Changes of APACHEⅡ scores, T lymphocyte subsets levels and T lymphocyte apoptosis on the 1st, 2nd and 3rd day after admission were analyzed. Results On the 1st, 2nd and 3rd day after onset compared with normal control group, the apoptosis rate of T lymphocytes in peripheral blood increased significantly in CA patients (%:17.17±0.56, 18.52±0.60, 20.24±0.90 vs. 9.87±0.76, P<0.05), and the T lymphocyte subsets decreased significantly (36.670.77, 32.44±0.80, 25.32±0.79 vs. 45.10±1.05, P<0.05). Compared with the survivalgroup, the apoptosis of T lymphocytes in the death group increased significantly (%:29.16±7.82 vs. 41.76±1.83, 31.60±6.23 vs. 38.71±2.10, 33.14±5.16 vs. 37.24±3.28, P<0.05), and the T lymphocyte subsets decreased significantly. In addition, the T lymphocyte subsets levels were significantly negatively correlated with APACHEⅡscores, and the correlation coefficients are respectively -0.362 (P=0.016) and-0.427 (P=0.013). Conclusion Count of the T lymphocyte subsets is a good indicator to evaluate the immune function and outcomes of patients with CA. In the early stages of the resuscitation, the body appears increased T lymphocyte apoptosis and decreased T lymphocyte count significantly. A constantly decrease of T lymphocyte count indicates impaired immune function and increased mortality of patients.
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Corresponding Authors:
Gu Wei, E-mail: banditgu@hotmail.com
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[1]Neumar RW, Nolan JP, Adrie C, et al. Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication[J]. Circulation, 2008, 118(23): 2452-2483.
[2]Gu W, Li CS, Yin WP, et al. Expression imbalance of transcription factors GATA-3 and T-bet in post-resuscitation myocardial immune dysfunction in a porcine model of cardiac arrest[J]. Resuscitation, 2013, 84(6):848-853.
[3]Gu W, Li C, Yin W, et al. Effects of Shen-Fu injection on the expression of T-cell specific transcription factors T-bet/GATA-〖JP〗3 in porcine postresuscitation lung injury[J]. Evid Based Complement Alternat Med, 2013, 2013:464 650.
[4]Jones AE, Shapiro NI, Kilgannon JH, et al. Goal-directed hemodynamic optimization in the post-cardiac arrest syndrome: a systematic review[J]. Resuscitation, 2008, 77(1):26-29.
[5]Adrie C, Adib-Conquy M, Laurent I, et al.Successful cardiopulmonary resuscitation after cardiac arrest as a“sepsis-like”syndrome[J].Circulation, 2002, 106(5):562-568.
[6]Miller AC, Rashid RM, Elamin EM. The“T”in trauma:the helper T-cell response and the role of immunomodulation in trauma and burn patients[J]. J Trauma, 2007, 63(6):1407-1417.
[7]Gu W, Zhang Q, Li CS. Effect of splenic regulatory T-cell apoptosis on the postresuscitation immune dysfunction in a porcine model[J]. Chin Med J (Engl), 2016,129(13):1577-1583.
[8]Gu W, Li CS, Yin WP, et al. Expression imbalance of transcription factors GATA-3 and T-bet in post-resuscitation myocardial immune dysfunction in a porcine model of cardiac arrest[J]. Resuscitation, 2013, 84(6):848-853.
[9]Von Boehmer H.Mechanisms of suppression by suppressor T cells [J].Nat Immunol, 2005, 6(4):338-344.
[10]Gu W, Zhang Q, Yin W, et al. Caspase-3-mediated splenic lymphocyte apoptosis in a porcine model of cardiac arrest[J]. Am J Emerg Med, 2014, 32(9):1027-1032.
[11]尹雪莲.内质网应激与常见危重症[J].中国急救医学, 2011, 31(6):551-554.
[12]聂文龙,调节性T细胞功能与脓毒症免疫抑制的研究进展[J].中国急救医学, 2016, 36(2):116-119.
[13]Hotchkiss RS,Karl IE.The pathophysiology and treatment of sepsis[J].N Engl J Med, 2003, 348(2):138-150.
[14]顾伟,李春盛,殷文朋,等.转录因子GATA-3和T-bet的表达失衡在复苏后急性肺损伤中的作用[J].中华急诊医学杂志, 2014, 23(1): 8-14.
[15]Von Boehmer H. Mechanisms of suppression by suppressor T cells[J]. Nat Immunol, 2005, 6(4):338-344. [16]Gu W, Li C, Yin W, et al. Shen-Fu injection reduces postresuscitation myocardial dysfunction in a porcine model of cardiac arrest by modulating apoptosis[J]. Shock, 2012, 38(3):301-306. |
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