Evaluation of the Level of Expression of CD45RC on T Lymphocytes as a Predictive Biomarker of Acute Rejection After Renal Transplantation (ECLAT)
Chronic renal failure is a major public health problem in industrialized countries, due to its frequency - about 3 million patients in France - and its socio-economic impact. At the end stage of renal failure, renal transplantation is the best treatment, allowing an improvement in patient survival compared to treatment by extra-renal purification. Despite improved immunosuppressive strategies, allograft rejection is common in transplantation - between 15% and 25% in the first year - and is associated with lower renal graft survival.
Different risk factors for rejection have been well identified, such as the young age of the recipient or a high number of human leukocyte antigen (HLA) incompatibilities between the donor and the recipient. However, these risk factors do not accurately identify the risk of acute rejection in order to optimize and individualize immunosuppressive strategies.
Also, the search for biomarkers to predict allograft tolerance prior to transplant is a major goal in renal transplantation.
The onset of acute rejection is caused by the ability of the recipient's T cells to recognize alloantigens. The CD45 molecule is a highly expressed tyrosine phosphatase on the surface of the lymphocytes that plays an important role in the activation of the T cell.
Investigators showed that the level of expression of CD45RC on T lymphocytes was associated with the risk of acute rejection. Thus, from a retrospective cohort of 89 renal transplant patients followed, recipients with a high percentage of circulating CD8 lymphocytes expressing high CD45RC (CD45RChigh) before transplant had a 5 to 8-fold higher risk of developing acute rejection of allograft during follow-up (11-year average follow-up) compared to recipients with a low percentage of CD8+CD45RChigh.
The purpose of this study is to confirm the first retrospective results on a larger prospective and contemporary regional cohort.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Anne-Sophie GARNIER, MD
- Phone Number: +33 0241356075
- Email: AnneSophie.Garnier@chu-angers.fr
Study Contact Backup
- Name: Béatrice GABLE
- Email: begable@chu-angers.fr
Study Locations
-
-
-
Angers, France
- Recruiting
- Dr Anne-Sophie GARNIER
-
Contact:
- Anne-Sophie GARNIER, Dr
- Phone Number: +33 2 41 35 44 76
- Email: annesophie.garnier@chu-angers.fr
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients over 18 and under 70 years old
- Patients in care for a first priority renal transplant.
- Patients with low immunological risk
- Patients with prior written informed consent
Exclusion Criteria:
- Poor understanding of the French language
- Pregnant, breastfeeding or partying women
- Persons deprived of liberty by an administrative or judicial decision
- Persons undergoing psychiatric care under duress
- Adults who are subject to a legal or non-state protection measure to express their consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Patient in need of a kidney transplant
|
Blood samples the day of the surgery and 4 times during the next year.
Blood samples and histological slides taken at each biopsy and if there is suspicion of rejection of the graft
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Number of patient with acute rejection diagnosis confirmed by anatomopathological analysis of a graft biopsy
Time Frame: 12 months
|
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of CD45RC for patient with acute rejection suspicion
Time Frame: 12 months
|
acute rejection confirmed or not
|
12 months
|
|
Rate of CD45RC on circulating T lymphocytes
Time Frame: from date of randomization until the date of acute rejection, up to 12 months
|
Evolution of the expression of CD45RC in the first year after introduction of immunosuppressive therapy
|
from date of randomization until the date of acute rejection, up to 12 months
|
|
Rate of CD45RC on circulating T lymphocytes the day of acute rejection
Time Frame: 12 months
|
day of acute rejection
|
12 months
|
|
Rate of CD4, CD8, CD45RA, CD25, CD127, CD19 markers on T cells the day of acute rejection
Time Frame: 12 months
|
day of acute rejection
|
12 months
|
|
anti-HLA antibodies' dosage at the time of acute rejection
Time Frame: 12 months
|
12 months
|
|
|
cytokines' dosage
Time Frame: Day 1
|
describe cytokine profile
|
Day 1
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 49RC18_0018
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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