Open AccessIMMUNOSUPPRESSION AS A COMPONENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME FOLLOWING CARDIAC SURGERY
Author(s) -
E. V. Grigoryev,
Д. Л. Шукевич,
В. Г. Матвеева,
R. A. Kornelyuk
Publication year - 2018
Publication title -
kompleksnye problemy serdečno-sosudistyh zabolevanij
Language(s) - English
Resource type - Journals
eISSN - 2587-9537
pISSN - 2306-1278
DOI - 10.17802/2306-1278-2018-7-4-84-91
Subject(s) - immunosuppression , cd33 , medicine , myeloid derived suppressor cell , cd14 , multiple organ dysfunction syndrome , myeloid , immunology , interleukin 10 , organ dysfunction , gastroenterology , flow cytometry , cytokine , sepsis , suppressor , cd34 , biology , stem cell , cancer , genetics
Aim. To defne the role of myeloid-derived suppressor cells in the development of persistent multiple organ dysfunction followed cardiac surgeries with cardiopulmonary bypass. Methods. 40 patients who have undergone cardiac surgery were included in the study. Granulocyte myeloid-derived suppressor cells (G-MDSC) were defned as cells with the HLA-DR– / CD11β+ / CD15+ / CD33+ phenotype, and monocytic MDSC (M-MDSC) as cells with the HLA-DR– / CD11β+ / CD14+ / CD33+ phenotype using ow cytometry. Levels of cytokines, IL-1β, IL-6, TNF-α, and IL-10 were measured with an enzyme immunoassay. All patients were assigned to three groups: Group 1 – patients with the uncomplicated postoperative period (n = 14), Group 2 – patients with non-persistent MODS and its early resolution (n = 16), and Group 3 – patients with persistent MODS at day 7. Results. We observed an increase in M-MDSCs and G-MDSC at day 1 following cardiac surgery. The most pronounced increase was found in monocytic-myeloid derived suppressor cells, i.e. an 8-fold increase in M-MDSCs in all study groups at day 1 after surgery. The number of M-MDSCs remained high in patients with persistent MODS at day 7 after cardiac surgery. Levels of IL-6 and IL-10 increased at day 1 after surgery. IL-6 reached its peak level, signifcantly exceeding baseline levels. By day 7, blood levels of all cytokines have decreased, except IL-10 levels, which remained above the baseline in patients with persistent MODS. Conclusion. An increase in M-MDSCs and elevated serum levels of the anti-inammatory cytokine IL-10 have been found in patients regardless of the presence or absence of the complications in the early postoperative period after cardiac surgery with cardiopulmonary bypass. Persistent MODS with the SOFA scoring > 5 scores at day 7 after cardiac surgery, is associated with an increase in M-MDSCs and elevated levels of the anti-inammatory cytokine IL-10, related to higher rate of hospital infections, prolonged intensive care unit stay and higher mortality.