Diagnosing and monitoring infection in critical illness
Research type
Research Study
Full title
Diagnosing and monitoring infection in critically ill patients using metabolic and immunological signatures
IRAS ID
166170
Contact name
Anthony Gordon
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Sepsis, or systemic infection, is a common reason for ICU admission and death throughout the world. Despite advances in the way we treat this condition, it remains a significant economic and healthcare burden. Sepsis and sterile injury/inflammation are often difficult to discriminate in clinical practice, which frequently results in antibiotic over-prescription and potentially increases bacterial resistance and costs.
Two opposing responses exist during sepsis; a pro-inflammatory and an anti-inflammatory immune response, aimed at restoring balance within the body. These responses sometimes become dysfunctional, resulting in an immunosuppressive state, which has been associated with poor outcomes.
Monocytes are white blood cells within the bloodstream, and are one of the key components of the early immune response to infection. During sepsis-associated immunosuppression, they show a reduced ability to effectively orchestrate an immune response, which some authors have called “monocyte deactivation”. However, recent work suggests that these cells can ‘reprogram’ their immune function, regaining their capacity to fight infection as they migrate across the blood vessel wall, toward infection within the tissues. This may be how the body protects itself against the potentially harmful chemicals that these cells release within the bloodstream during sepsis, instead aiming to target an infection within the tissues. Furthermore, our group and others have demonstrated that metobonomics, the science of analyzing the metabolic profiles of tissues and fluids, could be used to diagnose infection.
By developing novel laboratory tests (assays) we will study the immune function of monocytes obtained from patients with sepsis and systemic inflammation, and using metobonomics we will analyse the metabolic profiles of their body fluids. Our work may be used to develop novel diagnostics tests to discriminate sepsis from sterile injury, and give a more accurate indication of monocyte immune competence during sepsis.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
15/LO/0933
Date of REC Opinion
1 Jul 2015
REC opinion
Further Information Favourable Opinion