Erhvervet hæmofili A og autoimmunitet. Undersøgelse af lymfocytpopulationer og myeloid-afledte suppressorceller (IMMUNHEMAC)
Acquired hemophilia A is a rare condition of hemostasis secondary to the development of antibodies against factor VIII. This is a potentially serious pathology that can be life-threatening due to the major risk of bleeding caused by the sometimes drastic decrease in the level of circulating factor VIII.
This pathology occurs overwhelmingly in elderly subjects or, more rarely, in young women, during the postpartum period. It appears idiopathic in 50% of cases and associated, for the other cases, with underlying pathologies such as autoimmune pathologies (rheumatoid arthritis and bullous pemphigoid in particular) and neoplasias, or with a particular circumstance represented by the post -partum.
The association between this autoimmune pathology and its association with pathologies of the same type or with circumstances involving the immune system, suggests that common mechanisms could favor its emergence.
This study therefore proposes to study lymphocyte populations and subpopulations as well as Myeloid-Derived Suppressor Cells and the cytokine profile, which are abnormal in a large part of autoimmune pathologies.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Kontakter og lokationer
Studiesteder
-
-
-
Nantes, Frankrig
- CHU de Nantes
-
Saint-Nazaire, Frankrig
- CH de Saint Nazaire
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
Patients with acquired hemophilia A will be recruited prospectively when diagnosed with acquired hemophilia A and will be followed in the study until recovery.
Patients with constitutional hemophilia A will be recruited prospectively. They should be over 50 years old and have severe or moderate hemophilia A, and not be taking any treatment that could interfere with the immune system or inflammatory markers.
Population of control subjects without coagulation abnormalities, over 60 years of age and not taking any treatment likely to interfere with the immune system or inflammatory markers.
Patient population with inflammatory pathology will include subjects with an inflammatory pathology likely, according to the literature, to be associated with acquired hemophilia A and, in particular patients with rheumatoid arthritis, if possible at diagnosis and not taking any treatment likely to interfere with the disease. immune system or inflammatory markers.
Beskrivelse
Inclusion Criteria:
-
Patient population with acquired hemophilia A:
Adult patients with a diagnosis of acquired hemophilia A and with a social security system. Obtaining oral non-opposition from the patient to participate in the study following the submission of an information note relating to the project.
Obtaining signed and written informed consent for biocollection consent.
-
Population of Patients with constitutional hemophilia A:
Adult patients over 50 years of age with severe or moderate constitutional hemophilia A, with no history of autoimmune disease, and with a social security system.
Obtaining oral non-opposition from the patient to participate in the study following the submission of an information note relating to the project.
Obtaining signed and written informed consent for biocollection consent.
-
Population of control subjects:
Adult patients, over the age of 60, without a coagulation abnormality, with no history of autoimmune disease, and with a social security system.
Obtaining oral non-opposition from the patient to participate in the study following the submission of an information note relating to the project.
Obtaining signed and written informed consent for biocollection consent.
-
Patient population with inflammatory pathology:
Adult patients over the age of 50 with an inflammatory pathology likely to be associated with acquired hemophilia A, and with a social security system.
Obtaining oral non-opposition from the patient to participate in the study following the submission of an information note relating to the project.
Obtaining signed and written informed consent for biocollection consent.
Exclusion Criteria:
For the 4 groups:
- Minor patient, under guardianship or curatorship.
- Pregnant and lactating women.
- Blood transfusion less than 7 days old.
- Treatment with corticosteroids in the 7 days preceding inclusion or any other immunomodulatory or immunosuppressive treatment in the 4 weeks preceding inclusion.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Observationsmodeller: CASE_CONTROL
- Tidsperspektiver: PROSPECTIVE
Antal grupper/kohorter
Kohorter og interventioner
Gruppe / kohorteGruppe / kohorte |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Patienter i Acquired Hemophilia A-gruppen.
|
no intervention |
|
patienter i den konstitutionelle hæmofili A-gruppe.
|
no intervention |
|
patienter i kontrolpersongruppen.
|
no intervention |
|
patienter i gruppen af patienter med inflammatorisk patologi.
|
no intervention |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Evaluate the evolution of lymphocyte populations and subpopulations, MDSCs and inflammatory cytokines in patients with hemophilia A acquired at diagnosis and during follow-up
Tidsramme: 2 years
|
Comparisons between diagnosis and during follow-up |
2 years
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
To test the link between the severity of the disease at diagnosis and the cellular and cytokine parameters.
Tidsramme: 2 years
|
Factor VIII level and inhibitor titration at diagnosis |
2 years
|
|
Comparisons of baseline lymphocyte and cytokine data between patients with a favorable versus unfavorable final diagnosis.
Tidsramme: 2 years
|
Cell populations and cytokine profile and half-life of the inhibitor under treatment, time before normalization of the Factor VIII / Willebrand factor ratio, total duration of treatment with corticosteroids, recurrence and mortality tested to define a favorable course of the disease or unfavorable. |
2 years
|
|
Comparison of lymphocyte populations and subpopulations, MDSCs and inflammatory cytokines between different groups.
Tidsramme: 2 years
|
Cell populations and cytokine profile of the different groups at diagnosis and at the end of follow-up. |
2 years
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Marc Fouassier, Nantes University Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- RC20_0253
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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