The Role of Immune Semaphorins in Steatotic Liver Disease and Sepsis

NCT ID: NCT06021743

Last Updated: 2023-09-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

160 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-01-01

Study Completion Date

2024-03-01

Brief Summary

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The impact of the complex liver immunological network on sepsis outcome is largely unknown. Steatotic liver disease (SLD) is the most common chronic liver disease with prevalence of 25% in European countries. The question remains whether patients with SLD are more prone to bacterial infections and what is the impact of persistent liver inflammation to the systemic response to infection, sepsis course and outcomes. Semaphorins are a large family of secreted and membrane-bound biological response modifiers present in many organ systems that are associated with SLD and development of fibrosis, but also might regulate systemic immune responses in sepsis. This study will investigate the association of semaphorins with sepsis outcomes in patients with SLD.

Detailed Description

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The liver, with its ability to produce acute phase proteins, complement and cytokines, plays a central role in regulating inflammation. A balanced pro- and anti-inflammatory liver response results in bacterial clearance and resolution of inflammation. Steatotic liver disease (SLD) is the most common chronic liver disease associated with systemic changes in immune response. Although there are numerous immunological links between sepsis and SLD, there is a significant gap in knowledge regarding the role of SLD in sepsis. Semaphorins were recently recognized as one of the key regulators of immune responses; while some suppress immune cells activation, proliferation and production of inflammatory cytokines, others stimulate immune responses. Semaphorins were recently shown to be associated with pathogenesis of viral hepatitis, SLD and progression of fibrosis. However, their role in sepsis is unknown. The hypothesis of this project is that semaphorins are regulators of inflammation in patients with SLD that have impact on sepsis outcome.

Conditions

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Steatosis of Liver Sepsis Immune Response

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Sepsis

Patients hospitalized due to the sepsis

Evaluation of the degree of steatosis

Intervention Type DIAGNOSTIC_TEST

The degree of steatosis will be estimated using the ultrasound and a method for grading steatosis will be measuring the degree of ultrasound attenuation by hepatic fat using a process based on simultaneous transient elastography (TE) which measures the degree of steatosis.

Screening for the components of metabolic syndrome

Intervention Type DIAGNOSTIC_TEST

Anthropometric measures including height, weight, waist circumference and hip circumference will be measured in all patients. Results of the routine laboratory tests as part of the standard diagnostic procedure will be collected: CRP, leukocyte count, ratio neutrophils and lymphocytes, hemoglobin, platelet count, urea, creatinine, bilirubin, AST, ALT, GGT, ALP, albumins, fasting glucose.

Measurement of serum semaphorin concentrations

Intervention Type DIAGNOSTIC_TEST

Semaphorin concentration will be measured in patient sera by ELISA.

Measurement of inflammatory cytokines

Intervention Type DIAGNOSTIC_TEST

A panel of pro- and anti-inflammatory markers will be determined by flow cytometer microsphere-based assay.

Interventions

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Evaluation of the degree of steatosis

The degree of steatosis will be estimated using the ultrasound and a method for grading steatosis will be measuring the degree of ultrasound attenuation by hepatic fat using a process based on simultaneous transient elastography (TE) which measures the degree of steatosis.

Intervention Type DIAGNOSTIC_TEST

Screening for the components of metabolic syndrome

Anthropometric measures including height, weight, waist circumference and hip circumference will be measured in all patients. Results of the routine laboratory tests as part of the standard diagnostic procedure will be collected: CRP, leukocyte count, ratio neutrophils and lymphocytes, hemoglobin, platelet count, urea, creatinine, bilirubin, AST, ALT, GGT, ALP, albumins, fasting glucose.

Intervention Type DIAGNOSTIC_TEST

Measurement of serum semaphorin concentrations

Semaphorin concentration will be measured in patient sera by ELISA.

Intervention Type DIAGNOSTIC_TEST

Measurement of inflammatory cytokines

A panel of pro- and anti-inflammatory markers will be determined by flow cytometer microsphere-based assay.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* 2 or more SIRS (Systemic Inflammatory Response Syndrome) criteria (1. Hyperthermia \>38.3°C or Hypothermia \<36°C; 2. Tachycardia \>90 bpm; 3. Tachypnea \>20 bpm; 3. Leukocytosis (\>12,000 μL-1) or Leukopenia (\<4,000 μL-1))
* clinical suspicion of sepsis
* enrolled within 24 hours of hospital admission

Exclusion Criteria

* no consent
* immunosuppression
* malignancies
* immune diseases
* pregnancy
* HIV infection
* presence of chronic liver disease
* consumption of alcohol \> 20 g/day
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Croatian Science Foundation

OTHER_GOV

Sponsor Role collaborator

University Hospital for Infectious Diseases, Croatia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Neven Papic, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

School of Medicine, University of Zagreb

Locations

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University Hospital for Infectious Diseases Zagreb

Zagreb, , Croatia

Site Status RECRUITING

Countries

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Croatia

Central Contacts

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Nina Vrsaljko, MD

Role: CONTACT

+385914012018

Facility Contacts

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Neven Papic, MD, PhD

Role: primary

+38512826222

Other Identifiers

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UHID-08

Identifier Type: -

Identifier Source: org_study_id

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