Plasma Levels of Danger-Associated Molecular Patterns in Young Children After Cardiac Surgery Under Cardiopulmonary Bypass

Nantes University Hospital88 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Cardiac Surgical Procedure

Interventions

Blood drop samplingDIAGNOSTIC_TEST

Eligibility

Sex: ALLMax age: 3 Months

Medical Language ↔ Plain English

Inclusion Criteria: * Patient admitted to pediatric intensive care at Nantes University Hospital after cardiac surgery * Age ≤ 3 months corrected age. * Control group: patients less than 3 months old following cardiac surgery without CPB or digestive surgery with a central venous catheter. Exclusion Criteria: * Futility of care with cessation of blood tests as part of a limitation of active therapies; * Absence of parents for information * Refusal of parents after information (Lack of parental consent) * Blood volume collected for medical purposes incompatible with the needs of the research.

Outcomes

Primary Outcomes

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.

Time frame: prior to the onset of CPB, 6 hours, day 1 and day 3 after surgery

Secondary Outcomes

Whole blood transcriptome before and after surgery.

Whole blood transcriptomic analysis before and after surgery.

Time frame: Prior to the onset of surgery and 6 hours after surgery

Characterization of CPB-immune dysfunction in vitro

In vitro experiments with immune cells phenotyping, in vitro-stimulation and intracellular cytokine staining.