探索脓毒症中一条新的免疫抑制通路及其治疗潜力

注册号:

Registration number:

ChiCTR2600117946 

最近更新日期:

Date of Last Refreshed on:

2026-01-30 14:34:55 

注册时间:

Date of Registration:

2026-01-30 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

探索脓毒症中一条新的免疫抑制通路及其治疗潜力

Public title:

Exploring a Novel Immunosuppressive Pathway in Sepsis and Its Therapeutic Potential

注册题目简写:

English Acronym:

研究课题的正式科学名称:

LAG3/FGL1轴介导CD8⁺T细胞耗竭在脓毒症免疫抑制中的作用机制及靶向干预研究

Scientific title:

LAG3/FGL1 Axis-Mediated CD8⁺ T Cell Exhaustion in Sepsis-Induced Immunosuppression: Mechanisms and Targeted Intervention Research

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

李娟娟 

研究负责人:

李娟娟 

Applicant:

Juanjuan Li 

Study leader:

Juanjuan Li 

申请注册联系人电话:

Applicant telephone:

+86 15858157956

研究负责人电话:

Study leader's
telephone:

+86 571 87312778

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

lijuanjuan-1@163.com

研究负责人电子邮件:

Study leader's E-mail:

lijuanjuan-1@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

浙江省杭州市拱墅区上塘路158号

研究负责人通讯地址:

浙江省杭州市拱墅区上塘路158号

Applicant address:

No. 158, Shangtang Road, Gongshu District, Hangzhou City, Zhejiang Province, China

Study leader's address:

No. 158, Shangtang Road, Gongshu District, Hangzhou City, Zhejiang Province, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

浙江省人民医院

Applicant's institution:

Zhejiang Provincial People's Hospital

研究负责人所在单位:

浙江省人民医院

Affiliation of the Leader:

Zhejiang Provincial People's Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

浙人医伦审2026研第(042)号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

浙江省人民医院医学伦理委员会

Name of the ethic committee:

Ethical Committee of Zhejiang Provincial Peoples Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2026-01-14 00:00:00

伦理委员会联系人:

李青青

Contact Name of the ethic committee:

Li Qingqing

伦理委员会联系地址:

浙江省杭州市拱墅区上塘路158号

Contact Address of the ethic committee:

No. 158, Shangtang Road, Gongshu District, Hangzhou City, Zhejiang Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 571 85893643

伦理委员会联系人邮箱:

Contact email of the ethic committee:

zryllwyh@163.com

研究实施负责(组长)单位:

浙江省人民医院

Primary sponsor:

Zhejiang Provincial People's Hospital

研究实施负责(组长)单位地址:

浙江省杭州市拱墅区上塘路158号

Primary sponsor's address:

No. 158, Shangtang Road, Gongshu District, Hangzhou City, Zhejiang Province, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

浙江省

市(区县):

Country:

China

Province:

Zhejiang

City:

单位(医院):

浙江省人民医院

具体地址:

浙江省杭州市拱墅区上塘路158号

Institution
hospital:

Zhejiang Provincial People's Hospital

Address:

No. 158, Shangtang Road, Gongshu District, Hangzhou City, Zhejiang Province, China

经费或物资来源:

浙江省医药卫生科技计划项目

Source(s) of funding:

Zhejiang Provincial Medical and Health Science and Technology Program Project

研究疾病:

脓毒症  

Target disease:

Sepsis

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

病例对照研究 

Study design:

Case-Control study 

研究目的:

脓毒症是一种由感染引起的全身炎症反应综合症,具有较高的发病率和死亡率。目前的治疗手段包括支持性治疗和抗生素,但缺乏降低继发感染相关死亡率的特异性干预措施。CD8+ T细胞在脓毒症期间的细胞和体液免疫反应中起着至关重要的作用。其细胞耗竭是脓毒症免疫抑制的核心环节,主要表现为功能低下、凋亡增加及抑制性受体。因此,了解脓毒症对CD8+ T细胞免疫抑制的影响,对其病理生理学研究至关重要。淋巴细胞活化基因3(lymphocyte activation gene-3,LAG3)是一种主要在T淋巴细胞表面表达的抑制性受体,是近些年最有潜力的免疫检查点之一。LAG3与其配体的结合向活化的T细胞传递负信号,防止免疫介导的组织损伤。纤维蛋白原样蛋白(fibrinogen-like protein 1, FGL1)最近作为LAG3的新型配体备注关注,其可与LAG3结合,形成独立于PD-1/PD-L1的新免疫检查点通路,从而导致T细胞耗竭和随后的功能障碍。申请人前期研究发现,脓毒症患者外周血中CD8+ T细胞上LAG3表达较健康对照者显著增高,高表达LAG3的CD8+ T细胞杀伤功能显著弱于LAG3- CD8+ T细胞。本项目将深入研究LAG3+ CD8+ T细胞在脓毒症中的作用及机制,阐明FGL1/LAG3轴在脓毒症中如何直接驱动CD8+ T细胞耗竭;通过靶向LAG3/FGL1通路的动物干预实验明确其在脓毒症中的治疗价值,为研发以其为基础的新型免疫治疗策略,用于治疗脓毒症患者提供理论和技术支撑。  

