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Volume 13
Issue 12
10.3390/biomedicines13122962
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Perioperative Profiles of Immune Cells in Patients with Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass

by
Juan Wu
1,†,
Zhenzhen Cheng
1,2,†,
Xinyi Liao
1,†,
Ping Yang
1,3,
Qinjuan Wu
1,4,
Tingting Wang
5,
Wentong Meng
6,
Zongcheng Tang
1 and
Lei Du
1,*
1
Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu 610041, China
2
Department of Anesthesiology, Jiangxi Provincial People’s Hospital, Nanchang 330000, China
3
Department of Anesthesiology, Chongqing University Three Gorges Hospital, Chongqing 404100, China
4
Department of Anesthesiology, Chengdu Second People’s Hospital, Chengdu 610041, China
5
Department of Anesthesiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
6
Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Biomedicines 2025, 13(12), 2962; https://doi.org/10.3390/biomedicines13122962 (registering DOI)
Submission received: 22 October 2025 / Revised: 17 November 2025 / Accepted: 24 November 2025 / Published: 1 December 2025
(This article belongs to the Special Issue Chronic Vascular Impairment in Heart, Brain, and Kidney Disorders: Molecular Mechanisms and Therapeutic Strategies)
Versions Notes

Abstract

Background: Postoperative delirium (POD) is known to involve systemic inflammatory responses, but the characteristics of the immune cell types involved in these responses are unclear. Methods: In this prospective study, we compared relative abundances and transcriptomes of circulating immune cells between patients who experienced POD (n = 11) or not (n = 109) within 7 days after elective cardiac surgery with cardiopulmonary bypass. Blood was sampled before and at 24 h after surgery; features of immune cells were profiled using multi-channel spectral flow cytometry, 10× single-cell RNA sequencing, and measurement of plasma levels of cytokines. Results: Patients with POD were older and with higher incidence of congestive heart failure than patients without POD, and these risk factors in turn positively correlated with preoperative proportion of CD40+/HLA-DR+ monocytes and CD69+CD8+ T cells. In addition, preoperative activation of antigen presentation in monocytes and chemotaxis in CD8+ T cells, as well as elevated plasma levels of chemokines CCL3 and CXCL8, were detected in patients with POD. After cardiac surgery, activation of antigen presentation and chemotaxis were also found in patients with POD. Conclusions: This study described the perioperative landscape of immune cells in POD and found possible links between preoperative immune dysfunction and risk factors, which may guide future research to explore how the immune system contributes to POD and to design preventive strategies.
Keywords: delirium; CD69; antigen presentation; chemotaxis; cardiac surgery delirium; CD69; antigen presentation; chemotaxis; cardiac surgery

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MDPI and ACS Style

Wu, J.; Cheng, Z.; Liao, X.; Yang, P.; Wu, Q.; Wang, T.; Meng, W.; Tang, Z.; Du, L. Perioperative Profiles of Immune Cells in Patients with Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass. Biomedicines 2025, 13, 2962. https://doi.org/10.3390/biomedicines13122962

AMA Style

Wu J, Cheng Z, Liao X, Yang P, Wu Q, Wang T, Meng W, Tang Z, Du L. Perioperative Profiles of Immune Cells in Patients with Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass. Biomedicines. 2025; 13(12):2962. https://doi.org/10.3390/biomedicines13122962

Chicago/Turabian Style

Wu, Juan, Zhenzhen Cheng, Xinyi Liao, Ping Yang, Qinjuan Wu, Tingting Wang, Wentong Meng, Zongcheng Tang, and Lei Du. 2025. "Perioperative Profiles of Immune Cells in Patients with Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass" Biomedicines 13, no. 12: 2962. https://doi.org/10.3390/biomedicines13122962

APA Style

Wu, J., Cheng, Z., Liao, X., Yang, P., Wu, Q., Wang, T., Meng, W., Tang, Z., & Du, L. (2025). Perioperative Profiles of Immune Cells in Patients with Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass. Biomedicines, 13(12), 2962. https://doi.org/10.3390/biomedicines13122962

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