Impact of cardiac surgery on the expression of CD40, CD80, CD86 and HLA-DR on B cells and monocytes

Holmannová, Drahomíra; Koláčková, Martina; Kuneš, P; Krejsek, Jan; Mandak, Jiri; Andrýs, Ctirad

doi:10.1177/0267659115612905

Cited by 14 publications

(10 citation statements)

References 34 publications

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“…The mechanism for this change has yet to be determined and is beyond the scope of the present manuscript, but does highlight the need to better understand the functional significance of the observation beyond the association with AE as we have suggested. Others have described significant changes in cell surface expression of other markers of activation (HLA-DR, CD163, TM) of various subsets of immune cells like lymphocytes, B cells, and monocytes associated with CPB supporting our findings, but like others we do not fully understand its implications (7, 28, 29). It is noteworthy that the changes we observed early after cardiac surgery did resolve over time suggesting that some of these changes may not only be related to the surgery, but may also be important in healing and/or involved in regulating either the initial inflammatory response or its resolution.…”

Section: Discussionsupporting

confidence: 72%

Changes in Circulating Monocyte Subsets (CD16 Expression) and Neutrophil-to-Lymphocyte Ratio Observed in Patients Undergoing Cardiac Surgery

Gawdat

Legere

Wong

et al. 2017

Front. Cardiovasc. Med.

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BackgroundThe characteristics of circulating inflammatory cells (leukocytes) in patients undergoing heart surgery remains poorly understood. Recently, neutrophil-to-lymphocyte ratio (NLR) and specific monocyte subsets (based on CD14/CD16 expression) have been suggested as markers of inflammation and predictors of outcomes. The present study aims to characterize the influence cardiac surgery with cardiopulmonary bypass has on specific circulating leukocytes.MethodsAll enrolled patients had blood samples taken pre- (0 days), early post- (5 days), and late post- (90 days) surgery. Complete blood counts were performed and whole leukocyte isolations were obtained from blood samples and analyzed with flow cytometry. Fluorophore-linked antibodies (CD45, CD11b, CD14, and CD16) were added to the blood cell isolations and later assessed by flow cytometry.ResultsSeventeen patients were enrolled and samples obtained at 0, 5, and 90 days. We demonstrated a significant increase in NLR (2.2-fold; p = 0.0028) and CD16 mean fluorescence index (MFI-measure fluorescence intensity shift of CD16 in a gated cell population) early at day 5 (2.0-fold; p = 0.0051). Both NLR and CD16 MFI levels generally returned to normal by day 90. There was a significant positive correlation between NLR and CD16 MFI (r2 = 0.29; p = 0.0064). Adverse cardiovascular event (AE) was defined as prolonged length of hospitalization or readmission to hospital for cardiac reasons after discharge was seen in 59% of patients (no deaths occurred). In an unadjusted analysis of AE, we identified NLR as a likely predictor of AE, which meant that patients developing AE had a significantly higher baseline NLR (p = 0.0065), something that was not observed with CD16 MFI (p = 0.2541).ConclusionCardiac surgery is associated with a significant increase in NLR and CD16 MFI (non-classical monocytes) early after surgery corresponding to the early inflammatory phase after surgery. Furthermore, we have, for the first time, identified a significant correlation between NLR and CD16 MFI. While the mechanism for this relationship remains unclear, our findings support the use of a simple test of NLR as a biomarker of inflammation for predicting outcomes in cardiac surgery patients.

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Section: Discussionsupporting

confidence: 72%

Changes in Circulating Monocyte Subsets (CD16 Expression) and Neutrophil-to-Lymphocyte Ratio Observed in Patients Undergoing Cardiac Surgery

Gawdat

Legere

Wong

et al. 2017

Front. Cardiovasc. Med.

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“…Exclusion criteria were pregnancy, emergency operations and patients aged less than 18 years. Out of these 107 patients, 3 patients received "off-pump" cardiac surgery; these three patients were excluded from the analysis due a potentially different activation of immune cells that had not been exposed to extracorporeal circulation 16,17 . Patient data, clinical information and blood samples were collected prospectively immediately before (pre) surgery, after (post) surgery as well as 1 day and 4 days after cardiac surgery.…”

Section: Methodsmentioning

confidence: 99%

Elevated circulating CD14++CD16+ intermediate monocytes are independently associated with extracardiac complications after cardiac surgery

