- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02386228
Micro Ribonucleic Acid (miRNA) Markers of Hydrocephalus in Intraventricular Hemorrhage (IVH)
January 5, 2017 updated by: Madelon Petersen, St. Joseph's Hospital and Medical Center, Phoenix
miRNA Markers of Hydrocephalus in Intraventricular Hemorrhage (IVH)
A collection of biological samples (cerebrospinal fluid [CSF] and blood) from patients under 6 years of age who are diagnosed with intraventricular hemorrhage or spina bifida.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Detailed Description
IVH is an important cause of brain injury in newborns and more so in those born prematurely.
Depending on the severity of the hemorrhage and the care provided the newborn, the impact of IVH can range from a temporary issue with no permanent consequences to a life-threatening condition with severe neurodevelopmental sequelae.
The outcomes of patients with IVH are not only dictated by the direct effects of the hemorrhage, but to associated processes such as hydrocephalus, periventricular infarction and leukomalacia.
Despite the availability of better diagnostic and therapeutic tools, the incidence of IVH has remained constant over the past 50 years, and is mostly due to the increased survival rates of very low weight premature infants.
Recent statistics demonstrate that close to 12,000 premature infants develop IVH in the United 'states every year and more than 50% of them develop some degree of posthemorrhagic hydrocephalus (PHH).
It is believed that PHH originates as a result or arachnoiditis, gliosis, and subsequent fibrosis impairing the flow and reabsorption of cerebrospinal fluid (CSF).
Despite the lack of clarity about the pathogenesis of PHH, it is well accepted that its presence exacerbates the damage caused by the hemorrhage to the periventricular white matter.
Multiple efforts have been made to identify the mechanisms and mediators of the development of PHH and white matter damage.
Molecules such as transforming growth factor-beta (TGF-beta) have been demonstrated to enhance the expression of genes encoding for fibronectin, collagen and other extracellular matrix components.
Unfortunately, not enough evidence has been generated to be able to envision a potential solution for the problem.
The current management of PHH is focused on controlling the damage that pressure, distortion, and/or ischemia may cause to the immature brain.
Direct evacuation of ventricular contents with CSF diversion mechanisms remains, such as sequential lumber punctures, external ventricular draining, and reservoir placement.
Intraventricular fibrinolytic therapy or permanent shunting represent most effective tools by mechanically evacuating bleeding products and preventing the accumulation of CSF.
However, they are all highly invasive techniques that carry major risks and complications.
The use of diuretics has been presented as a non-invasive alternative, but the results prove them inefficient.
Extracellular miRNA sequences have been found to be major modulators of protein coding genes involved in differentiation, proliferation, and apoptosis.
Several studies have reported the presence of significant amounts of miRNA in extracellular fluids such as plasma, urine, saliva, and semen.
The researchers believe that extracellular miRNAs are present in CSF and that sequential evaluation of their expression can provide a unique biomarker signature, time sensitive enough to reflect the evolution of pathological events underlying the development of PHH.
The identification of a miRNA biomarker for PHH development and/or hemorrhagic related injury would also be a means to quickly evaluate treatment response.
Study Type
Observational
Enrollment (Actual)
1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Arizona
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Phoenix, Arizona, United States, 85013
- St. Joseph's Hospital and Medical Center
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
No older than 6 years (Child)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Sampling Method
Non-Probability Sample
Study Population
infants with IVH or spina bifida
Description
Inclusion Criteria:
- Age between 0 and 6 years.
- Diagnosis of IVH or spina bifida
- Granted access to CSF and blood via surgery, CSF diversion device, venous access, and/or arterial access.
Exclusion Criteria:
- Older than 6 years.
- Diagnosis of infection or other acute inflammatory process involving the central nervous system.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
miRNA sequences
Time Frame: within 30 days of blood or CSF collection
|
Identification of miRNA sequences common to patients with IVH and patients with spina bifida to determine condition specific expression profiles, multivariate analysis of candidate miRNA sequences that are differentially expressed between the two conditions but between different outcomes (development of hydrocephalus) to target potential markers.
Once identified, mechanisms for the rapid detection of marker sequences will be developed and their predictive value tested in future collections.
|
within 30 days of blood or CSF collection
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Robert Spetzler, MD, Barrow Brain and Spine physician with SJHMC privileges
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
March 1, 2015
Primary Completion (Actual)
December 1, 2016
Study Completion (Actual)
December 1, 2016
Study Registration Dates
First Submitted
March 5, 2015
First Submitted That Met QC Criteria
March 10, 2015
First Posted (Estimate)
March 11, 2015
Study Record Updates
Last Update Posted (Estimate)
January 6, 2017
Last Update Submitted That Met QC Criteria
January 5, 2017
Last Verified
January 1, 2017
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Congenital Abnormalities
- Nervous System Malformations
- Intracranial Hemorrhages
- Neural Tube Defects
- Hemorrhage
- Cerebral Hemorrhage
- Hydrocephalus
- Spinal Dysraphism
Other Study ID Numbers
- 14BN104
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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