Prospective Descriptive Study of the Angiogenic T Cell Population in Subjects With Hereditary Hemorrhagic Telangiectasia (HHT) (TangRO)

November 19, 2020 updated by: Centre Hospitalier Universitaire Dijon

Hereditary hemorrhagic telangiectasia (HHT) results from genetic deregulation of angiogenesis. It is characterized by mucocutaneous telangiectasia responsible for recurrent epistaxis affecting quality of life (anaemia, iron deficiency, social distress). More rarely, HHT is complicated by the appearance of pulmonary, hepatic or cerebral arteriovenous malformations that can lead to serious complications: cerebrovascular accidents, cerebral abscesses, high output heart failure, and massive hemoptysis (1). The intensity of symptoms increases with age but with significant individual variability, even for the same mutation in the same family. Thus, while the mutations responsible for the disease have been identified, the pathophysiology is not fully understood because these mutations do not explain the great diversity of clinical presentations. Other factors not yet identified probably play an important role. Angiogenic T cells (TANG) are a newly individualized T cell population, defined by a CD4+CXCR4+CD31+ phenotype, which plays a key role in differentiating endothelial progenitors (2).

In an earlier study, the investigators showed that patients with HHT had a decrease in CD4+ and CD8+ LT compared to a cohort of healthy subjects (3).

They hypothesize that the lymphopenia mainly involves TANG, whose quantification could make it possible to assess the individual level of angiogenesis during HHT. The evaluation of the TANG levels could thus make it possible to personalize HHT management.

Study Overview

Study Type

Observational

Enrollment (Actual)

60

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

      • Dijon, France, 21079
        • CHU Dijon Bourgogne

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

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

outpatient

Description

Inclusion Criteria:

  • Person who has given consent
  • Adult
  • Person capable of understanding spoken and written French

"Patient" group:

  • Certain HHT (3 or 4 Curacao criteria - Appendix 2):
  • Recurring epistaxis
  • Telangiectasia of the skin or mouth
  • Family hereditary context
  • Arteriovenous visceral malformations
  • Causal mutation identified
  • Person capable of completing monthly epistaxis charts

"Control" group :

- Control subjects will be matched to patients for age (+/- 6 years) and sex.

Exclusion Criteria:

  • Person not affiliated to a national health insurance scheme
  • Pregnant or breastfeeding woman
  • Protected adult
  • Hemoglobin levels less than 9 g/dl in the last 15 days
  • Progressive or recent infectious disease, autoimmune disease or cancer (less than 6 months)
  • Immunosuppressive treatment in progress or recent (less than 6 months), including systemic steroid therapy. The use of inhaled or topical steroids is not an exclusion criterion.
  • Treatment in progress or stopped less than 6 months ago or to be introduced within the next 3 months of the following medications:

    • bevacizumab
    • tranexamic acid
    • dipeptidyl peptidase 4 inhibitors (diabetic patient)
    • beta-blockers (hypertensive patient)

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Patients
Hereditary hemorrhagic telangiectasia patients
  • 5 mL dry tube to separate serum
  • Two 6 mL EDTA tubes for plasma separation
  • Eight 6 mL heparinized tubes for flow cytometry (quantification of TANG such as CD3+CD31+CXCR4+ and CEC) and quantification of angiogenesis markers.
Three monthly epistaxis charts to be completed
Controls
Matched for age (+/- 5 ans) and sex.
  • 5 mL dry tube to separate serum
  • Two 6 mL EDTA tubes for plasma separation
  • Eight 6 mL heparinized tubes for flow cytometry (quantification of TANG such as CD3+CD31+CXCR4+ and CEC) and quantification of angiogenesis markers.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Average monthly duration (in minutes) of epistaxis over the 3 months following inclusion
Time Frame: Through study completion, an average of 3 months
Through study completion, an average of 3 months
Number/mm3 of circulating TANG (CD3+CXCR4+CD31+) at inclusion.
Time Frame: At inclusion
At inclusion

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

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 (Actual)

June 28, 2018

Primary Completion (Actual)

March 9, 2020

Study Completion (Actual)

May 3, 2020

Study Registration Dates

First Submitted

June 8, 2018

First Submitted That Met QC Criteria

June 27, 2018

First Posted (Actual)

June 28, 2018

Study Record Updates

Last Update Posted (Actual)

November 20, 2020

Last Update Submitted That Met QC Criteria

November 19, 2020

Last Verified

November 1, 2019

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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