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Utility of CD64 and TLR2 Assays to Diagnose Acute Pulmonary Exacerbations in Cystic Fibrosis

31. august 2021 opdateret af: National Jewish Health
Cystic fibrosis (CF) is the most common inherited disease in the western world. On a yearly basis, 56% of CF patients, or nearly 17,000 individuals in the US, suffer from acute pulmonary exacerbations (APE). The purpose of this study is to test a candidate assay for its ability to diagnose APE, the most important disease event in CF. While previous studies have been able to identify biomarkers of CF prognosis and risk stratification, three markers have demonstrated characteristics ideal for APE diagnosis: CD64, TLR2, and GILT. CD64 is a cellular receptor, expressed on numerous cells of the immune system, whose role is to bind antibodies which are attached to infected cells or pathogens. TLR2 plays a major role in early host-microbial interactions. GILT has been shown to be more precise in targeting immune responses against antigens and influences T lymphocyte response. This study looks to identify the differences in the expression of neutrophil CD64 and CD4+ T cell TLR2 and GILT between acute illness and baseline health as a sensitive marker of acute pulmonary exacerbation so that it may facilitate rapid hematologic diagnosis of the condition. The study also looks to compare sensitivity and specificity of the assays above to standard measures, such as health related quality of life scores (CFQ-R), loss of lung function, white blood cell counts and CRP, for diagnosing acute exacerbations.

Studieoversigt

Status

Afsluttet

Betingelser

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

150

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Colorado
      • Denver, Colorado, Forenede Stater, 80206
        • National Jewish Health

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

CF patients aged 18 years or older at the time of an acute pulmonary exacerbation or at baseline health who are followed by the Adult CF Program at National Jewish Health will be eligible to enroll in this study.

Beskrivelse

Inclusion Criteria:

  • Documented diagnosis of CF.
  • Age 18 years old or greater.
  • Presentation at baseline health OR at the start of treatment for a pulmonary exacerbation of CF.
  • Ability to perform reproducible Pulmonary Function Tests
  • Ability to produce sputum.
  • Willingness to complete a health-related quality of life questionnaire
  • Willingness to comply with study procedure and provide written consent.

Exclusion Criteria:

• Presence of a condition or abnormality that, in the opinion of the Principal Investigator (PI), would compromise the safety of the patient or the quality of the data.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: Kohorte
  • Tidsperspektiver: Fremadrettet

Kohorter og interventioner

Gruppe / kohorte
Acute Pulmonary Exacerbation (APE)
Those subjects presenting with APE will be treated with at least two pathogen specific I.V. antibiotics, as dictated by their treating physician and compliant with standard guidelines for care of an APE.
Baseline Health
Those subjects presenting at baseline health will be identified by their treating physician as such and will not be starting on any treatments for APE.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Difference in neutrophil CD64 expression
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
The primary outcome measure is the difference in expression of neutrophil CD64 as measured by flow cytometry from circulating blood between the two groups (APE and baseline).
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
Difference in CD4+ T cell TLR2 expression
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
The primary outcome measure is the difference in expression of CD4+ T cell TLR2 as measured by flow cytometry from circulating blood between the two groups (APE and baseline).
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
Difference in GILT expression
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
The primary outcome measure is the difference in expression of GILT as measured by flow cytometry from circulating blood between the two groups (APE and baseline).
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Correlation of primary outcome measurements with lung function tests
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
A secondary outcome measure is the correlation of the differences in expression of neutrophil CD64, CD4+ T cell TLR2, and GILT with changes in FEV1 as measured by spirometry.
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
Correlation of primary outcome measurements with C-Reactive Protein
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
A secondary outcome measure is the correlation of the differences in expression of neutrophil CD64, CD4+ T cell TLR2, and GILT with differences in C-Reactive Protein (CRP)
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
Correlation of primary outcome measurements with total white blood cell counts
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
A secondary outcome measure is the correlation of the differences in expression of neutrophil CD64, CD4+ T cell TLR2, and GILT with differences in total white blood cell counts (WBC).
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
Correlation of primary outcome measurements with sputum inflammatory markers
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
A secondary outcome measure is the correlation of the differences in expression of neutrophil CD64, CD4+ T cell TLR2, and GILT with differences in sputum inflammatory markers as measured by sputum neutrophil counts and neutrophil elastase expression.
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
Correlation of primary outcome measurements with phagocytosis
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
A secondary outcome measure is the correlation of the differences in expression of neutrophil CD64, CD4+ T cell TLR2, and GILT with differences in the percentage of phagocytosis by isolated neutrophils.
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
Correlation of primary outcome measurements with quality of life questionnaire score
Tidsramme: Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health
A secondary outcome measure is the correlation of the differences in expression of neutrophil CD64, CD4+ T cell TLR2, and GILT with differences in patient reported health related quality of life scores as measured by the Cystic Fibrosis Questionnaire-Revised (CFQ-R).
Within 24 hours of initiation of IV antibiotic treatment for CF pulmonary exacerbation or at Baseline health

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

National Jewish Health

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

10. september 2014

Primær færdiggørelse (Faktiske)

23. maj 2019

Studieafslutning (Faktiske)

31. august 2021

Datoer for studieregistrering

Først indsendt

18. maj 2020

Først indsendt, der opfyldte QC-kriterier

18. maj 2020

Først opslået (Faktiske)

21. maj 2020

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. september 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

31. august 2021

Sidst verificeret

1. august 2021

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 14BGF-10

Plan for individuelle deltagerdata (IPD)

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