Relationship between the expression of biomarkers in the activated innate immune cell and vital organs injuries during the cardiopulmonary bypass_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIONG Wen ¹ , ZHANG Jinghan ² , DU Lei ³ ,  HU Xiaoling ¹

1. The First Affiliated Hospital of University of South China, Hengyang, 421001, Hunan, P. R. China;
2. School of Anaesthesia, Zunyi Medical University, Zunyi, 563099, Guizhou, P. R. China;
3. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China;

Corresponding author：

HU Xiaoling, Email: 2469155911@qq.com

Keywords：

Cardiopulmonary bypass; inflammatory response; biomarkers; organ injury; review

DOI：

10.7507/1007-4848.202302089

Video：

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Abstract Full text Figures/Tables Video References Cited by

Although great progress has been achieved in the techniques and materials of cardiopulmonary bypass (CPB), cardiac surgery under CPB is still one of the surgeries with the highest complication rate. The systemic inflammatory response is an important cause of complications, mainly characterized by activation of innate immune cells and platelets, and up-regulation of inflammatory cytokines. After activation, a variety of molecules on the membrane surface are up-regulated or down-regulated, which can amplify tissue inflammatory damage by releasing cytoplasmic protease and reactive oxygen species, and activate multiple inflammatory signaling pathways in the cell, ultimately leading to organ dysfunction. Therefore, the expression of these cell membrane activation markers is not only a marker of cell activation, but also plays an important role in the process of vital organ injury after surgery. Identification of these specific activation markers is of great significance to elucidate the mechanisms related to organ injury and to find new prevention and treatment methods. This article will review the relationship between these activated biomarkers in the innate immune cells and vital organ injuries under CPB.

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16.	Hadley JS, Wang JE, Michaels LC, et al. Alterations in inflammatory capacity and TLR expression on monocytes and neutrophils after cardiopulmonary bypassShock2007275466473.
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18.	Ots HD, Tracz JA, Vinokuroff KE, et al. CD40–CD40L in neurological diseaseInt J Mol Sci20222384115.
19.	Perros AJ, Esguerra-Lallen A, Rooks K, et al. Coronary artery bypass grafting is associated with immunoparalysis of monocytes and dendritic cellsJ Cell Mol Med202024847914803.
20.	Holmannova D, Kolackova M, Kunes P, et al. Impact of cardiac surgery on the expression of CD40, CD80, CD86 and HLA-DR on B cells and monocytesPerfusion2016315391400.
21.	Zhang J, Ding W, Liu J, et al. Scavenger receptors in myocardial infarction and ischemia/reperfusion injury: The potential for disease evaluation and therapyJ Am Heart Assoc2023122e027862.
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23.	Asmussen A, Busch HJ, Helbing T, et al. Monocyte subset distribution and surface expression of HLA-DR and CD14 in patients after cardiopulmonary resuscitationSci Rep202111112403.
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26.	Ivetic A, Hoskins Green HL, Hart SJL-selectin: A major regulator of leukocyte adhesion, migration and signalingFront Immunol2019101068.
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30.	Shu Q, Zhang XH, Wu LJ, et al. Effect of cardiopulmonary bypass on CD11/CD18 expression of neutrophils in children undergoing cardiac surgeryZhejiang Da Xue Xue Bao Yi Xue Ban20073616670.
31.	Rinder CS, Fontes M, Mathew JP, et al. Neutrophil CD11b upregulation during cardiopulmonary bypass is associated with postoperative renal injuryAnn Thorac Surg2003753899905.
32.	Genschmer KR, Russell DW, Lal C, et al. Activated PMN exosomes: Pathogenic entities causing matrix destruction and disease in the lungCell20191761-2113126.
33.	Mizurini DM, Hottz ED, Bozza PT, et al. Fundamentals in Covid-19-associated thrombosis: Molecular and cellular aspectsFront Cardiovasc Med20218785738.
34.	Dehghani T, Panitch AEndothelial cells, neutrophils and platelets: Getting to the bottom of an inflammatory triangleOpen Biol20201010200161.
35.	Ling L, Zhang J, Li Y, et al. Platelets play a dual role in the pathophysiology of transfusion-related acute lung injuryRespir Physiol Neurobiol2023309104004.
36.	Yang S, Huang X, Liao J, et al. Platelet-leukocyte aggregates: A predictor for acute kidney injury after cardiac surgeryRen Fail202143111551162.
37.	Liu C, Yang Y, Du L, et al. Platelet-leukocyte aggregate is associated with adverse events after surgical intervention for rheumatic heart diseaseSci Rep20199113069.
38.	Sakamaki F, Ishizaka A, Handa M, et al. Soluble form of P-selectin in plasma is elevated in acute lung injuryAm J Respir Crit Care Med1995151618211826.
39.	Stengel D, Bauwens K, Keh D, et al. Prognostic value of an early soluble L-selectin (sCD62L) assay for risk assessment in blunt multiple trauma: A metaanalysisClin Chem20055111624.
40.	Shantsila E, Ghattas A, Griffiths HR, et al. Mon2 predicts poor outcome in ST-elevation myocardial infarctionJ Intern Med20192853301316.
41.	Suzuki A, Fukuzawa K, Yamashita T, et al. Circulating intermediate CD14++CD16+monocytes are increased in patients with atrial fibrillation and reflect the functional remodelling of the left atriumEuropace20171914047.
42.	Lukasik M, Dworacki G, Kufel-Grabowska J, et al. Upregulation of CD40 ligand and enhanced monocyte-platelet aggregate formation are associated with worse clinical outcome after ischaemic strokeThromb Haemost20121072346355.
43.	Garlichs CD, Kozina S, Fateh-Moghadam S, et al. Upregulation of CD40-CD40 ligand (CD154) in patients with acute cerebral ischemiaStroke200334614121418.

