Do injured red blood cells damage the kidneys of patients with sepsis?
Dr Laura Carey, from the University of Bristol, has received a training fellowship grant of £95,000 in collaboration with the Medical Research Council (MRC). She wants to know if injured red blood cells (RBCs) from patients with sepsis can cause kidney damage.
The problem
Sepsis is a life-threatening condition. In a healthy body, the immune system fights infection but in sepsis, the immune system becomes too active. This can damage organs which then stop working. In the kidney, we call this acute kidney injury (AKI). One in three patients with sepsis will develop AKI.
Laura and the team in Bristol have been studying RBCs. RBCs carry oxygen around the body and have a jelly like outer layer called glycocalyx. They have found glycocalyx is broken down in sepsis and AKI. They now want to know if RBCs without a glycocalyx switch on too many immune cells, called neutrophils, allowing them to damage the kidney.
Neutrophils
Neutrophils are a type of white blood cell (WBC) that help fight infection. In sepsis they become too active and can damage the organs and tissues. One place they can cause damage is to the blood vessels inside the kidney.
The solution
The glycocalyx is very fragile which makes it hard to detect with tests. The team at the University of Bristol have developed a new blood test which can show glycocalyx damage on RBCs. Laura will use this test in patients with sepsis and AKI in the intensive care unit.
Laura will look at whether damaged RBCs can activate healthy neutrophils. She will then see if protecting the RBC glycocalyx switches off neutrophils which are too active. This could be a new way to stop neutrophils from causing damage in the kidney.
What might this mean for kidney patients?
Better treatments are needed for sepsis and AKI. This study will help us understand how kidney damage occurs in patients with sepsis. Understanding the behaviour of RBCs and neutrophils will help to develop new treatments in the future.
“Sepsis is so common, but we do not have treatments to stop the kidney from failing. This is devastating for patients. The unique thing about this study is our sepsis patient group. We are working closely with patients who have experienced sepsis. We are now looking at the problem from a new angle. This gives us the best chance at finding new treatments that work.” Laura Carey.
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