Project description:The aim of the experiment was to assign patients enrolled in the VANISH randomised trial to sepsis response signature (SRS) endotypes based on a previously published gene expression signature, in order to test for differential responses to treatment. VANISH was a double-blind randomised clinical trial in septic shock, with patients randomised to receive norepinephrine or vasopressin followed by hydrocortisone or placebo. We collected blood samples upon enrolment, extracted RNA and performed transcriptomic profiling using microarrays, allocated patients to SRS1 or SRS2 using a linear model (Davenport 2016), and tested for an association between sepsis endotype and response to either norepinephrine or vasopressin, or to corticosteroids. There was a significant interaction between treatment with hydrocortisone or placebo, and SRS endotype (p=0·02)