Whole transcriptome analysis reveals T cell signaling activation in septic patients with thrombocytopenia

Sepsis, a life-threatening condition triggered by a dysregulated immune response to infection, remains one of the leading causes of mortality worldwide. Thrombocytopenia, a common sepsis complication, is linked to poor outcomes and reflects disease severity and specific immunological changes affecting patient outcomes. This study aims to elucidate this relationship using whole-transcriptome RNA sequencing (RNA-Seq) in intensive care unit (ICU) patients with sepsis. Overall design: We conducted a prospective study on 52 patients who were admitted to ICU for sepsis, including 22 with thrombocytopenia and 30 without. Blood samples were collected on both day-1 and -8, and RNA-Seq was performed to analyze transcriptomic profiles. Differentially expressed genes (DEGs) were identified, and functional enrichment analyses were conducted to explore biological pathways and processes. T-cell receptor (TCR) diversity was assessed using MiXCR and VDJTools software.