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.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Beräknad)
Kontakter och platser
Studiekontakt
- Namn: Marine JACQUIER
- Telefonnummer: +33 0380293751
- E-post: marine.jacquier@chu-dijon.fr
Studieorter
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Dijon, Frankrike, 21000
- CHU Dijon Bourgogne
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Kontakt:
- Marine JACQUIER
- Telefonnummer: +33 0380293751
- E-post: marine.jacquier@chu-dijon.fr
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Testmetod
Studera befolkning
Beskrivning
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
Studieplan
Hur är studien utformad?
Designdetaljer
Kohorter och interventioner
Grupp / Kohort |
Intervention / Behandling |
|---|---|
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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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Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
|---|---|
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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
Tidsram: 3 months
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3 months
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Samarbetspartners och utredare
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
- Patologiska processer
- Infektioner
- Systemiskt inflammatoriskt svarssyndrom
- Inflammation
- Patologiska tillstånd, tecken och symtom
- Sepsis
- Undersökningstekniker
- Provhantering
- Kliniska laboratorietekniker
- Diagnostiska tekniker och procedurer
- Diagnos
- Punktering
- Kirurgiska ingrepp, operativ
- Blodprovsamling
Andra studie-ID-nummer
- JACQUIER CRBFC 2023
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