Temporal profile of lymphocytes in patients during Sepsis and without end of 1 year after the clinical picture

• Grant number: 17/00810-3
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• Start date: March 01, 2018
• End date: May 16, 2021
• Field of knowledge: Biological Sciences - Physiology - General Physiology
• Principal Investigator: Renata Gorjao
• Grantee: Laiane Cristina dos Santos
• Host Institution: Pró-Reitoria de Pós-Graduação e Pesquisa. Universidade Cruzeiro do Sul (UNICSUL). São Paulo , SP, Brazil

Abstract

Sepsis is caused by an exacerbated and a dysregulated systemic immune response secondary to infectious agent that can lead to death. Excessive secretion of inflammatory mediators and activation of leukocytes may compromise the function of tissues and organs. Organ failure is associated with high mortality rates in the intensive unit centers. However, there are also high mortality rates of post-septic patients in the years following the disease occurrence. In the long-term period after Sepsis, leukocytes respond inefficiently to different stimuli. However, there is no data about changes in lymphocyte response profile in these patients after several periods discharge from hospital, both in the short term (hospitalization period, discharge from hospital), medium term (3 and 6 months after) and long term (12 months after the illness). Therefore, the aim of this study is to evaluate the lymphocyte profile and gene expression pattern involved in the activation and regulation of differentiation process in patients with Sepsis and after discharge from hospital. Forty patients treated at the USP University Hospital (HU-USP) that developed Sepsis will be selected to participate from the study. These patients will be evaluated during hospital stay, immediately after the intensive care unit and 3, 6 and 12 months after discharge from hospital. Blood was collected in tubes containing EDTA and lymphocyte separation was performed. In these cells, it will be evaluated regulatory T lymphocytes, Th1, Th2 and Th17 percentages by flow cytometry. IL-35, TGF-beta, Foxp3, Blimp-1, ROR-alpha, RORgamat, GATA3, and T-bet gene expression will be determined by real-time PCR. Studies have shown that a high mortality rate due to Sepsis during the first year after the illness. However, the information available in the literature that shows how changes in the body after Sepsis can lead to the death of patients are scarce. There are no studies evaluating lymphocyte characteristics during this long period. It’s extremely important to understand what occurs in the immune system after Sepsis, because these alterations may favor other important complications after discharge from hospital. The present study will enable the better investigation about lymphocyte profile in patients after discharge from hospital leading to a better understanding of the impacts caused by Sepsis to the body and mainly to the control of immune system. (AU)