High plasma levels of pro-inflammatory factors interleukin-17 and interleukin-23 are associated with poor outcome of cardiac-arrest patients: a single center experience

BMC Cardiovasc Disord. 2020 Apr 15;20(1):170. doi: 10.1186/s12872-020-01451-y.

Abstract

Background: Systemic inflammation is an important feature of post-cardiac arrest syndrome (PCAS). This study was designed to determine whether the plasma concentrations of some circulating pro-inflammatory cytokines (interleukin-17 [IL-8], IL-22, IL-23 and IL-33) are of value in predicting the outcome of patients after return of spontaneous circulation (ROSC) during the post-cardiac arrest period.

Methods: This was a prospective observational clinical study. In total, 21 patients (survivors, n = 10; non-survivors, n = 11) who experienced cardiac arrest and successful ROSC with expected survival of at least 7 days were consecutively enrolled from January 2016 to December 2017. Of the 21 enrolled patients, ten survived were designated "survivors". The other eleven patients died between 2 days and 1 months post ROSC. Venous blood was drawn at three time-points: baseline (< 1 h post ROSC), 2 days post ROSC and 7 days post ROSC. Plasma IL-8, IL-22, IL-23 and IL-33 were determined using commercial enzyme-linked immunosorbent assays.

Results: Plasma creatinine levels, but aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, were elevated in non-survivors compared with survivors. Plasma levels of IL-17, IL-22, IL-23 and IL-33 of the 21 total patients did not change at 2 or 7 days post ROSC compared to baseline. In survivors, the plasma levels of IL-17 and IL-23 at 2 or 7 days post ROSC were lower than baseline. In non-survivors, plasma levels of IL-17 increased compared with baseline. Receiver operating characteristic curve analysis showed that the plasma levels of IL-17 and IL-23 at 2 or 7 days post ROSC were able to predict the mortality of PCAS patients, and positively correlated with Acute Physiology and Chronic Health Evaluation (APACHE)-II score and time to ROSC.

Conclusion: These results provide the first evidence that the elevated plasma IL-17 and IL-23 levels are associated with poor outcome in PCAS patients. The role of IL-17/IL-23 axis post ROSC is worth paying attention to in PCAS patients.

Trial registration: Clinicaltrial.govNCT02297776, 2014-11-21.

Keywords: IL-17; IL-23; Inflammation; Post-cardiac arrest syndrome; ROSC.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • China
  • Female
  • Heart Arrest / blood*
  • Heart Arrest / diagnosis
  • Heart Arrest / mortality
  • Heart Arrest / therapy
  • Humans
  • Inflammation Mediators / blood*
  • Interleukin-17 / blood*
  • Interleukin-23 / blood*
  • Male
  • Post-Cardiac Arrest Syndrome / blood*
  • Post-Cardiac Arrest Syndrome / diagnosis
  • Post-Cardiac Arrest Syndrome / mortality
  • Post-Cardiac Arrest Syndrome / therapy
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Up-Regulation

Substances

  • Biomarkers
  • Inflammation Mediators
  • Interleukin-17
  • Interleukin-23

Associated data

  • ClinicalTrials.gov/NCT02297776