A study of oxysterols as a marker for sepsis induced brain dysfunction
Research type
Research Study
Full title
A pilot study to assess 24-OH-cholesterol as a biomarker for sepsis-induced brain dysfunction
IRAS ID
337414
Contact name
David Brealey
Contact email
Sponsor organisation
University College London Hospital Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Sepsis induced brain dysfunction, often referred to ICU delirium, was first described by Hippocrates in 2500BC. Since then it has been recognised as common, affecting up to 40% of septic patients and is associated with an increased mortality and, in survivors, long lasting psychological sequalae and permanent cognitive decline. Despite this it remains challenging to diagnose, particularly in patients receiving heavy sedation as a result there is no specific management. We believe we have identified a novel biomarker in the blood, 24-OH-cholesterol. 24-OH-cholesterol,a product of cholesterol, is only found in nerve cells, we found these levels to be raised in patients with SIBD. In this single centre study, we now want to examine the specificity of the biomarker, comparing levels in patients with other causes of brain injury or those undergoing non-septic insults (e.g., the trauma of surgery). We aim to enrol 20 patients with sepsis taking a blood sample within 24hours of ICU admission, repeating the sampling up to 6 times in 2 weeks. We would like to compare these patients with samples taken from 20 with non-infective brain injury (stroke, trauma, haemorrhage), 10 having neurosurgery, 10 having major abdominal surgery and 10 healthy volunteers. We will compare the levels of 24-OH-cholesterol to other (non-specific) biomarkers such as S100b and Neurone Specific Enolase. For those nursed on the ICU we will assess cognitive impairment on or near the ICU discharge day using the Montreal Cognitive Assessment score which can be reliably performed in an ICU environment. This will be used to determine any association between the biomarker and cognitive decline. Should this project be successful (and it would require further prospective validation), this would be the first specific biomarker for SIBD, which would be a significant advance with respect to determining aetiology, describing epidemiology and potentially developing management strategies.
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
24/YH/0258
Date of REC Opinion
11 Dec 2024
REC opinion
Further Information Favourable Opinion