Defining the Skin and Blood Biomarkers of Ichthyosis

Ichthyosis is a group of genetic skin disorders that present with dry, thickened, scaly, or flaky skin. As of today, there is no cure or treatment. Doctors can only treat the dry skin with different types of emollients to soften the scale. A deeper understanding of this disease is required to develop better treatments. There are different types of cells and cell-produced signals (biomarkers) that are being studied in order to help find these new treatments. Looking at biomarkers has been successful in helping us to understand other skin disorders better. The purpose of this study is to determine which blood and skin biomarkers characterize ichthyosis.

Hypothesis: We predict that the biomarkers correlating with disease activity in Netherton syndrome will be different than the biomarkers found to correlate with the lamellar and other ichthyosis phenotype.

Study Overview

• Status: Recruiting
• Conditions: Netherton Syndrome; Ichthyosis

Detailed Description

Objectives:

1. To define a panel of skin and blood biomarkers associated with disease activity and pruritus in Netherton syndrome, lamellar ichthyosis, and other ichthyosis subtypes.
2. To determine if blood samples can serve as surrogates for skin immune activation and will correlate with disease severity.
3. To determine FLG, SPINK5, TGM1, or other mutation via buccal/saliva samples in ichthyosis subjects
4. To determine differences in alterations of epidermal lipids and proteins in the outer stratum corneum of epidermis collected from tape strips in patients with ichthyosis compared to the general population. There will also be a difference detected in epidermal lipids from blood samples.

• Study Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

• Study Contact: Name: Amy Paller, MD
• Study Contact Backup: Name: Dermatology CTU; Phone Number: 312-503-5944; Email: NUderm-research@northwestern.edu

Study Locations

• United States
  • Illinois
    • Chicago, Illinois, United States, 60611
      • Recruiting
      • Northwestern University
      • Contact: Amy Paller, MD; Phone Number: 312-695-3721; Email: apaller@northwestern.edu
    • Chicago, Illinois, United States, 60611
      • Recruiting
      • Ann & Robert H. Lurie Children's Hospital of Chicago
      • Principal Investigator: Emma Guttman, MD
      • Principal Investigator: Amy Paller, MD
      • Contact: DermatologyCTU; Phone Number: 312-503-5944; Email: NUderm-research@northwestern.edu
    • Chicago, Illinois, United States, 60611
      • Recruiting
      • Northbrook Lurie Children's Outpatient Clinic
      • Contact: Amy Paller, MD; Phone Number: 312-695-3721; Email: apaller@northwestern.edu
  • New York
    • New York, New York, United States, 10029
      • Recruiting
      • Icahn School of Medicine at Mount Sinai
      • Contact: Emma Guttman, MD, PhD; Phone Number: 212-241-9728; Email: Emma.Guttman@mountsinai.org

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 year to 60 years (Child, Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

150 subjects (1 year to 60 years of age) with diagnosis of Netherton Syndrome or ichthyosis will be enrolled. Approximately 50 healthy controls will be enrolled. The blood sample, skin biopsy, and buccal/saliva sample may be obtained from the same ichthyosis subject. However there will be separate groups of control patients for the skin biopsies and blood sample studies.

Description

Inclusion Criteria:

• Control and ichthyosis subjects may be of either sex and must be between 1-60 years of age at the time of enrollment
• Ichthyosis subjects include individuals with a diagnosis Netherton syndrome, lamellar ichthyosis, or other ichthyosis subtypes
• Ichthyosis subjects should not have administered systemic immunosuppressant therapy in the month before the study
• Ichthyosis subjects should not use topical immunosuppressants in the week before the study
• Ichthyosis subjects should not have applied emollients to the planned biopsy sites within 12 hours before biopsy, but can be applied elsewhere
• Controls may have no inflammatory disease, atopy, or obvious xerosis (urticaria, food allergy, allergic rhinitis or conjunctivitis, asthma)
• Controls for skin sampling may have no observable abnormality in the sampled skin and, to further assure the normality of the "normal" skin edges, must not have evidence of inflammation or epidermal change in the lesion to be surgically removed
• Subjects and guardians of minors must sign the approved IRB consent form(s) prior to initiation of the study protocol

Exclusion Criteria:

• Subjects who are unable to give informed consent or assent
• Subjects who administered anti-inflammatory systemic and topical therapy or emollients that do not comply with inclusion criteria prior to blood and biopsy sampling
• Subjects whose main diagnosis is deemed unsafe by the study investigator for study participation

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Control; Healthy subjects with no history of ichthyosis from 1 year to 60 years of age.
Ichthyosis; Subjects with a diagnosis of Netherton syndrome or ichthyosis from 1 year to 60 years of age.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cellular infiltrates	We will examine your skin and blood samples for various immune cells known to be involved in ichthyosis.	One year
Gene expression	We will examine your skin and blood samples for various genes known to contribute to ichthyosis by analyzing RNA and cytokines.	One year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation of biomarkers to quality of life	We will analyze the blood and tissue biomarkers to determine whether they are comparable to quality of life and itch (pruritus) measures.	One year

Collaborators and Investigators

• Sponsor: Northwestern University
• Collaborators: Icahn School of Medicine at Mount Sinai; Galderma R&D

Study record dates

Study Major Dates

• Study Start (Actual): January 31, 2018
• Primary Completion (Estimated): December 31, 2025
• Study Completion (Estimated): December 31, 2025

Study Registration Dates

• First Submitted: January 24, 2018
• First Submitted That Met QC Criteria: January 24, 2018
• First Posted (Actual): January 31, 2018

Study Record Updates

• Last Update Posted (Actual): March 13, 2024
• Last Update Submitted That Met QC Criteria: March 12, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: Ichthyosis; Netherton Syndrome
• Additional Relevant MeSH Terms: Skin Diseases; Congenital Abnormalities; Infant, Newborn, Diseases; Genetic Diseases, Inborn; Skin Diseases, Genetic; Skin Abnormalities; Abnormalities, Multiple; Keratosis; Ichthyosiform Erythroderma, Congenital; Netherton Syndrome; Ichthyosis; Ichthyosis, Lamellar
• Other Study ID Numbers: 2014-15801

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No