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Signatures in the blood reveal how sepsis patients will respond to condition

Scientists have identified molecular signatures in the immune component of the blood which indicate how patients in intensive care with sepsis, septic shock and systemic inflammatory response syndrome are likely to respond to the conditions.

Intensive care
Sepsis is a life-threatening condition, requiring admission to intensive care

The work – led by Public Health England and involving Nottingham Trent University and Cardiff University – means that for the first time clinicians would be able to test and pre-emptively manage and treat patients based on their immune profiles.

It is hoped that the study could also pave the way to new therapies, as the researchers were able to identify molecules that were most influential in the immune system and could therefore become druggable targets.

Sepsis is a life-threatening condition – requiring admission to intensive care – and occurs when the immune system overreacts to an infection and starts to damage the body's tissues and organs.

It is a major healthcare problem in the UK, accounting for a quarter of intensive care unit admissions.

Despite this there is a lack of knowledge of the immune processes involved in sepsis or the clinically relevant molecules at play. This would help clinicians to distinguish between sepsis and SIRS – which are very similar – to improve patient management through more appropriate treatment as well as help to identify potential new therapies.

The team analysed molecules in the white blood cells, which function as part of the immune system, of patients with sepsis, septic shock – the most severe form of sepsis – and SIRS.

Using Nottingham Trent University-led machine learning and artificial intelligence, they were then able to develop molecular signatures that were able to predict the outcome of patients based on their immune response, the condition they had and whether it had started in the lungs or the abdomen. Work is ongoing at PHE and Cardiff to further develop these signatures into clinically useful diagnostic assays.

The researchers also believe that their approach could be applied to covid-19, given that it manifests as a sepsis-like disease in the more severe cases.

“This approach provides new insights into how patients respond to these serious conditions based on their immune response and the molecular processes that define and drive disease progression,” said Nottingham Trent University scientist Professor Graham Ball.

He said: “Our work highlights the importance of examining these molecular immune responses in determining outcome for patients.

“Another important aspect of this study is that the molecular processes we identified are similar to those defining patient outcome in covid-19. As such our methods could potentially be used to predict response and outcome for these patients too.”

Dr Tamas Szakmany, Senior Lecturer in Intensive Care at Cardiff University, said: “Sepsis on the intensive care unit can present in several ways and we have learnt that defining the group of patients based on solely clinical parameters is difficult.

“Detailed understanding of the molecular response to infection will help us to treat those patients with novel therapies, who are most likely to benefit from these experimental approaches.”

The work, published in the journal Frontiers in Immunology, was funded by Innovate UK and also involved First City University College in Malaysia.

  • Notes for editors

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    NTU’s Professor Graham Ball is also a director of Intelligent OMICS, a University spin out which is working in this area and has further developed the AI technologies for this project.

    Public Health England exists to protect and improve the nation's health and wellbeing, and reduce health inequalities. PHE is responsible for: making the public healthier and reducing differences between the health of different groups by promoting healthier lifestyles, advising government and supporting action by local government, the NHS and the public; protecting the nation from public health hazards; preparing for and responding to public health emergencies; improving the health of the whole population by sharing our information and expertise, and identifying and preparing for future public health challenges; supporting local authorities and the NHS to plan and provide health and social care services such as immunisation and screening programmes, and to develop the public health system and its specialist workforce; researching, collecting and analysing data to improve our understanding of public health challenges, and come up with answers to public health problems.

    Nottingham Trent University was named University of the Year 2019 in the Guardian University Awards. The award was based on performance and improvement in the Guardian University Guide, retention of students from low-participation areas and attainment of BME students. NTU was also the Times Higher Education University of the Year 2017, and The Times and Sunday Times Modern University of the Year 2018. These awards recognise NTU for its high levels of student satisfaction, its quality of teaching, its engagement with employers, and its overall student experience. The university has been rated Gold in the Government’s Teaching Excellence Framework – the highest ranking available.

    It is one of the largest UK universities. With nearly 32,000 students and more than 4,000 staff located across four campuses, the University contributes £900m to the UK economy every year. With an international student population of more than 3,000 from around 100 countries, the University prides itself on its global outlook. The university is passionate about creating opportunities and its extensive outreach programme is designed to enable NTU to be a vehicle for social mobility. NTU is among the UK’s top five recruiters of students from disadvantaged backgrounds and was awarded University of the Year in the UK Social Mobility Awards 2019.

    A total of 82% of its graduates go on to graduate entry employment or graduate entry education or training within six months of leaving. Student satisfaction is high: NTU achieved an 87% satisfaction score in the 2019 National Student Survey.

Published on 27 May 2020
  • Subject area: Sciences including sport sciences
  • Category: Press office; Research; School of Science and Technology