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Mediators of Inflammation
Volume 2017, Article ID 8473171, 10 pages
https://doi.org/10.1155/2017/8473171
Research Article

Significant Cytokine mRNA Expression Changes Immediately after Initiation of Cardiopulmonary Resuscitation

1Department of Trauma Surgery, University Hospital Munich, Ludwig Maximilians University, Nussbaumstr. 20, 80336 Munich, Germany
2Department of Trauma Surgery, Chirurgisches Klinikum München Süd, Am Isarkanal 30, 81379 Munich, Germany
3Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany

Correspondence should be addressed to Mareen Braunstein; ed.nehcneum-inu.dem@nietsnuarb.neeram

Received 28 September 2017; Accepted 23 November 2017; Published 27 December 2017

Academic Editor: Maja Surbatovic

Copyright © 2017 Mareen Braunstein et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The purpose of this study was to evaluate immediate immunological changes following cardiopulmonary resuscitation (CPR). mRNA expression levels of selected immunomodulatory cytokines in out-of-hospital cardiac arrest (OHCA) survivors were detected and correlated to clinical parameter. Methods. OHCA survivors with sustained unconsciousness after return of spontaneous circulation (ROSC) were included. PAXgene whole blood samples were drawn immediately after initiation of CPR and subsequently after 6 h, 12 h, 24 h, 48 h, and 72 h. TNF-alpha, IL-8, IL-10, and IL-1ra mRNA levels were quantified by RT-qPCR and compared to multiple organ failure, 30-day survival, and the induction of therapeutic hypothermia (TH). Results. 25 patients (63 ± 15 years) were enrolled presenting a characteristic time-dependent cytokine profile in the early postresuscitation period. High initial TNF-alpha and IL-8 mRNA levels were followed by a significant decrease. IL-1ra mRNA levels significantly increased beginning after 6 h. Nonsurvivors showed significantly higher IL-8 mRNA levels immediately after CPR. TH induced significantly higher IL-1ra mRNA levels compared to normothermia. Conclusion. Significant mRNA cytokine expression changes are already detectable immediately after initiation of CPR. These expressional changes are significantly different depending on 30-day survival. TH seems to attenuate proinflammatory immune reaction by a significant increase of IL-1ra mRNA levels. This trial is registered with DRKS00012940.