Cardiac Surgical Procedure
Conditions
Keywords
cardiopulmonary bypass; immunosuppression; infant, immunosuppression, infant
Brief summary
The investigators have previously reported that cardiac surgery with cardiopulmonary bypass (CPB) in young infants induced a drastic reduction in mHLA-DR (Human Leucocyte Antigen) expression, which represents one of innate immune mediator. Danger-Associated Molecular Patterns (DAMPs) can elicit immune response and may subsequently induce an immune-suppressed state. We hypothesize that analyzing the proteomic and the whole blood transcriptomic response after cardiac surgery would provide new insights into the pathophysiological mechanisms of CPB-related inflammatory response.
Detailed description
Plasma levels of heat shock protein and inflammatory-related proteins will be measured at four time points (prior to the onset of surgery, Hour 6 postoperative, day 1 and day 3 after surgery). Whole blood transcriptomic analysis will be performed before and after surgery. The immune suppression induced by CPB will be assessed by in vitro experiments.
Interventions
DIAGNOSTIC_TESTBlood drop sampling
For each patient included, 1 additional EDTA blood tube (2 ml) will be collected for research purposes at different times (4 visits), and 1 PAXgene-type tube adapted for pediatric collection of only 500 μl (2 visits).
Sponsors
Nantes University Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 3 Months
Healthy volunteers
No
Inclusion criteria
* Patient admitted to pediatric intensive care at Nantes University Hospital after cardiac surgery * Age ≤ 3 months corrected age. * Control group: patients less than 3 months old following cardiac surgery without CPB or digestive surgery with a central venous catheter.
Exclusion criteria
* Futility of care with cessation of blood tests as part of a limitation of active therapies; * Absence of parents for information * Refusal of parents after information (Lack of parental consent) * Blood volume collected for medical purposes incompatible with the needs of the research.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Plasma levels of inflammation-related proteins, including some DAMPs, heat shock protein (HSP 70), high mobility group box (HMGB1), S100A9, IL-33 before and after surgery. | prior to the onset of CPB, 6 hours, day 1 and day 3 after surgery | Change of plasma levels of inflammation-related proteins before and after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Whole blood transcriptome before and after surgery. | Prior to the onset of surgery and 6 hours after surgery | Whole blood transcriptomic analysis before and after surgery. |
| Characterization of CPB-immune dysfunction in vitro | Prior to the onset of surgery and 6 hours after surgery | In vitro experiments with immune cells phenotyping, in vitro-stimulation and intracellular cytokine staining. |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORAlexis Chenouard
Nantes University Hospital
Outcome results
None listed