- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01473927
Significance of Ficolin 2 in the Determination of Serological Activity in Chronic Inflammatory Bowel Disease
Background Determining disease activity in IBD is sometimes difficult and, to be accurate, requires endoscopy. The serum marker CRP has not proven sufficiently valuable as a marker for IBD specific inflammation. As an alternative, so far fecal calprotectin appears to be more reliable and has shown a certain value as predictive marker. Our preliminary data now show, that the serum concentrations of ficolin-2 are significantly higher in CD patients with a HBI >3. Ficolin-2 is a lectin and acute phase protein produced in the liver and, like MBL, can activate the lectin pathway of complement. Unlike MBL, deficiency for ficolin-2 was not detected in our patient cohort, nor could we find functional deficiencies for ficolin-2 (paper submitted).
Study Aims The study is aimed to substantiate the data from our pilot study which shows that ficolin-2 is significantly increased in CD patients during inflammation. Therefore, the study will measure ficolin-2 concentrations in a sufficiently large patient group to obtain enough statistical power and to compare these results with the endoscopic disease score (SES-CD) and CRP and calprotectin values. Statistical analysis of the data will show us if ficolin-2 is a reliable and easy to obtain new marker for active inflammation in CD.
Study Design Based on a power analysis 112 CD patients and 112 UC patients need to be analyzed. They will be recruited from Bern, Basel and Lausanne. Only patients with routine endoscopy will be included in the study and will be scored by SES-CD. Blood samples will be collected at the day of endoscopy. Stool sample will be collected within the same week of endoscopy. Calprotectin and CRP concentrations will be determined by routine diagnostics, ficolin-2 concentrations will be determined by ELISA in our laboratory. Finally, all data will be statistically analyzed.
Study Overview
Detailed Description
Background
Background Like mannan-binding lectin (MBL), ficolins are important soluble receptors for microbial associated molecular patterns leading to the activation of the lectin pathway complement. Ficolins are structurally related to MBL, but due to their different carbohydrate recognition domain represent an own family of lectins (1). The single polypeptide chains of ficolins form trimers and the trimers finally form higher order structures (tetramers up to hexamers) which constitute the functional protein. Humans have three ficolins: Ficolin-1 (M-ficolin), -2 (L-ficolin) and -3 (H-ficolin), whereas ficolin-2 and -3 are present in the serum, ficolin-1 is found on the surface of monocytes. Both, ficolin-2 and -3 are produced in the liver with an additional source for ficolin-3 in the lung. Like MBL, ficolins have to assemble with the MBL-associated serin proteases (MASPs) in order to activate the complement pathway (1). In our study on a possible role for the influence of the complement system in the development of CD-associated anti-Saccharomyces cerevisiae antibodies (ASCAs), we noticed that chronic inflammatory bowel disease (CIBD) patients, specifically Crohn's disease (CD) patients, exhibited high serum ficolin 2 concentrations.
Our research group is interested in the interaction of the innate immune system with microorganisms of the intestinal flora, focusing on possible defects in innate immune mechanisms. We have more than ten years experience in the field, with a special focus on ASCA and MBL. We have been able to continuously publish our work about these theories.
Our earlier and present studies on the role of MBL and the lectin pathway of complement in CD led to the finding of increased ficolin-2 concentration in the sera of CD patients. Moreover, we found that CD patients with a Harvey-Bradshaw index >3 had significantly higher ficolin 2 concentrations than those with a Harvey-Bradshaw index of ≤ 3.
Study Hypotheses
The following hypotheses are to be tested:
- The ficolin 2 concentration is higher in Crohn's patients with active disease than in CD patients in remission.
- Ficolin 2 correlates with endoscopic activity.
- Ficolin 2 correlates with calprotectin.
Objective
The findings from the first part of the study are to be confirmed in a prospective and more detailed study with a larger patient cohort, testing our (new) working hypothesis that ficolin 2 represents a serum marker for disease activity in CD.
Since it is currently difficult to reliably determine disease activity in CD patients using serum and stool markers without simultaneous endoscopic examination, another specific and easy to obtain disease marker which correlates well with disease activity would be highly welcome. Particularly because the current standard marker, to monitor disease activity (faecal calprotectin), is much less accepted than testing for parameters in the blood.
Therefore, the study aims at answering the question of whether ficolin 2 is present in greater concentrations in the blood of Crohn's patients with active inflammation compared to CD patients in remission or to ulcerative colitis (UC) patients.
Methods
For the purposes of the study, the endoscopic activity index will be recorded using the SES-CD (simplified endoscopic score for CD) for Crohn's patients and the Mayo score for colitis patients.
Approximately 5 ml blood will be taken to prepare serum. (5.5 ml or 4.9 ml S Monovette or 4.7 ml or 4.9 ml serum gel Monovette).
A second test tube of blood will be taken for CRP determination. In order to measure calprotectin, the patient will be asked to provide a stool sample shortly before or shortly after the endoscopic examination (within one week).
