Study on the Relationship Between Neutrophil-mediated Thrombocytopenia and the Condition and the Course of Disease in Patients With HFRS

Overview

Thrombocytopenia is an important pathological feature of HFRS(Hemorrhagic Fever With Renal Syndrome, HFRS). However, the cause of thrombocytopenia in HFRS is not yet fully understood. Neutrophils, as the largest number of white blood cells in the human body, can widely participate in the immune process of viral infections. Previous studies have found that the neutrophils of patients with acute myocardial infarction can interact with activated platelets and further mediate platelet phagocytosis.Therefore, this study aims to systematically elucidate the immunological process of neutrophil mediated thrombocytopenia in patients with HFRS by exploring the correlation between platelet activation, neutrophil activation and neutrophil proportion of adherent / phagocytic platelets peripheral blood of HFRS patients, and to analyze its relationship with the course of HFRS disease, which lays a theoretical foundation for further understanding the pathogenesis of HFRS and provides a basis for clinical use.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Cross-Sectional
  • Study Primary Completion Date: February 28, 2024

Interventions

  • Other: clinical classification of HFRS
    • Based upon clinical classification of HFRS , the patients were classified into four types

Arms, Groups and Cohorts

  • Mild patients
    • defined as patients who had kidney injury without oliguria and hypotension
  • moderate patients
    • defined as patients who had uremia, effusion (bulbar conjunctiva), hypotension, hemorrhage (skin and mucous membranes), and AKI with typical oliguria
  • severe patients
    • defined as patients who had severe uremia, effusion (bulbar conjunctiva and either peritoneum or pleura), hemorrhage (skin and mucous membranes), hypotension and AKI with oliguria (urine output of 50-500 mL/day) for ≤ 5 days or anuria (urine output of < 100 mL/day) for ≤ 2 days
  • critical patients
    • defined as patients who usually had one or more of the following complications compared with the severe patients: refractory shock (≥ 2 days), visceral hemorrhage, heart failure, pulmonary edema, brain edema, severe secondary infection, and severe AKI with oliguria (urine output of 50-500 mL/day) for > 5 days or anuria (urine output of < 100 mL/day) for > 2 days
  • healthy control
    • defined as people without HFRS

Clinical Trial Outcome Measures

Primary Measures

  • Changes in the platelet activation ratio, %
    • Time Frame: through study completion, an average of 2 year
    • flow cytometry
  • Changes in neutrophils MPO content, MFI
    • Time Frame: through study completion, an average of 2 year
    • enzyme-linked immunosorbent assay
  • Changes in the neutrophils with adherent platelets, %
    • Time Frame: through study completion, an average of 2 year
    • flow cytometry
  • Changes in the neutrophils with internalized platelets, %
    • Time Frame: through study completion, an average of 2 year
    • flow cytometry

Secondary Measures

  • Changes in Neutrophils Mac-1 expression, MFI
    • Time Frame: through study completion, an average of 2 year
    • flow cytometry
  • Changes in the platelets with phosphatidylserine exposure,%
    • Time Frame: through study completion, an average of 2 year
    • flow cytometry

Participating in This Clinical Trial

Inclusion Criteria

  • Age ≥18 years; – Clinical diagnosis meets the diagnostic criteria of the national HFRS prevention and treatment plan (Hantavirus-specific IgM antibody is positive). The classification and staging standards of HFRS patients are based on the "Expert Consensus of Shaanxi Province on Diagnosis and Treatment of Hemorrhagic Fever with Renal Syndrome". Exclusion Criteria:

  • Age <18 years; – Have a history of kidney disease; – Have a history of liver disease; – Have a history of malignant tumor; – Receive dialysis treatment before admission; – Combined with hypertension, coronary heart disease and diabetes history; – Combined with HIV infection and patients with autoimmune diseases and pregnancy.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Investigator Details

  • Lead Sponsor
    • First Affiliated Hospital Xi’an Jiaotong University
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • xiaojiao Li, Study Director, First Affiliated Hospital of Xian Jiaotong University
  • Overall Contact(s)
    • xiaojiao Li, 0086-17521011271, lixiaojiao@xjtufh.edu.cn

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