12,13-diHOME is increased during targeted temperature management and correlates with survival after cardiac arrest resuscitation

Abstract

CONTEXT: Trials of targeted temperature management (TTM) after cardiac arrest (CA) have had conflicting results. Brown adipose tissue (BAT) is a thermogenic organ activated by cold temperature to regulate body temperature, systemic metabolism and the immune system. Approximately 10-30% of adult patients have BAT and this heterogeneity may explain variable treatment to TTM. OBJECTIVE: This study sought to measure differences in outcome, metabolic and immune activation between patients treated with TTM following CA with varying BAT activity, measured through BAT-associated lipid 12,13-diHOME concentrations in circulation. DESIGN: BAT biomarker 12,13-diHOME was quantified using liquid chromatography-mass spectrometry (LC-MS) on plasma from 74 patients at various time points starting at 6 hours and up until 7 days after return of spontaneous circulation (ROSC). Additionally, circulating glucose, C-peptide and fatty acids were measured by glucometer, ELISA and LC-MS, respectively. Peripheral blood mononuclear cells were analyzed by flow cytometry. RESULTS: 12,13-diHOME was increased in patients treated with TTM at 33°C and positively correlated with favorable outcomes. 12,13-diHOME levels peaked in the first 12 to 48 hours and decreased below the first post-ROSC level by 7 days. Glucose homeostasis was not associated with 12,13-diHOME levels. In a subset of patients, we could detect a specific phospholipid signature in patients with higher 12,13-diHOME. Patients with higher 12,13-diHOME also had increased mature neutrophils and lower immature neutrophils. CONCLUSIONS: Circulating 12,13-diHOME levels are increased in some patients undergoing targeted temperature management after cardiac arrest, which may be indicative of increased BAT activity. 12,13-diHOME is associated with survival, alterations of phospholipid metabolism, and a profile of less activated immune system. BAT may mediate the effects of temperature management on outcome after cardiac arrest.

The authors' abstract, as published at the source. The Journal of Clinical Endocrinology & Metabolism, 2026 · DOI ↗