1. Gibbon JHApplication of a mechanical heart and lung apparatus to cardiac surgeryMinnes Med1954373171185.
2. Zheng XM, Yang Z, Yang GL, et al. Lung injury after cardiopulmonary bypass: Alternative treatment prospectsWorld J Clin Cases2022103753761.
3. Hausenloy DJ, Candilio L, Evans R, et al. Remote ischemic preconditioning and outcomes of cardiac surgeryN Engl J Med20153731514081417.
4. Eikelboom R, Sanjanwala R, Le ML, et al. Postoperative atrial fibrillation after cardiac surgery: A systematic review and meta-analysisAnn Thorac Surg20211112544554.
5. Berger M, Terrando N, Smith SK, et al. Neurocognitive function after cardiac surgery: From phenotypes to mechanismsAnesthesiology20181294829851.
6. Raffa GM, Agnello F, Occhipinti G, et al. Neurological complications after cardiac surgery: A retrospective case-control study of risk factors and outcomeJ Cardiothorac Surg201914123.
7. Alghamdi BA, Alharthi RA, AlShaikh BA, et al. Risk factors for post-cardiac surgery infectionsCureus20221411e31198.
8. Sun C, Chen D, Jin X, et al. Association between acute kidney injury and prognoses of cardiac surgery patients: Analysis of the MIMIC-Ⅲ databaseFront Surg202391044937.
9. Hill A, Wendt S, Benstoem C, et al. Vitamin c to improve organ dysfunction in cardiac surgery patients-review and pragmatic approachNutrients2018108974.
10. Weber C, Shantsila E, Hristov M, et al. Role and analysis of monocyte subsets in cardiovascular disease. Joint consensus document of the European Society of Cardiology (ESC) Working Groups "Atherosclerosis & Vascular Biology" and "Thrombosis". Thromb Haemost, 20161164626637.
11. Gawdat K, Legere S, Wong C, et al. Changes in circulating monocyte subsets (CD16 expression) and neutrophil-to-lymphocyte ratio observed in patients undergoing cardiac surgeryFront Cardiovasc Med2017412.
12. Merbecks MB, Ziesenitz VC, Rubner T, et al. Intermediate monocytes exhibit higher levels of TLR2, TLR4 and CD64 early after congenital heart surgeryCytokine2020133155153.
13. Mayer D, Altvater M, Schenz J, et al. Monocyte metabolism and function in patients undergoing cardiac surgeryFront Cardiovasc Med20229853967.
14. Wu Z, Zhang Z, Lei Z, et al. CD14: Biology and role in the pathogenesis of diseaseCytokine Growth Factor Rev2019482431.
15. O'Neill LA, Golenbock D, Bowie AGThe history of Toll-like receptors: Redefining innate immunityNat Rev Immunol2013136453460.
16. Hadley JS, Wang JE, Michaels LC, et al. Alterations in inflammatory capacity and TLR expression on monocytes and neutrophils after cardiopulmonary bypassShock2007275466473.
17. Flier S, Concepcion AN, Versteeg D, et al. Monocyte hyporesponsiveness and Toll-like receptor expression profiles in coronary artery bypass grafting and its clinical implications for postoperative inflammatory response and pneumonia: An observational cohort studyEur J Anaesthesiol2015323177188.
18. Ots HD, Tracz JA, Vinokuroff KE, et al. CD40–CD40L in neurological diseaseInt J Mol Sci20222384115.
19. Perros AJ, Esguerra-Lallen A, Rooks K, et al. Coronary artery bypass grafting is associated with immunoparalysis of monocytes and dendritic cellsJ Cell Mol Med202024847914803.
20. Holmannova D, Kolackova M, Kunes P, et al. Impact of cardiac surgery on the expression of CD40, CD80, CD86 and HLA-DR on B cells and monocytesPerfusion2016315391400.
21. Zhang J, Ding W, Liu J, et al. Scavenger receptors in myocardial infarction and ischemia/reperfusion injury: The potential for disease evaluation and therapyJ Am Heart Assoc2023122e027862.
22. Goldstein JI, Goldstein KA, Wardwell K, et al. Increase in plasma and surface CD163 levels in patients undergoing coronary artery bypass graft surgeryAtherosclerosis20031702325332.
23. Asmussen A, Busch HJ, Helbing T, et al. Monocyte subset distribution and surface expression of HLA-DR and CD14 in patients after cardiopulmonary resuscitationSci Rep202111112403.
