Severe Sepsis or Septic Shock Clinical Trial
— HEP-SEPSISOfficial title:
Hepcidin: a Prognostic Marker of Morbidity and Mortality in Severe Sepsis?
Verified date | September 2018 |
Source | Rennes University Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Many biomarkers have been evaluated in sepsis, especially for prognostic purposes, but none has yet been shown to have sufficient sensitivity or specificity for routine use in clinical practice. However, highlighting a biomarker facilitating the evaluation of the severity of sepsis remains relevant in a pathology where survival is largely conditioned by the initiation of an early and adapted treatment. Recent evidence suggests that hepcidin, which is the key hormone for systemic regulation of iron metabolism, may be an interesting prognostic biomarker. The synthesis of this peptide is regulated by the iron stocks of the body, erythropoiesis, but also inflammation. The mechanisms inducing the expression of hepcidin during inflammation are multiple: interleukin-6 (IL-6) in particular, pro-inflammatory cytokine is a strong inducer of hepcidin. In addition, its expression is increased by the effect of lipopolysaccharide via Toll-like receptors . In septic patients, elevated levels of hepcidin or pro-hepcidin have been reported . A new role for hepcidin in the control of inflammatory and / or immune response has recently been reported. Thus, in a model of murine septic shock, the deleterious character of a lack of expression of hepcidin could be demonstrated . In humans, hepcidinemia has been shown to be a predictive factor in the development of immunotolerance in hepatic transplant patients. Hepcidin therefore plays a major role in the regulation of the inflammatory and / or immune response and in particular during sepsis. The investigators therefore hypothesize that hepcidin could be the marker of an adverse prognosis in septic patients expressing this
Status | Active, not recruiting |
Enrollment | 114 |
Est. completion date | December 1, 2019 |
Est. primary completion date | July 12, 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - man or woman, - older than or equal to 18 years, in severe sepsis or septic shock according to the criteria of the American College of Chest Physicians / Society of Critical Care Medicine (ACCP / SCCM), - no opposition from the patient, a relative or the legal representative Exclusion Criteria: - pregnant or lactating woman, - patient with hemochromatosis. |
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
Rennes University Hospital |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Sensitivity of plasma hepcidin assayed at admission to intensive care on mortality at D28 in patients with severe sepsis. | Sensitivity of plasma hepcidin assayed at admission to intensive care on mortality at D28 in patients with severe sepsis. | day 28 | |
Secondary | mortality at day 90 | mortality at day 90 | day 90 | |
Secondary | occurrence of care-related infections as defined by the Center for Disease Control and Prevention during hospitalization | occurrence of care-related infections as defined by the Center for Disease Control and Prevention during hospitalization | day 90 | |
Secondary | occurrence of new organ failure (SOFA) or the aggravation of an existing organ failure on seventh day of sepsis | occurrence of new organ failure (SOFA) or the aggravation of an existing organ failure on seventh day of sepsis | day 90 |
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT03068741 -
Paramedic Initiated Treatment of Sepsis Targeting Out-of-hospital Patients (PITSTOP)
|
Phase 4 | |
Completed |
NCT01845766 -
Effects of Early Exercise Rehabilitation on Long-term Functional Recovery in Patients With Severe Sepsis
|
N/A | |
Completed |
NCT01689441 -
Randomized Controlled Trial of Calcitriol vs. Placebo Among Critically-ill Patients With Sepsis
|
Phase 2 | |
Completed |
NCT02656654 -
COrporeal Compression at the ONset of Severe Sepsis and Septic Shock
|
N/A |