Sepsis after cardiac surgery: preliminary analysis of cytokines gene expression

Objective: According to SSC Sepsis is defined as “life-threatening organ dysfunction caused by a dysregulated host response to infection”.Sepsis remains one of the leading causes of morbidity and mortality (17-65 %) worldwide and it remains a challenge to be defined and for which an appropriate cure is desired. Different studies have been conducted on genes coding for inflammatory cytokines that could predispose to the development of sepsis [e.g., IL-10 and PD1]. This multicentric observational prospective study aims to evaluate the genetic expression kinetics of two molecules involved in the inflammatory process, IL10 and PD1, to search for a possible molecular marker predictive of the development of sepsis Design and method: 162 patients scheduled for planned cardiac surgery were enrolled in the study. For each patient, 4 blood samples have been collected at 4 different time points. Patients were defined as septic according to SSC guidelines. From each blood sample, RNA was extracted and used for a qPCR. Results and conclusions: Of 162 patients enrolled (100M and 62F), 25 (15%) developed sepsis (15M and 10F). The results show that the CBP time was longer in septic patients (143 Vs. 105 means in minutes) than in Clamping time (89.6 Vs 76.29 mim). The expression of IL10 highlights how 30 minutes after the start of the intervention, septic patients showed much lower levels of IL10 expression (p<0.05). This result, however, is reversed upon entry into the ICU. The same results are confirmed by the expression of PD1, which appears to be deactivated in septic patients (p<0.05). This expression kinetics demonstrates how patients who developed sepsis show a dysregulation of the immune response, which leads to decompensation of the immune system, which is thus unable to respond adequately. These data suggest how CBP and Clamping time influence more patients genetically predisposed to sepsis.