The Potential of Mesenchymal Stromal Stem Cells to Correct Immune and Metabolic Dysfunctions in Circulating Immune Cells During Sepsis: An Ex Vivo Pilot Study. (REPROCELL)
Sepsis is a life-threatening organ dysfunction caused by the host's dysregulated immune response to infection. It represents a major global public health challenge. A state of post-septic compensatory immunosuppression may contribute to excess mortality by promoting secondary infections, thereby prolonging the stay in the intensive care unit and increasing the risk of death.
New therapeutic strategies to complement antimicrobial treatments-which may correct sepsis-induced functional alterations in immune cells (such as endotoxin tolerance and reduced HLA-DR expression), partly mediated by metabolic abnormalities-are currently being investigated. Among these, mesenchymal stromal cells (MSCs) appear particularly promising. They are capable of reprogramming immune cells by redirecting certain metabolic pathways, notably improving mitochondrial function. MSCs generally have an anti-inflammatory effect in preclinical models of infection, particularly in the early phase of severe ventilated pneumonia, as illustrated by the animal model we have developed, and preliminary trials are currently underway in humans. The ability of CSMs to correct sepsis-induced immunosuppression has not yet been explored. Nevertheless, CSMs possess the ability to communicate with the inflammatory microenvironment in which they are found, conferring plasticity to their response.
We hypothesize that CSMs could correct certain immune and metabolic dysfunctions in circulating immune cells from patients with sepsis meeting severity criteria who are admitted to the intensive care unit.
Furthermore, priming (or prior stimulation) of CSMs could enable a more precise and personalized therapeutic approach, with the possibility of directing CSMs toward a pro-inflammatory (CSM1) or anti-inflammatory (CSM2) phenotype through prior incubation with specific agonists (LPS; IFN-γ/TNF, respectively) before their administration. Depending on the patient's immune status (pro-inflammatory or anti-inflammatory phase), such a personalized approach would optimize treatment with CSMs.
調査の概要
研究の種類
入学 (推定)
連絡先と場所
研究連絡先
- 名前：Marine JACQUIER
- 電話番号：+33 0380293751
- メール：marine.jacquier@chu-dijon.fr
研究場所
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Dijon、フランス、21000
- CHU Dijon Bourgogne
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コンタクト：
- Marine JACQUIER
- 電話番号：+33 0380293751
- メール：marine.jacquier@chu-dijon.fr
-
-
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Patient or authorized representative, informed and having given consent
- Age ≥ 18 years
Patients admitted for sepsis defined by the association as:
- Clinically or microbiologically documented infection
SOFA-2 score ≥ 2
- Or +2 points if pre-existing organ dysfunction
Complicated
ARDS (Berlin criteria (1))
- Acute respiratory failure
- AND Bilateral pulmonary opacities (X-ray or CT scan) with no evidence of predominant hydrostatic edema
- AND PaO₂/FiO₂ ≤ 300 mmHg under invasive or non-invasive ventilation with PEEP ≥ 5 cmH₂O
or septic shock (2)
- Vasopressors required to maintain mean arterial pressure (MAP) ≥ 65 mmHg
- AND arterial lactate > 2 mmol/L
- AND despite adequate fluid resuscitation
- Blood sample may be collected within 72 hours of admission to the intensive care unit
Exclusion Criteria:
- Individuals not enrolled in or not eligible for a social security program
- Individuals subject to a legal protection order
- Pregnant women, women in labor, or breastfeeding women
Known severe immunodeficiency prior to sepsis:
- cytostatic chemotherapy within the previous 3 months,
- previously known neutropenia < 500/mm³ (within the past month) not attributed to sepsis,
- active hematologic malignancy currently undergoing treatment,
- allogeneic bone marrow transplant < 1 year ago,
- solid organ transplant receiving immunosuppressants
- corticosteroid therapy ≥ 0.5 mg/kg/day of prednisone equivalent for > 3 weeks,
- anti-TNF or anti-IL-6 biologic therapy within the past 3 months,
- HIV infection with a detectable viral load while not on treatment
Secondary exclusion criteria :
- A diagnosis of sepsis was ruled out following a comprehensive medical evaluation and/or an alternative diagnosis was identified that explains the elevated SOFA-2 score
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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Patient with sepsis complicated by ARDS or septic shock
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Drawing an EDTA tube
Collection of 5 heparinized tubes
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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Concentration of TNF-α in the supernatant from ex vivo co-incubation of whole blood collected on days 1-3 after admission to the intensive care unit (± CSMs), as measured by ELISA, following stimulation of immune cells with LPS
時間枠：3 months
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3 months
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- JACQUIER CRBFC 2023
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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