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Assessing Immune Dysfunction in Sepsis

Not yet recruiting
Conditions
Sepsis
Registration Number
NCT07154615
Lead Sponsor
University of Minnesota
Brief Summary

Sepsis leads to sustained immune system dysfunction resulting in increased susceptibility to secondary infection while in the hospital or after discharge. Consequently, many of the \~2 million Americans that develop sepsis every year will end up back in the ICU, weeks and months later. The objective of this study is to define the cellular and molecular mechanisms driving the dysfunction and reprogramming of T cells and B cells that mediate cellular and humoral immunity using a combination of phenotypic, functional, genomic, and metabolomic assays.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Age ≥ 18

  • Presumed diagnosis of sepsis, defined as "patients with life-threatening organ dysfunction caused by a dysregulated host response to infection"

  • Patients in the ICU who meet 2 or more of the quick SOFA (qSOFA) definition along with organ dysfunction:

    1. Respiration rate ≥ 22 breaths/min and/or mechanically ventilated
    2. An alteration in mental status
    3. Systolic blood pressure of less than 100 mm Hg and/or receiving inotropes to maintain blood pressure AND/OR
    <!-- -->
    1. An acute change in SOFA score ≥2 points, consequent to the infection (can assume SOFA score = 0 in patients with no pre-existing organ dysfunction)

ICU Without Sepsis Inclusion Criteria:

  • Age ≥ 18
  • Patients requiring care at a M Health Fairview ICU due to high acuity of illness and no other evidence of sepsis

Healthy Volunteer Inclusion Criteria

  • Age greater or equal to 18
  • ASA status 1, 2 or 3
  • May include patients who are receiving dialysis in an outpatient setting

Exclusion Criteria (all groups):

  • Active cancer with chemotherapy and/or radiation treatment within the past 6 weeks
  • Medication usage that includes immunosuppressive drugs, biologic agents, cytokines, growth factor and interleukins
  • Steroid medication usage of &gt; 300mg hydrocortisone per day (equivalent of &gt; 20mg prednisone). Patients with chronic steroid use will be excluded, however patients who have had stress dose steroids administered following admission will be included.
  • Patients with a history of, or who currently have evidence of autoimmune disease, including but not limited to: myasthenia gravis, Guillain Barré syndrome, systemic lupus erythematosus, multiple sclerosis, scleroderma, ulcerative colitis, Crohn's disease, autoimmune hepatitis, Wegener's granulomatosis, HIV/AIDS, etc.
  • Patients with active or a history of acute or chronic lymphocytic leukemia
  • Known history of chronic hepatitis B (HBV) infection and not on treatment with HBV nucleoside analogues prior to the current hospitalization, or HBV DNA &gt; 100 IU/mL
  • Known history of infection with hepatitis C (HCV) and currently undergoing treatment for HCV infection or has detectable HCV RNA
  • Participation in another investigational interventional drug study within the past 4 weeks
  • Current pregnancy
  • Current incarceration
Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
EliSpot - Day 1Day 1

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

EliSpot - Day 4Day 4

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

EliSpot - Day 7Day 7

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

EliSpot - Day 14Day 14

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

EliSpot - Day 21Day 21

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

EliSpot - Day 28Day 28

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Ex Vivo TNF Production - Day 1Day 1

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Ex Vivo TNF Production - Day 4Day 4

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Ex Vivo TNF Production - Day 7Day 7

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Ex Vivo TNF Production - Day 14Day 14

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Ex Vivo TNF Production - Day 21Day 21

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Ex Vivo TNF Production - Day 28Day 28

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Flow Cytometry of Peripheral Blood Leukocytes - Day 1Day 1

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Flow Cytometry of Peripheral Blood Leukocytes - Day 4Day 4

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Flow Cytometry of Peripheral Blood Leukocytes - Day 7Day 7

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Flow Cytometry of Peripheral Blood Leukocytes - Day 14Day 14

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Flow Cytometry of Peripheral Blood Leukocytes - Day 21Day 21

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Flow Cytometry of Peripheral Blood Leukocytes - Day 28Day 28

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Cytokines in Serum - Day 1Day 1

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Cytokines in Serum - Day 4Day 4

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Cytokines in Serum - Day 7Day 7

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Cytokines in Serum - Day 14Day 14

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Cytokines in Serum - Day 21Day 21

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Cytokines in Serum - Day 28Day 28

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Chemokines in Serum - Day 1Day 1

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Chemokines in Serum - Day 7Day 7

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Chemokines in Serum - Day 4Day 4

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Transcriptional Profiling - Day 14Day 14

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Transcriptional Profiling - Day 21Day 21

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

CBC - Day 1Day 1

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Chemokines in Serum - Day 14Day 14

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Chemokines in Serum - Day 21Day 21

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Quantification of Chemokines in Serum - Day 28Day 28

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Transcriptional Profiling - Day 7Day 7

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Transcriptional Profiling - Day 1Day 1

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Transcriptional Profiling - Day 4Day 4

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Transcriptional Profiling - Day 28Day 28

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

CBC - Day 4Day 4

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

CBC - Day 7Day 7

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

CBC - Day 14Day 14

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

CBC - Day 21Day 21

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

CBC - Day 28Day 28

Sample analysis to determine waxing and waning of Course of Sepsis parameters associated with clinical outcomes

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

University of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

University of Minnesota
🇺🇸Minneapolis, Minnesota, United States
Kristine Kancans
Contact
kanca008@umn.edu

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