IMMunE dysfunction and Recovery from SEpsis - IMMERSE V1.0
Research type
Research Study
Full title
cellular and molecular mechanisms of IMMunE dysfunction and Recovery from SEpsis related critical illness (IMMERSE): an observational cohort study
IRAS ID
257753
Contact name
Manu Shankar-Hari
Contact email
Sponsor organisation
Guy's and St Thomas' NHS Foundation Trust
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Sepsis is life threatening organ dysfunction caused by a dysregulated response to infection. Globally, sepsis causes over 5 million deaths per year. Sepsis is increasing in incidence in the UK, with a current incidence of approximately 1/1000 adult person-years. Approximately one third of intensive care unit (ICU) admissions are secondary to sepsis, and one third of these patients will die in hospital. To-date, aside from supportive treatments and perhaps prompt antibiotic therapy, there are no specific interventions that been proven to reduce sepsis-related deaths. Non-specific interventions to improve prognosis for patients with sepsis are urgently needed.
Sepsis is associated with both high levels of inflammation and immunosuppressive components during acute stages of sepsis and prolonged immunosuppression following discharge. Until recently, immunomodulation was focused on suppressing hyper-inflammation. However, dozens of negative trials of immunosuppressant agents were concluded, with none reaching clinical practice. Since this time, an appreciation of the heterogeneity of sepsis in individual patients, has raised interest in "precision medicine": the targeting of specific therapies to individual patients.
Who? Where? and How?
We therefore propose to undertake the first extensive study of the time course of sepsis integrating detailed clinical data, white blood cell characteristics, platelet function, cytokine (inflammation signalling molecules) concentrations and the whole blood transcriptome (gene expression data). This will involve participants undergoing blood sampling at four timepoints. This study will comprehensively analyse the immune system in adults over 18 years of age at Guy’s and St Thomas Hospital critical care units and recruit for two years. Ultimately, we aim to identify the molecular and cellular pathways that could be targeted to "shift" a patient's immune trajectory from a "high risk" subgroup to a "low risk" subgroup of sepsis.REC name
South Central - Berkshire Research Ethics Committee
REC reference
19/SC/0187
Date of REC Opinion
7 May 2019
REC opinion
Favourable Opinion