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Комплексные проблемы сердечно-сосудистых заболеваний

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IMMUNOSUPPRESSION AS A COMPONENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME FOLLOWING CARDIAC SURGERY

https://doi.org/10.17802/2306-1278-2018-7-4-84-91

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Аннотация

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 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. 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-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.

Об авторах

E. V. Grigoryev
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 Federation
Россия

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



D. L. Shukevich
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 Federation
Россия

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



V. G. Matveeva
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Россия

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

6, Sosnoviy Blvd., Kemerovo, 650002



R. A. Kornekyuk
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 Federation
Россия

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



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Для цитирования:


Grigoryev E.V., Shukevich D.L., Matveeva V.G., Kornekyuk R.A. IMMUNOSUPPRESSION AS A COMPONENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME FOLLOWING CARDIAC SURGERY. Комплексные проблемы сердечно-сосудистых заболеваний. 2018;7(4):84-91. https://doi.org/10.17802/2306-1278-2018-7-4-84-91

For citation:


Grigoryev E.V., Shukevich D.L., Matveeva V.G., Kornekyuk R.A. IMMUNOSUPPRESSION AS A COMPONENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME FOLLOWING CARDIAC SURGERY. Complex Issues of Cardiovascular Diseases. 2018;7(4):84-91. https://doi.org/10.17802/2306-1278-2018-7-4-84-91

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