- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05880121
Neuron-specific Humoral and Cellular Immune Correlates of Structural and Functional Brain Connectomics in Neuropsychiatric Lupus (INLES)
May 18, 2023 updated by: Giuseppe A. Ramirez, IRCCS San Raffaele
Systemic lupus erythematosus (SLE) is the prototype systemic autoimmune disease.
Neuropsychiatric SLE (NPSLE) is a major cause of morbidity.
Its pathophysiology remains unclear and target autoantigens have not yet been identified.
Site- specific autoantigen expression might correlate with imaging abnormalities.
Based on existing expertise on the use of peptide/protein arrays and on antigen-specific T cell tracking, we plan to identify new fingerprints and targets for NPSLE.
SLE patients +/- NPSLE and healthy subjects will undergo advanced magnetic resonance imaging.
Three-dimensional data on structural or functional brain architecture will be integrated with brain transcriptome atlases and candidate antigens for autoreactive autoantibodies and T lymphocytes identified and validated.
The evidence will add to current knowledge on NPSLE pathophysiology, provide new multimodal diagnostic tools for better patient care and a platform for innovative, personalized treatments.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Observational
Enrollment (Estimated)
200
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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Milano, Italy
- Recruiting
- IRCCS Ospedale San Raffaele
-
Contact:
- NA NA
- Phone Number: 0226437912
- Email: ctc.trialstartup@hsr.it
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Principal Investigator:
- Giuseppe A. Ramirez, MD, PhD
-
-
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
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
N/A
Sampling Method
Non-Probability Sample
Study Population
see above
Description
Inclusion Criteria:
Patients with SLE
- Diagnosis of SLE according to the ACR 1997, SLICC 2012 or EULAR/ACR 2019 criteria
- age ≥ 18 years (reference centre)
- age 15-17 years (affiliated centre)
Healthy subjects
- Charlson's Comorbidity Index=0 and no chronic treatment
- age ≥ 18 years (reference centre)
- age 15-17 years (affiliated centre)
Exclusion Criteria:
- History of T-cell neoplasia
- Active B-cell neoplasia or history of B-cell neoplasia of less than five years
- Contraindications to MRI
- Pregnancy
- Ongoing or past treatment with T-depleting agents
- History of brain cancer
- History of congenital brain disorders
- Cerebral disorders secondary to trauma, toxins or other metabolic or environmental factors unrelated to SLE according to the Investigator's evaluation
- Any other condition conferring excessive physical and psychological risk to the subject according to the Investigator's opinion
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 |
---|---|
systemic lupus erythematosus
Patients with SLE according to the 1997 ACR, 2012 SLICC or 2019 EULAR/ACR criteria will undergo MRI along with neuropsychological tests, rheumatological evaluation and blood sample collection at baseline and after at least 12 months or during a new neuropsychiatric manifestation.
In case of existing MRI with compatible features, they will be used as baseline studies.
|
brain MRI
|
healthy controls
Subjects with Charlson's Comorbidity Index=0 with no ongoing chronic therapy and no history of immune-mediated disease will undergo a single MRI study, along with neuropsychological tests and blood sample collection.
In case of existing MRI with compatible features, no additional studies will be performed in this cohort.
|
brain MRI
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To detect regional brain functional abnormalities in patients with SLE through advanced magnetic resonance imaging (MRI).
Time Frame: 12 months (extensions allowed for existing images before study onset)
|
All study subjects will be assessed at baseline through 3T MRI.
Repeat MRI will be performed after at least 12 months or in case of new neuropsychiatric events in all patients with SLE.
The MRI protocol will include conventional structural sequences (3D fluid-attenuated inversion recovery [FLAIR], 3D T1-weighted inversion recovery prepared gradient echo), advanced structural sequences (diffusion-weighted [DW] pulsed-gradient spin-echo [PSGE] single-shot echo-planar imaging, optimized for an accurate estimation of the neuriteorientation dispersion and density imaging [NODDI] model), and functional MRI sequences acquired in resting-state condition.
|
12 months (extensions allowed for existing images before study onset)
|
To identify autoantigen-specific circulating antibodies associated with neuropsychiatric morbidity and imaging features in patients with SLE.
Time Frame: 12 months (extensions allowed for existing MRI images before study onset)
|
High-throughput peptide and/or protein arrays customised according to the data derived from neuroimaging-annotated transcriptome analyses and/or from previous evidence from immune studies performed in a large multicentre cohort of patients with SLE (ZEUS study: NCT02403115) will be used to define candidate antigen targets for autoantibodies.
Serum samples will be collected longitudinally at time of clinical evaluation and neuroimaging and analysed by ELISA.
|
12 months (extensions allowed for existing MRI images before study onset)
|
To correlate antigen-specific CD4+ T-cell dynamics over time with the spectrum of SLE, NPSLE and associated MRI findings.
Time Frame: 12 months (extensions allowed for existing MRI images before study onset)
|
Major histocompatibility complex (MHC) multimers bound to relevant autoepitopes identified through in silico analyses of data from neuroimaging-annotated transcriptome analyses and/or from previous evidence from immune studies performed in a large multicentre cohort of patients with SLE (ZEUS study: NCT02403115) will be used to detect and track antigen-specific CD4+ T-cells.
Further characterisation of T-cells will be performed in terms of differentiation and polarisation.
In vitro T-cell reactivity assays with relevant autoepitopes will also be performed
|
12 months (extensions allowed for existing MRI images before study onset)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
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)
April 30, 2023
Primary Completion (Estimated)
October 30, 2024
Study Completion (Estimated)
April 29, 2026
Study Registration Dates
First Submitted
May 5, 2023
First Submitted That Met QC Criteria
May 18, 2023
First Posted (Actual)
May 30, 2023
Study Record Updates
Last Update Posted (Actual)
May 30, 2023
Last Update Submitted That Met QC Criteria
May 18, 2023
Last Verified
May 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- GR-2021-12372172
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
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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