Evidence map›Paper›PMID 41467403›Full record

ArticleJournal of the American Heart Association2026

Mitochondrial DNA-Mediated Immune Activation After Resuscitation From Cardiac Arrest.

Tyler J Rolland, Emily R Hudson, Luke A Graser, Sumbule Zahra, Daniel Cucinotta, Swati D Sonkawade, Umesh C Sharma, Brian R Weil

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Tyler J RollandDepartment of Physiology & Biophysics State University of New York at Buffalo Buffalo NY USA.ORCID 0000-0003-2700-8160
Emily R HudsonDepartment of Physiology & Biophysics State University of New York at Buffalo Buffalo NY USA.ORCID 0009-0009-8875-3261
Luke A GraserCenter for Research in Cardiovascular Medicine State University of New York at Buffalo Buffalo NY USA.ORCID 0009-0008-6931-8224
Sumbule ZahraCenter for Research in Cardiovascular Medicine State University of New York at Buffalo Buffalo NY USA.
Daniel CucinottaCenter for Research in Cardiovascular Medicine State University of New York at Buffalo Buffalo NY USA.
Swati D SonkawadeCenter for Research in Cardiovascular Medicine State University of New York at Buffalo Buffalo NY USA.
Umesh C SharmaCenter for Research in Cardiovascular Medicine State University of New York at Buffalo Buffalo NY USA.ORCID 0000-0003-0476-2523
Brian R WeilDepartment of Physiology & Biophysics State University of New York at Buffalo Buffalo NY USA.ORCID 0000-0002-8832-6771

Funding

Immunomodulatory Therapy After Resuscitation From Cardiac ArrestR01HL160538 · NHLBI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI Brian Raymond Weil · 2022 to 2026
$2.3M
NHLBI NIH HHS R01 HL160538
6 · The paper itself

Abstract

backgroundPostcardiac arrest syndrome is characterized by systemic inflammation that contributes to poor outcomes after resuscitation from sudden cardiac arrest. Mitochondrial DNA (mtDNA) has been implicated as a proinflammatory stimulus in other contexts, but its role in postcardiac arrest syndrome is unclear. We determined if postcardiac arrest syndrome is characterized by a rise in circulating mtDNA, how mtDNA activates immune cells, and if targeting mtDNA-sensing pathways attenuates leukocyte activation.

methodsPlasma mtDNA and nuclear DNA levels were measured ~4-hours after return of spontaneous circulation following sudden cardiac arrest in swine (n=8) and humans (n=57). Additionally, porcine peripheral blood mononuclear cells were treated with mtDNA or extracellular vesicles (EVs) isolated from porcine plasma collected after return of spontaneous circulation. Pharmacological agents were used to inhibit TLR9 (toll-like receptor 9)- and cGAS (cyclic GMP-AMP synthase)-mediated mtDNA sensing.

resultsA ~250-fold elevation in circulating mtDNA was observed after return of spontaneous circulation in swine despite negligible changes in circulating nuclear DNA, a finding that was corroborated in humans. Circulating mtDNA was largely encapsulated within EVs in both species, suggesting a conserved mechanism of release. In vitro studies demonstrated that peripheral blood mononuclear cell internalization of mtDNA-containing-EVs was required for leukocyte activation. This response was attenuated by EV disruption, DNA degradation, and blockade of TLR9 or cGAS pathways, identifying novel targets to modulate inflammation in postcardiac arrest syndrome.

conclusionsBrief whole-body ischemia and reperfusion in the context of resuscitation from sudden cardiac arrest elicits mtDNA release, primarily within EVs, that triggers leukocyte activation. Targeting mtDNA release or its downstream sensors may offer a new therapeutic strategy to improve outcomes after sudden cardiac arrest.

Indexed as

Cardiopulmonary ResuscitationDNA, MitochondrialHeart ArrestLeukocytes, MononuclearAnimalsCell-Free Nucleic AcidsDisease Models, AnimalExtracellular VesiclesFemaleHumansMaleMiddle AgedSwineToll-Like Receptor 9Cell-Free Nucleic AcidsDNA, MitochondrialToll-Like Receptor 9inflammationleukocyte mobilizationpost‐cardiac arrest syndromesudden cardiac arrest

Identifiers

PMID41467403
PMCPMC12909052

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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 Socratic graph.