Calcium Phosphate Disorders, Calcium Sensing Receptor, Inflammation, Monocyte, Septic Shock
Conditions
Keywords
Septic shock, Calcium Sensing Receptor, Calcium Phosphate disorders, Inflammation, Monocyte
Brief summary
In septic shock, bacterial LPS is able to activate the CaSR of cardiomyocytes inducing their apoptosis in vitro. CaSR activation in monocytes is responsible for activation of the NLRP3 inflammasome and macropinocytosis. In front of this immune axis, a variation in the monocyte expression of the CaSR is expected in the state of shock. This is already observed in other pathologies such as renal failure or in animal models of severe burns. If this is considered as an overall reflection of CaSR expression in the body, it would be consistent with the phosphocalcic disturbances associated with septic shock. The phosphocalcic balance is often modified, and not treated during the acute episode, with in particular hypocalcaemia which could be consecutive to a hyperactivation or overexpression of the CaSR. This study proposes to explore for the first time the expression of monocytic CaSR in patients in a state of shock, with possible therapeutic perspectives by the existence of calcimimetics and calcilytics. In this study, the investigators propose to explore the CasR and its implication in septic shock in a three - part protocol : measurement by flow cytometry of monocyte expression of CASR (primary objective) and CD33, CD14, CD163, CD16 and HLA-DR), survey of clinical and biological parameters in patients with septic shock and healthy volunteers and acquisition of calcium score in patients with septic shock.
Interventions
BIOLOGICALblood sampling
Patients with septic shock will have three differents times of blood sampling and of clinical and biological statements. Healthy volunteers will have a unique visit to collect clinical data and blood samples.
Sponsors
Centre Hospitalier Universitaire, Amiens
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Male or female patients over the age of 18, * patients who have not participated in a study evaluating an investigational drug in the 30 days preceding the samples, * intensive care patients in a state of septic shock within the first 24 hours of the introduction of pressor amines, * French resident year-round, * lactate \> 2mmol/L, * patients with social security coverage.
Exclusion criteria
* Patients in hemorrhagic shock, * history of parathyroidectomy, patient with hypersecretion of PTHrp, * sarcoidosis, * genetic disturbance of CaSR including familial hypocalciuric hypercalcaemia, * current immunosuppressant treatment (anticalcineurin, mTOR inhibitor, methotrexate, high-dose corticosteroids excluding hydrocortisone and fludrocortisone), * chronic myelomonocytic leukemia, * patients with febrile neutropenia, * patients with acquired or constitutional immune system, * pregnant or breastfeeding patient, * patients under curators, guardianship or safeguard of justice.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Monocyte CaSR expression in healthy patient | 1 day | Monocyte CaSR expression in healthy patient |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Monocyte CasR expression in patient with septic shock | day 0 | Monocyte CasR expression in patient with septic shock |
Countries
France
Contacts
Primary ContactQuintana SOULIER
Outcome results
None listed