Circulating CD24/Siglec-10 biomarkers predict post-resuscitation outcomes in a cardiac arrest cohort

Abstract

Abstract CD24 can bind to its receptor, Siglec-10, and suppress immune responses induced by tissue damage. We aimed to study serum biomarkers in CD24/Siglec-10 axis and explore their associations with the survival and neurological prognosis of patients after return of spontaneous circulation (ROSC) following cardiac arrest. A prospective cohort study was performed. Eligible patients with ROSC were enrolled. Clinical information and serum levels of sCD24, sSiglec-10, sialic acid, tumor necrosis factor (TNF-α), interleukin-6 (IL-6), high mobility group protein 1 (HMGB1), neuron specific enolase (NSE), and neuraminidase activity were collected on days 1, 3 and 7 after ROSC. The 28-day survival and neurological outcome were documented. The study included 104 ROSC patients, with 30 and 74 in survivor and non-survivor groups, respectively. The levels of all biomarkers, except for sSiglec-10, sialic acid, and neuraminidases on day 1, were significantly higher in non-survivor than survivor group. Serum sCD24 level was positively correlated with sialic acid, HMGB1, TNF-α, IL-6, NSE, neuraminidases activity, and APACHE II score. Multivariate logistic regression analysis showed that serum sCD24 level was independently associated with 28-day poor neurological prognosis and mortality after ROSC. Multiple serum biomarkers within the CD24/Siglec-10 axis were significantly elevated following ROSC. Elevated serum sCD24 level emerged as a predictor of both 28-day poor neurological prognosis and all-cause mortality in patients after cardiac arrest. Further large-scale studies are warranted to validate these findings.