Objectives of Study:

Sepsis, a life-threatening inflammatory syndrome, leads to CD8⁺ T cell exhaustion—a key factor in sepsis-induced immunosuppression. The LAG‑3/FGL1 axis, an emerging immune checkpoint, is directly involved in driving this exhaustion. This project investigates the mechanism of the FGL1/LAG‑3 axis in promoting CD8⁺ T cell dysfunction during sepsis and evaluates the therapeutic value of targeting this pathway. The study aims to provide a foundation for novel immunotherapy strategies against sepsis.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.合并严重如HIV感染、恶性肿瘤晚期等免疫缺陷疾病患者;
2.妊娠或哺乳期女性;
3.入组前72小时内接受过诸如抗PD-1抗体在内的免疫调节治疗;
4.合并严重肝肾功能不全(如基础肌酐>200μmol/L或ALT>3倍正常上限);
5.预期生存时间<7天(如严重多器官衰竭);

Exclusion criteria:

1.Patients with severe immunodeficiency diseases, such as HIV infection or advanced malignant tumors; 2.Pregnant or lactating women; 3.Having received immunomodulatory therapy, such as anti-PD-1 antibody, within 72 hours prior to enrollment; 4.Severe hepatic or renal insufficiency (e.g., baseline creatinine >200 μmol/L or ALT >3 times the upper limit of normal [ULN]); 5.Life expectancy of less than 7 days (e.g., due to severe multiple organ failure).

研究实施时间:

Study execute time:

From 2026-02-01 00:00:00 To 2028-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-02-01 00:00:00 To 2027-12-31 00:00:00

干预措施:

Interventions:

组别:

脓毒症患者组

样本量:

30

Group:

Sepsis patient group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

健康对照者组

样本量:

30

Group:

Healthy control group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

浙江省 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

浙江省人民医院 

单位级别:

三级甲等 

Institution
hospital:

Zhejiang Provincial People's Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

淋巴细胞活化基因3,CD8+ T细胞、纤维蛋白原样蛋白

指标类型:

主要指标

Outcome:

Lymphocyte activation gene-3,CD8+ Tcell(LAG3+ CD8+ Tcell)、Fibrinogen-like protein 1(FGL1)

Type:

Primary indicator

测量时间点:

明确诊断后抽取标本测量

测量方法:

流式细胞术检测脓毒症患者外周血中LAG3+ CD8+ T细胞表型及功能变化采用ELISA定量检测脓毒症患者外周血血浆中可溶性FGL1蛋白在疾病不同阶段的表达水平;使用qPCR技术分析各组样本中FGL1 mRNA表达水平

Measure time point of outcome:

Sample collection and measurement were performed after a confirmed diagnosis.

Measure method:

Flow cytometry was employed to examine the phenotype and function of LAG3+ CD8+ T cells in the peripheral blood of sepsis patients; the expression levels of soluble FGL1 protein in plasma at different disease stages were quantitatively measured by ELISA; and the mRNA expression levels of FGL1 in samples from each group were analyzed using quantitative real-time PCR (qPCR).

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 70 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

本研究不进行公开数据共享。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Individual participant data (IPD) from this study will not be made publicly available.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

研究数据通过病例记录表进行标准化采集,并录入电子数据采集与管理系统。所有采集数据采用唯一编码方式进行去标识化处理,仅研究人员可访问。数据采集、录入、核查和存储均遵循医院数据管理规范及伦理委员会要求。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Research data was collected in a standardized manner using case report forms (CRFs) and entered into an electronic data capture and management system. All collected data were de-identified using a unique coding system and are accessible only to the research team. The processes of data collection, entry, verification, and storage adhered to hospital data management regulations and the requirements of the ethics committee.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-01-30 14:34:18