The Potential of Mesenchymal Stromal Stem Cells to Correct Immune and Metabolic Dysfunctions in Circulating Immune Cells During Sepsis: An Ex Vivo Pilot Study.

Inclusion criteria

• Patient or authorized representative, informed and having given consent
• Age ≥ 18 years
• Patients admitted for sepsis defined by the association as:

• Clinically or microbiologically documented infection
• SOFA-2 score ≥ 2

• Or +2 points if pre-existing organ dysfunction
• Complicated

• ARDS (Berlin criteria (1))

• Acute respiratory failure
• AND Bilateral pulmonary opacities (X-ray or CT scan) with no evidence of predominant hydrostatic edema
• AND PaO₂/FiO₂ ≤ 300 mmHg under invasive or non-invasive ventilation with PEEP ≥ 5 cmH₂O
• or septic shock (2)

• Vasopressors required to maintain mean arterial pressure (MAP) ≥ 65 mmHg
• AND arterial lactate > 2 mmol/L
• AND despite adequate fluid resuscitation
• Blood sample may be collected within 72 hours of admission to the intensive care unit

Exclusion criteria

• Individuals not enrolled in or not eligible for a social security program
• Individuals subject to a legal protection order
• Pregnant women, women in labor, or breastfeeding women
• Known severe immunodeficiency prior to sepsis:

• cytostatic chemotherapy within the previous 3 months,
• previously known neutropenia < 500/mm³ (within the past month) not attributed to sepsis,
• active hematologic malignancy currently undergoing treatment,
• allogeneic bone marrow transplant < 1 year ago,
• solid organ transplant receiving immunosuppressants
• corticosteroid therapy ≥ 0.5 mg/kg/day of prednisone equivalent for > 3 weeks,
• anti-TNF or anti-IL-6 biologic therapy within the past 3 months,
• HIV infection with a detectable viral load while not on treatment

Secondary exclusion criteria :

• A diagnosis of sepsis was ruled out following a comprehensive medical evaluation and/or an alternative diagnosis was identified that explains the elevated SOFA-2 score