Key result
High plasma levels of IL-17 and IL-23 at 2 and 7 days post-return of spontaneous circulation were strong predictors of mortality in cardiac arrest patients, with IL-23 at 7 days yielding an AUC of 1.
Why the study?
Systemic inflammation is an important feature of post-cardiac arrest syndrome, and the value of circulating pro-inflammatory cytokines in predicting outcome after ROSC was unclear.
Do plasma levels of IL-17 and IL-23 predict mortality in patients after return of spontaneous circulation following cardiac arrest?
Observational (n=21)
No
Do plasma levels of IL-17 and IL-23 predict mortality in patients after return of spontaneous circulation following cardiac arrest?
Effect estimate: AUC 1
p-value: p=0.0002
Elevated plasma levels of IL-17 and IL-23 at 2 or 7 days post-ROSC are associated with poor outcomes and higher mortality in post-cardiac arrest syndrome patients.
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.
No takes yet. Share an insight, caveat, or question.
Zhuang et al. (2020) conducted an observational in Post-cardiac arrest syndrome (n=21). High plasma levels of IL-17 and IL-23 vs. Survivors (lower plasma levels) was evaluated on Mortality prediction (AUC 1, p=0.0002). High plasma levels of IL-17 and IL-23 at 2 and 7 days post-return of spontaneous circulation were strong predictors of mortality in cardiac arrest patients, with IL-23 at 7 days yielding an AUC of 1.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: