Nociceptin is a protein found in the body, with a number of functions in the central nervous system, blood vessels and the gut. There is evidence that it may have a role in controlling the immune response to infection, and may act as a link between the brain and immune system. In infection, or after surgery, there is an increase in nociceptin, and subjects greater elevations of nociceptin have a poorer outcome. There is evidence that cells of the immune system may produce nociceptin, although it is not yet known which cells are capable of producing it, and what "switches on" production. This study aims to determine 1. Which cells of the immune system can produce nociceptin 2. If there is a difference in the ability to produce nociceptin between healthy volunteers and patients with severe infections
Study Type
OBSERVATIONAL
Enrollment
14
30mls of blood will be sampled by venepuncture, or sampled from indwelling lines (in the case of septic patients on intensive care). Blood will be sampled using standard techniques, and transferred to EDTA containing blood bottles, and undergo processing immediately.
Leicester Royal Infirmary
Leicester, Leicestershire, United Kingdom
University of Leicester
Leicester, Leicestershire, United Kingdom
Proportion of Responsive Biosensor Cells Responding to Granulocyte Addition in the Presence and Absence of NOP Antagonist
Measure of N/OFQ presence in granulocytes and associated supernatant
Time frame: Day 1
Granulocyte Count
Count of the number of neutrophils in the original sample
Time frame: Day 1
Mortality In-hospital, at 30 Days
All cause mortality at 30 days
Time frame: 30 days
Time to ICU Discharge (or Death if on ICU)
Time frame: Time to ICU discharge (or death if on ICU)
Time to Death or Discharge
Time to death or discharge (days)
Time frame: Number of days between admission and death or discharge from hospital
Acute Physiology and Chronic Health Evaluation (APACHE-2) Score
The Acute Physiology and Chronic Health Evaluation (APACHE-2) score for the patient. APACHE 2 is an international standard,12 variable score from 0-71 reflecting disease severity in the critically unwell during the first 24 hours of illness. The score is a combined measure of illness severity (acute physiology), and background chronic health factors. Increased score represents increased predicted mortality. Variables recorded include AaDO2 or PaO2 (depending on FiO2), temperature, mean arterial pressure, blood pH, heart rate, respiratory rate, serum sodium, serum potassium, creatinine, hematocrit, white blood cell count, Glasgow Coma Scale Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985). "APACHE II: a severity of disease classification system". Critical Care Medicine. 13 (10): 818-29
Time frame: Day 1
Sequential Organ Failure Assessment (SOFA) Score
The Sequential Organ Failure Assessment (SOFA) score for the patient, a score predictive of mortality in sepsis for intensive care patients based on respiratory, cardiovascular, hepatic, coagulation, renal and neurological function (each scored 0-4, with a maximum overall score of 24). The worst (most deranged) physiological values for the first 24 hours are used. A higher score predicts increased mortality. The mortality breakdown for each sofa score range is - SOFA 0-6 (\<10% mortality), 7-9 (15-20%), 10-12 (40-50%), 13-14 (50 - 60%), 15 (\> 80%), 16 to 24 (\> 90%)
Time frame: Day 1
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