The adaptive immune response in cardiac arrest resuscitation induced ischemia reperfusion renal injury
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Journal of Biological Research-Thessaloniki Open Access
RESEARCH
The adaptive immune response in cardiac arrest resuscitation induced ischemia reperfusion renal injury Maria Tsivilika1* , Eleni Doumaki2, George Stavrou3,4, Antonia Sioga5, Vasilis Grosomanidis3, Soultana Meditskou5, Athanasios Maranginos6, Despina Tsivilika7, Dimitrios Stafylarakis8, Katerina Kotzampassi3 and Theodora Papamitsou5
Abstract Background: The present study aims to investigate, immunohistochemically, the role of the adaptive immune response in cardiac arrest/resuscitation-induced ischemia–reperfusion renal injury (IRI), namely to assess the presence of lymphocytes in renal tissue samples and the connection between the extent of the damage and the concentration of the lymphocytes by comparing the kidneys of non resuscitated swine with the kidneys of resuscitated swine. Methods: Twenty four swine underwent cardiac arrest (CA) via a pacemaker wire. After 7 min, without any intervention, Cardiopulmonary Resuscitation, CPR, was commenced. Five min after CPR was commenced advanced life-support, ALS. Animals were divided into resuscitated animals and non resuscitated animals. Tissue samples obtained from the two groups for immunohistological study aiming to detect T-cells, B-cells and plasma cells using CD3 + , CD20 + , and CD138 + antibodies. Results: There seems to be a strong concentration of T lymphocytes in the kidney tissues after ischemia of both non-resuscitated and resuscitated swine. B lymphocytes, also, appear to have infiltrated the ischemic kidneys of both animal groups; nevertheless, the contribution of T lymphocytes to the induction of injury remains greater. There is no strong evidence of correlation between the plasma cells and the damage. Conclusion: The adaptive immune response seems to have a strong association with kidney injury and acute tubular necrosis after cardiac arrest/ resuscitation-induced ischemia–reperfusion. However, the extent to which the adaptive immune cells are involved in the induction of renal injury remains uncertain and there are many questions about the mechanism of function of these cells, the answers of which require further studies. Keywords: Kidney, Ischemia reperfusion, Cardiac arrest, Renal injury, Acute tubular necrosis, Immunohistochemistry, Adaptive immune response Background Acute tubular necrosis (ATN) and subsequent renal failure induced by ischemia–reperfusion injury (IRI) or sepsis remain the leading cause of morbidity and mortality *Correspondence: [email protected] 1 Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Gianni Chalkidi 45, Charilaou, 54249 Thessaloniki, Greece Full list of author information is available at the end of the article
among patients in the intensive care unit [1]. ATN after ischemic shock has a mortality rate of 30% and many survivors are subject to dialysis [2]. Among patients surviving cardiac arrest (CA), the onset of acute kidney injury (AKI) is also common (> 75%) and persistent AKI (PAKI) occurs in more th
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