The Role of Emergency Neutrophils and Glycans in Postoperative and Septic Patients

NCT04117568 | Terminated

• 1 other identifier: AKB-Block
• Study Type: observational
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

Surgical trauma elicits an immune response aiming to initiate healing and remove debris and damaged tissue locally at the wound site (1). This local reaction includes a considerable production of cytokines and chemokines that enters the circulation and initiate a systemic inflammatory response mediated by circulating cytokines and chemokines. This response is called systemic inflammatory immune response (SIRS) and is an aseptic systemic inflammation. Postoperative inflammation produces proinflammatory cytokines, mainly IL-6, IL1 beta, and tumor necrosis factor alfa (2). Neutrophils and emergency granulopoesis Polymorphonuclear neutrophils constitute the most abundant population of white blood cells. Their main task is to provide innate immune protection of the host from microbial attack, migrating to the site of infection, engulfing the microbes by phagocytosis, and killing the prey through attack by reactive oxygen species (ROS) and antimicrobial granule pro¬teins (22). Upon systemic infection or inflammation, e.g., sepsis or trauma, the bone marrow enters a state of emergency granulopoiesis, drenched in cytokines that augment production and survival of neutrophils for rapid delivery to the blood (23-25). Recently, advanced techniques have evolved that al¬low the isolation of different developmental stages of steady-state and emergency neutrophils, and characterization of these has just begun (26). Glycans Glycans (polysaccharides) attached to proteins and lipids on the surfaces on immune cells serve as ligands for glycan-binding proteins, lectins. Several neutrophil processes are directed by gly¬can - lectin interactions; selectin-directed rolling on the endothelium, siglec-mediated in¬hibitory signals, and activation of effector function by galectins. Many of the proteins that end up in neutrophil intra-cellular granules are highly glycosylated, but not much is known about if and how the neutrophil glycome evolves during the 'targeting-by-timing' process of differentiation and how this is affected by emergency granulopoiesis during systemic infection and inflammation. Here is a clear knowledge gap.

Conditions

Sepsis; Septic Shock; Sepsis, Severe; Post-Op Complication; SIRS

Outcome Measures

Primary Outcomes (3)

• Emergency granulopoesis in postoperative patients undergoing major surgery for malignancies.

  Outcome : Is there an emergency granulopoesis in this category of patients? When does the granulopoesis occur? To what extent are the neutrophils affected by the emergency granulopoesis? Can the neutrophils produce reactive oxygen species?

  2019-2020

• Emergency granulopoesis perioperatively in patients undergoing cardiac surgery with the use of perioperative heart-lung machine.

  Is there an emergency granulopoesis in this category of patients? When does the granulopoesis occur? To what extent are the neutrophils affected by the emergency granulopoesis? Can the neutrophils produce reactive oxygen species?

  2020

• Emergency granulopoesis in septic shock patients with and without a positive blood culture.

  Is there an emergency granulopoesis in this category of patients? When does the granulopoesis occur? To what extent are the neutrophils affected by the emergency granulopoesis? Can the neutrophils produce reactive oxygen species?

  2019-2020

Interventions

Blood sampling OTHER

Blood sampling at 3-5 occasions per admission

Also known as: No other intervention as this is an observational study

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Postoperative patients or patients presenting with sepsis at Sahlgrenska University hospital, Gothenburg, Sweden

You may qualify if:

• Patients over 18 years of age
• undergoing surgery or presenting with sepsis according to definitions.

You may not qualify if:

• Interrupted surgery
• Neuropenia caused by cytostatics

Sponsors & Collaborators

• Göteborg University: lead

Study Sites (1)

Sahlgrenska University Hospital

Gothenburg, 41345, Sweden

Location

Biospecimen

Retention: SAMPLES WITH DNA

Blood

MeSH Terms

Conditions

Sepsis; Shock, Septic; Postoperative Complications

Interventions

Blood Specimen Collection

Condition Hierarchy (Ancestors)

Infections; Systemic Inflammatory Response Syndrome; Inflammation; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Shock

Intervention Hierarchy (Ancestors)

Specimen Handling; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Punctures; Surgical Procedures, Operative; Investigative Techniques

Study Officials

• Anna Karlsson-Bengtsson, Prof

  Göteborg University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 3, 2019
• First Posted: October 7, 2019
• Study Start: September 4, 2019
• Primary Completion: April 1, 2020
• Study Completion: April 1, 2020
• Last Updated: August 19, 2021

Record last verified: 2021-08

Data Sharing

• IPD Sharing: Will not share

Locations

SE (1)