24. Radley G, Ali S, Pieper IL, et al. Mechanical shear stress and leukocyte phenotype and function: Implications for ventricular assist device development and useInt J Artif Organs2019423133142.
25. Castanheira FVS, Kubes PNeutrophils and NETs in modulating acute and chronic inflammationBlood20191332021782185.
26. Ivetic A, Hoskins Green HL, Hart SJL-selectin: A major regulator of leukocyte adhesion, migration and signalingFront Immunol2019101068.
27. Hambsch J, Osmancik P, Bocsi J, et al. Neutrophil adhesion molecule expression and serum concentration of soluble adhesion molecules during and after pediatric cardiovascular surgery with or without cardiopulmonary bypassAnesthesiology200296510781085.
28. Zhou H, Liao J, Aloor J, et al. CD11b/CD18 (Mac-1) is a novel surface receptor for extracellular double-stranded RNA to mediate cellular inflammatory responsesJ Immunol20131901115125.
29. Paśnik J, Cywińska-Bernas A, Moll J, et al. Alterations of metalloproteinases and their inhibitors concentrations in peripheral blood in children with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypassPrzeglad Lekarski2009667359364.
30. Shu Q, Zhang XH, Wu LJ, et al. Effect of cardiopulmonary bypass on CD11/CD18 expression of neutrophils in children undergoing cardiac surgeryZhejiang Da Xue Xue Bao Yi Xue Ban20073616670.
31. Rinder CS, Fontes M, Mathew JP, et al. Neutrophil CD11b upregulation during cardiopulmonary bypass is associated with postoperative renal injuryAnn Thorac Surg2003753899905.
32. Genschmer KR, Russell DW, Lal C, et al. Activated PMN exosomes: Pathogenic entities causing matrix destruction and disease in the lungCell20191761-2113126.
33. Mizurini DM, Hottz ED, Bozza PT, et al. Fundamentals in Covid-19-associated thrombosis: Molecular and cellular aspectsFront Cardiovasc Med20218785738.
34. Dehghani T, Panitch AEndothelial cells, neutrophils and platelets: Getting to the bottom of an inflammatory triangleOpen Biol20201010200161.
35. Ling L, Zhang J, Li Y, et al. Platelets play a dual role in the pathophysiology of transfusion-related acute lung injuryRespir Physiol Neurobiol2023309104004.
36. Yang S, Huang X, Liao J, et al. Platelet-leukocyte aggregates: A predictor for acute kidney injury after cardiac surgeryRen Fail202143111551162.
37. Liu C, Yang Y, Du L, et al. Platelet-leukocyte aggregate is associated with adverse events after surgical intervention for rheumatic heart diseaseSci Rep20199113069.
38. Sakamaki F, Ishizaka A, Handa M, et al. Soluble form of P-selectin in plasma is elevated in acute lung injuryAm J Respir Crit Care Med1995151618211826.
39. Stengel D, Bauwens K, Keh D, et al. Prognostic value of an early soluble L-selectin (sCD62L) assay for risk assessment in blunt multiple trauma: A metaanalysisClin Chem20055111624.
40. Shantsila E, Ghattas A, Griffiths HR, et al. Mon2 predicts poor outcome in ST-elevation myocardial infarctionJ Intern Med20192853301316.
41. Suzuki A, Fukuzawa K, Yamashita T, et al. Circulating intermediate CD14++CD16+monocytes are increased in patients with atrial fibrillation and reflect the functional remodelling of the left atriumEuropace20171914047.
42. Lukasik M, Dworacki G, Kufel-Grabowska J, et al. Upregulation of CD40 ligand and enhanced monocyte-platelet aggregate formation are associated with worse clinical outcome after ischaemic strokeThromb Haemost20121072346355.
43. Garlichs CD, Kozina S, Fateh-Moghadam S, et al. Upregulation of CD40-CD40 ligand (CD154) in patients with acute cerebral ischemiaStroke200334614121418.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesRelationship between the expression of biomarkers in the activated innate immune cell and vital organs injuries during the cardiopulmonary bypass

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