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The investigators have previously reported that cardiac surgery with cardiopulmonary bypass (CPB) in young infants induced a drastic reduction in mHLA-DR (Human Leucocyte Antigen) expression, which represents one of innate immune mediator. Danger-Associated Molecular Patterns (DAMPs) can elicit immune response and may subsequently induce an immune-suppressed state. We hypothesize that analyzing the proteomic and the whole blood transcriptomic response after cardiac surgery would provide new insights into the pathophysiological mechanisms of CPB-related inflammatory response.
Plasma levels of heat shock protein and inflammatory-related proteins will be measured at four time points (prior to the onset of surgery, Hour 6 postoperative, day 1 and day 3 after surgery). Whole blood transcriptomic analysis will be performed before and after surgery. The immune suppression induced by CPB will be assessed by in vitro experiments.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study population | The study population must correspond to the research inclusion criteria: Patient admitted to pediatric intensive care at Nantes University Hospital after cardiac surgery on bypass grafts |
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| Control group | Infants under 3 months of age undergoing heavy digestive surgery and having a central venous catheter to facilitate access to blood samples. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blood drop sampling | Diagnostic Test | For each patient included, 1 additional EDTA blood tube (2 ml) will be collected for research purposes at different times (4 visits), and 1 PAXgene-type tube adapted for pediatric collection of only 500 μl (2 visits). |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma levels of inflammation-related proteins, including some DAMPs, heat shock protein (HSP 70), high mobility group box (HMGB1), S100A9, IL-33 before and after surgery. | Change of plasma levels of inflammation-related proteins before and after surgery. | prior to the onset of CPB, 6 hours, day 1 and day 3 after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Whole blood transcriptome before and after surgery. | Whole blood transcriptomic analysis before and after surgery. | Prior to the onset of surgery and 6 hours after surgery |
| Characterization of CPB-immune dysfunction in vitro |
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Inclusion Criteria:
Exclusion Criteria:
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All patients admitted to pediatric resuscitation at the Nantes University Hospital after cardiac surgery under CEC ( extra-corporal circulation) and aged less than 3 months meeting the criteria for inclusion and non-inclusion of the study will be included. We can objectify the recruitment of 80 patients in total over 3 years.
Since natural evolution (variation of rates and their kinetics) of the secretion of different DAMPs during the first months of life is unknown, the investigators added a control group to know the expression and kinetics of DAMPs outside cardiac surgery under CEC. This control group will be defined by infants under 3 months of age undergoing heavy digestive surgery and having a central venous catheter to facilitate access to blood samples (n = 20).
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| Name | Affiliation | Role |
|---|---|---|
| Alexis Chenouard | Nantes University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nantes University Hospital | Nantes | 44093 | France |
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In vitro experiments with immune cells phenotyping, in vitro-stimulation and intracellular cytokine staining.
| Prior to the onset of surgery and 6 hours after surgery |