A Study of Exosome Proteomics and Hemodynamics in Sepsis
Condition: Hemodynamic Instability; Autophagy
MeSH terms: Sepsis
Study type: Observational

Summary: 
      This research will be the first study for exosomes purified in blood and urine from septic
      patients who had multiple organ failures. Proteomics studies in exosomes from blood or urine
      specimens. Analyze autophage, and apoptosis related biomarkers of exosomes by bioinformatics.
      To find the correlations between exosomes biomarkers and hemodynamic parameters.
    

Detailed description: 
      Background: Sepsis, defined as an infection with evidence of systemic infection, continues to
      be a source of considerable morbidity and mortality. Many animal sepsis models had found that
      sepsis induced multiple organ failure. Autophagy, apoptosis may involve the process of sepsis
      related multiple organ failure. Mass spectrometry-based proteomics studies in clinical
      populations and in rodent and mammalian animal models had started with discovered many novel
      biomarkers of sepsis. Esoxomes had been found in blood or urine presented the signal of
      autophagy and apoptosis. On the other hand, pulse contour cardiac output (PiCCO) can
      calculate hemodynamic parameters that had been used for evaluation in cardiopulmonary failure
      of sepsis.

      Aims of the study: This research will be the first study for exosomes purified in blood and
      urine from septic patients who had multiple organ failures. Proteomics studies in exosomes
      from blood or urine specimens. Analyze autophage, and apoptosis related biomarkers of
      exosomes by bioinformatics. To find the correlations between exosomes biomarkers and
      hemodynamic parameters.

      Materials and Methods: A total of 30 patients with sepsis, septic shock, or multiple organ
      failure will be included, of whom 15 septic patients had cardiopulmonary organ failure,
      others will be not. All patients included and classified according to the surviving sepsis
      campaign criteria, also treat according to surviving sepsis campaign guidelines. Data will be
      collected from January 2016 to December 2016. Exosome will be isolated and purified by
      sucrose gradient ultracentrifugation. Magnetic beads purification, 2D gel electrphoresis, and
      MALDI-TOF will be used to analyze proteomics of exosome in urine or blood of septic patients.
      Western blotting will be done to prove the proteins found by proteomics. Pulse contour
      cardiac output monitored heart contractility, end-diastolic volume parameters, and lung water
      parameters. Finally, to find the correlations between exosome specific organ and
      autophagy-apoptosis biomarkers and hemodynamic parameters.

      Possible effect: Systematic establishment of exosome proteomics in blood and urine from
      septic patients who had multiple organ failure or not will be done. Autophagy-apoptosis
      biomarkers in exosomes will be detected and correlated to hemodynamic parameters, to judge
      specific organ failure in sepsis.
    

Intervention name(s): Hemodynamic parameters
Intervention type(s): Diagnostic Test
Intervention description(s): Pulse contour cardiac output monitored heart contractility, end-diastolic volume parameters, and lung water parameters.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Sepsis was defined as a life-threatening organ dysfunction due to a dysregulated host
        response to infection.

        Patient with sepsis who was admitted to ICU. PiCCO hemodynamics was setted
      
Biospecimen description: 
      Blood and urine, extract exosome collection