Mossanen

Jansen

Pracht

et al. 2020

Sci Rep

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Elective cardiac surgery has low procedural complications. However, about 40% of patients develop extracardiac complications including delirium and acute kidney injury. We hypothesized that inflammatory processes and immune cell activation might be associated with these complications. We therefore prospectively included 104 patients undergoing cardiac surgery in our study. We assessed peripheral blood leukocyte populations by flow cytometry and circulating cytokines before operation, after surgery and at days one and four post-operatively. Patients undergoing cardiac surgery showed significantly elevated leukocytes and neutrophils after surgery. On the contrary, monocytes decreased after surgery and significantly increased at days 1 and 4, particularly classical (Mon1,CD14++CD16−) and intermediate (Mon2,CD14++CD16+) monocytes. While peripheral leukocyte subsets were unaltered in patients with infectious (n = 15) or cardiac complications (n = 31), post-operative leukocytes (p = 0.0016), neutrophils (p = 0.0061) and Mon2 (p = 0.0007) were clearly raised in patients developing extracardiac complications (n = 35). Using multiple logistic regression analyses, patient's age, ICU days, number of blood transfusions and elevated post-surgery Mon2 independently predicted extracardiac complications. Our findings demonstrate that elevated Mon2 after cardiac surgery are associated with an increased risk for extracardiac complications. These findings might improve the risk estimation after cardiac operations and the role of Mon2 for inflammation in cardiac surgery.Despite advances in surgical and anesthetic techniques as well as enhanced postoperative care, cardiac surgery is still associated with a high risk of postoperative complications 1 . Besides typical cardiac (e.g., arrhythmia, myocardial infarction) and infectious complications (e.g., wound infection, pneumonia and sepsis), extracardiac non-infectious complications like acute kidney injury (AKI, 30%) and delirium (up to 26-52%) are frequent in patients after cardiac surgery 2,3 . It has been speculated that a large part of these complications could be explained by excessive inflammation caused by extracorporeal cardio-pulmonary bypass (CPB), hypothermia, myocardial ischemia and reperfusion and tissue damage due to the surgical procedure 4,5 . The influence of distinct immune cells and their subpopulations on the occurrence of post-operative complications is still ambiguous and needs further investigations. Particularly monocytes seems to play in important role within this context 6,7 .Circulating monocyte subsets represent a continuum of differentiation stages 8,9 . Using the surface markers CD14 (LPS receptor) and CD16 (FcγRIII), blood monocytes can be subdivided into three subpopulations, CD14++CD16− "classical" monocytes (Mon1), CD14++CD16+ "intermediate" (Mon2) and CD14-16+

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“…The CD200 ligand (CD200L), produced by both neurons and astrocytes, can interact with CD200R, a cell surface glycoprotein that is expressed by microglia. The interaction between CD200 and CD200R inhibits microglial activation [91], and there is evidence that both CD200 and CD200R are decreased in the AD brain [92], suggesting that a lack in inhibitory signals can be a factor that contributes to microglial activation in AD. However, neurons and astrocytes also send signals that can activate microglia, e.g.…”

Section: Neuronsmentioning

confidence: 99%

Differential Regulation of Resolution in Inflammation induced by Amyloid-β42 and Lipopolysaccharides in Human Microglia

Zhu

Wang

Schultzberg

et al. 2014

JAD

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Resolution of inflammation terminates the inflammatory response in physiological conditions and promotes restoration and healing of the tissue; however, failure in resolution results in chronic inflammation that may lead to disease. Chronic inflammation mediated by microglia is a feature of Alzheimer's disease (AD) and can be a pathogenic factor in which both treatment targets and diagnostic markers may be found. In addition, there is evidence that the resolution pathway is altered in AD. It is therefore relevant to investigate whether amyloid-β (Aβ) peptide, the major component of senile plaque in AD brain, may have a negative influence on components of the resolution cascade. In this pursuit, we exposed microglia to Aβ42, and with bacterial lipopolysaccharides (LPS) for comparison with a general infectious stimulus. Differential effects were observed: LPS upregulated components of the resolution pathway including the LXA4 receptor/formyl peptide receptor 2 (ALX/FPR2) and phosphorylated 5-lipoxygenase (p-5-LOX), as well as cholinergic alpha 7 nicotinic receptor (α7nAChR) and peroxisome proliferator-activated receptor (PPAR)-δ whereas Aβ42 had an opposite or insignificant effect. Our results indicate that LPS-induced changes in the microglia were conducive for resolution of inflammation, whereas these responses were absent or suppressed in microglia treated with Aβ42. Further studies may prove if Aβ42-induced dysfunction of resolution in microglia contributes to the impaired resolution in the AD brain, and if stimulation of microglial resolution constitutes a treatment strategy for AD.

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Impact of cardiac surgery on the expression of CD40, CD80, CD86 and HLA-DR on B cells and monocytes

Cited by 14 publications

References 34 publications

Changes in Circulating Monocyte Subsets (CD16 Expression) and Neutrophil-to-Lymphocyte Ratio Observed in Patients Undergoing Cardiac Surgery

Changes in Circulating Monocyte Subsets (CD16 Expression) and Neutrophil-to-Lymphocyte Ratio Observed in Patients Undergoing Cardiac Surgery

Elevated circulating CD14++CD16+ intermediate monocytes are independently associated with extracardiac complications after cardiac surgery

Differential Regulation of Resolution in Inflammation induced by Amyloid-β42 and Lipopolysaccharides in Human Microglia

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