kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2018-7-4-84-91kpccz-485Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESIMMUNOSUPPRESSION AS A COMPONENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME FOLLOWING CARDIAC SURGERYIMMUNOSUPPRESSION AS A COMPONENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME FOLLOWING CARDIAC SURGERYGrigoryevE. V.GrigoryevE. V.

Grigoriev Evgeny V., MD, PhD, Professor of the Russian Academy of Sciences, Deputy Director for Research and Clinical Issues, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; Head of the Department of Intensive Care, Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation

6, Sosnoviy Blvd., Kemerovo, 650002, 

22a, Voroshilova St., Kemerovo, 650029

Grigoriev Evgeny V., MD, PhD, Professor of the Russian Academy of Sciences, Deputy Director for Research and Clinical Issues, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; Head of the Department of Intensive Care, Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation

6, Sosnoviy Blvd., Kemerovo, 650002, 

22a, Voroshilova St., Kemerovo, 650029

grigev@kemcardio.ruShukevichD. L.ShukevichD. L.

Shukevich Dmitriy L., MD, PhD, Head of the Laboratory of Critical Conditions, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; Professor at the Department of Intensive Care, Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation

6, Sosnoviy Blvd., Kemerovo, 650002, 

22a, Voroshilova St., Kemerovo, 650029

Shukevich Dmitriy L., MD, PhD, Head of the Laboratory of Critical Conditions, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; Professor at the Department of Intensive Care, Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation

6, Sosnoviy Blvd., Kemerovo, 650002, 

22a, Voroshilova St., Kemerovo, 650029

MatveevaV. G.MatveevaV. G

Matveeva Vera G., PhD, senior researcher at the Laboratory of Cell Technologies

6, Sosnoviy Blvd., Kemerovo, 650002

Matveeva Vera G., PhD, senior researcher at the Laboratory of Cell Technologies

6, Sosnoviy Blvd., Kemerovo, 650002

KornelyukR. A.KornelyukR. A.

Korneluk Roman A., MD, intensivist, PhD student, research assistant, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; lecturer assistant at the Department of Intensive Care, Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation

6, Sosnoviy Blvd., Kemerovo, 650002, 

22a, Voroshilova St., Kemerovo, 650029

Korneluk Roman A., MD, intensivist, PhD student, research assistant, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; lecturer assistant at the Department of Intensive Care, Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation

6, Sosnoviy Blvd., Kemerovo, 650002, 

22a, Voroshilova St., Kemerovo, 650029

Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian FederationРоссияFederal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian FederationRussian FederationFederal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”РоссияFederal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”Russian Federation201818122018748491Copyright © Grigoryev E.V., Shukevich D.L., Matveeva V.G., Kornelyuk R.A., 20182018Grigoryev E.V., Shukevich D.L., Matveeva V.G., Kornelyuk R.A.Grigoryev E.V., Shukevich D.L., Matveeva V.G., Kornelyuk R.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/485Aim

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

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 flow 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

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.

Aim

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

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 flow 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

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

Conclusion. An increase in M-MDSCs and elevated serum levels of the anti-inflammatory 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-inflammatory cytokine IL-10, related to higher rate of hospital infections, prolonged intensive care unit stay and higher mortality.

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The authors declare that there are no conflicts of interest present.