Serum ficolin values are measured by enzyme-linked immune sorbent assay (ELISA) in the laboratory at the Department of Clinical Research, University of Bern; all other values are determined in routine diagnostic laboratories.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
Bern, Switzerland, 3010
- DCR, Gastroenterology, Bern, University of Bern
-
-
Basel Stadt
-
Basel, Basel Stadt, Switzerland, 4031
- Gastroenterology and Hepatology, Basel University Hospital
-
-
Vaud
-
Lausanne, Vaud, Switzerland, 1011
- Service de gastro-entérologie et hépatologie, CHUV Lausanne
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- known IBD
- endoscopy for clinical reasons
- enrolled in the Swiss IBD cohort study
Exclusion Criteria
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Only
- Time Perspectives: Cross-Sectional
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
1
Crohn's Disease patients
|
Only patients undergoing endoscopy for clinical reasons will be included in the study, i.e. no endoscopies will be performed solely for study reasons.
For the purposes of our study, endoscopy serves to determine the degree of inflammation and no additional biopsies are taken.
Blood for CRP and ficolin-2 analysis will be taken through the Venflon® installed for endoscopy.
|
2
Ulcerative colitis patients
|
Only patients undergoing endoscopy for clinical reasons will be included in the study, i.e. no endoscopies will be performed solely for study reasons.
For the purposes of our study, endoscopy serves to determine the degree of inflammation and no additional biopsies are taken.
Blood for CRP and ficolin-2 analysis will be taken through the Venflon® installed for endoscopy.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Ficolin-2 concentration in serum
Time Frame: During endoscopy
|
During endoscopy
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
CRP concentration in serum
Time Frame: During endoscopy
|
During endoscopy
|
Calprotectin in stool sample
Time Frame: One week before endoscopy up to one week after endoscopy
|
One week before endoscopy up to one week after endoscopy
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Frank Seibold, Prof. Dr. med., Spital Tiefenau / Inselspital Bern
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 110/06
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.
Clinical Trials on Crohn Disease
-
ProgenaBiomeRecruitingCrohn Disease | Crohn Colitis | Crohn's Ileocolitis | Crohn's Gastritis | Crohn's Jejunitis | Crohn's Duodenitis | Crohn's Esophagitis | Crohn's | Crohn Disease of Ileum | Crohn Ileitis | Crohn's Disease Relapse | Crohns Disease Aggravated | Crohn Disease in Remission | Crohn's Disease of PylorusUnited States
-
Academisch Medisch Centrum - Universiteit van Amsterdam...CelltrionRecruitingBowel Disease | Inflammatory Disease | Disease CrohnNetherlands
-
Chinese University of Hong KongTerminatedCrohn Disease | Perianal Crohn DiseaseHong Kong
-
SandozCompletedCrohn´s DiseaseAustria, Germany, Poland, Spain, Sweden
-
Dr. Falk Pharma GmbHCompleted
-
University of Erlangen-Nürnberg Medical SchoolCompleted
-
Groupe Hospitalier Paris Saint JosephCompleted
-
Ferring PharmaceuticalsTerminatedCrohn´s DiseaseUnited Kingdom, United States, Germany, Belgium, Denmark, France, Sweden
-
Jinling Hospital, ChinaCompletedCrohn Disease in RemissionChina
-
Boehringer IngelheimTerminatedFibrostenotic Crohn´s DiseaseUnited States, Canada, Japan, Sweden
Clinical Trials on Endoscopy
-
Chinese University of Hong KongCompletedGastrointestinal Bleeding | Bleeding Peptic Ulcer | Active BleedingChina
-
Weill Medical College of Cornell UniversityUnknownInterventional Endoscopy Database for Pancreatico-biliary, Gastrointestinal and Esophageal DisordersColorectal Cancer | Pancreatic Cancer | Esophageal Cancer | Cholangiocarcinoma | Bile Duct Cancer | Cholangitis | Barrett's Esophagus | Gallstones | Choledocholithiasis | Bile Leak | Obstructive Jaundice | Duodenal Cancer | Pancreatic Pseudocysts | Ampullary Cancer | Biliary Strictures | Recurrent Pancreatitis | Bile Duct... and other conditionsUnited States
-
Unidade Local De Saúde Do Norte AlentejanoNOVA Medical SchoolRecruiting
-
Jagiellonian UniversityCompleted
-
University Medical Center GroningenMaastricht University Medical Center; Erasmus Medical Center; Medtronic - MITG; Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) and other collaboratorsCompletedLynch Syndrome | Small Bowel NeoplasiaNetherlands
-
Hvidovre University HospitalTerminatedUpper Gastrointestinal Disease,UlcersDenmark
-
Technical University of MunichRotkreuzklinikum München gGmbH; Klinikum Freising; Klinikum Landshut-Achdorf; Städtisches... and other collaboratorsCompletedEndoscopic Diagnosis in EsophagusGermany
-
Dallas VA Medical CenterCompleted
-
Johns Hopkins UniversityEthicon, Inc.WithdrawnEsophageal and Gastric VaricesUnited States
-
University Hospital, MontpellierTerminatedthe Management of Weight Regain After Gastric Bypass by Endoscopic SuturingFrance