ArticleJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2021
Cardiac arrest and resuscitation activates the hypothalamic-pituitary-adrenal axis and results in severe immunosuppression.
Article in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 43 citations in OpenAlex.
- Microglial state transitions dominate the brain immune response in the subacute phase after cardiac arrest.Journal of neuroinflammation · 2026Article
- Latest in Resuscitation Research: Highlights from the 2025 American Heart Association's Resuscitation Science Symposium.Journal of the American Heart Association · 2026Article
- The mechanisms by which hypothalamic neuroinflammation induced by neonatal cerebral ischemia-hypoxia leads to decreased thymic function via the HPA axis.Cell & bioscience · 2026Article
- Activation of Intestinal Mast Cells Contributes to Gut Damage After Cardiac Arrest in Mice.Shock (Augusta, Ga.) · 2026Article
- Sepsis and the diverse organ-gastrointestinal tract axis.World journal of critical care medicine · 2025Review
- When the Heart Hurts the Kidneys: From Flow to Translational Future.Seminars in nephrology · 2025Review
- An untargeted metabolomics analysis suggests pathophysiological changes for post cardiac arrest syndrome.Resuscitation plus · 2025Article
- Changes in T-lymphocyte subsets and natural killer cells of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study.Resuscitation plus · 2025Article
- Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study.BMC emergency medicine · 2025Article
- Sodium butyrate attenuates microglia-mediated neuroinflammation by modulating the TLR4/MyD88/NF-κB pathway and microbiome-gut-brain axis in cardiac arrest mice.Molecular brain · 2025Article
- Electroacupuncture negatively regulates the Nesfatin-1/ERK/CREB pathway to alleviate HPA axis hyperactivity and anxiety-like behaviors caused by surgical trauma.Chinese medicine · 2024Article
- Microglial heterogeneity in the ischemic stroke mouse brain of both sexes.Genome medicine · 2024Article
- Glucocorticoids impair T lymphopoiesis after myocardial infarction.American journal of physiology. Heart and circulatory physiology · 2024Article
- Therapeutic potential of mitochondrial transplantation in modulating immune responses post-cardiac arrest: a narrative review.Journal of translational medicine · 2024Review
- Ferroptosis-related gene MAPK3 is associated with the neurological outcome after cardiac arrest.PloS one · 2024Article
- Fingerprint of Circulating Immunocytes as Biomarkers for the Prognosis of Brain Inflammation and Neuronal Injury after Cardiac Arrest.ACS chemical neuroscience · 2023Article
- Electroacupuncture Ameliorates Hypothalamic‒Pituitary‒Adrenal Axis Dysfunction Induced by Surgical Trauma in Mice Through the Hypothalamic Oxytocin System.Neurochemical research · 2023Article
- Epinephrine-induced Effects on Cerebral Microcirculation and Oxygenation Dynamics Using Multimodal Monitoring and Functional Photoacoustic Microscopy.Anesthesiology · 2023Article
- General Critical Care, Temperature Control, and End-of-Life Decision Making in Patients Resuscitated from Cardiac Arrest.Journal of clinical medicine · 2023Review
- Mouse Cardiac Arrest Model for Brain Imaging and Brain Physiology Monitoring During Ischemia and Resuscitation.Journal of visualized experiments : JoVE · 2023Article
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 2 countries.
Funding
Abstract
In patients who are successfully resuscitated after initial cardiac arrest (CA), mortality and morbidity rates are high, due to ischemia/reperfusion injury to the whole body including the nervous and immune systems. How the interactions between these two critical systems contribute to post-CA outcome remains largely unknown. Using a mouse model of CA and cardiopulmonary resuscitation (CA/CPR), we demonstrate that CA/CPR induced neuroinflammation in the brain, in particular, a marked increase in pro-inflammatory cytokines, which subsequently activated the hypothalamic-pituitary-adrenal (HPA) axis. Importantly, this activation was associated with a severe immunosuppression phenotype after CA. The phenotype was characterized by a striking reduction in size of lymphoid organs accompanied by a massive loss of immune cells and reduced immune function of splenic lymphocytes. The mechanistic link between post-CA immunosuppression and the HPA axis was substantiated, as we discovered that glucocorticoid treatment, which mimics effects of the activated HPA axis, exacerbated post-CA immunosuppression, while RU486 treatment, which suppresses its effects, significantly mitigated lymphopenia and lymphoid organ atrophy and improved CA outcome. Taken together, targeting the HPA axis could be a viable immunomodulatory therapeutic to preserve immune homeostasis after CA/CPR and thus improve prognosis of post-resuscitation CA patients.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.