Anti-BK Virus Immune Response and Kidney Transplantation (BKv)
Role of Specific Immune Cellular Response in the Control of BK Virus Infection: Prospective Study, Monocentric and Longitudinal During the First Nine Months After a Kidney Transplantation
BK virus infections are very frequent during months following a kidney transplantation: a viral reactivation is observed for almost 50% of patients during first year. This reactivation leads to a viremia for 10 to 15% of patient during this same period. The most frequent complication is interstitial nephritis for 2 to 8% of patients (27 patients representing 2.7% during 6 years in Nantes).
An intensive et persisting viral replication, assessed by detection of high blood viral load, could evolved to a viral nephropathy which lead to a very pejorative functional issue for the graft.
Biological follow-up of these infections lay on the measures of viral load. Their positivity must alert the physician and lead him to modulate immunosuppressive treatment.
Actually, there is no real consensus about the modalities of pharmacological immunosuppression decrease (decrease dose or change of molecule).
Specific lymphocytic anti-BKv evaluated on several cohorts of patients permit to prove:
- weakness of immune cellular response for patient with high viremia
- increase of this response when viral load decrease These studies laid on detection of INFg synthesis by Elispot after stimulation with viral antigens and in vitro cellular expansion.
New prospective and longitudinal data comparing the immune cellular response (systematic and early) after graft between patients controlling or not BKv infection are necessary to improve the comprehension of illness natural history.
The investigators propose to enlarge the investigation of anti-BKv immune cellular response to other functions than IFNg synthesis in the aim of detecting the eventual role of polyfunctional lymphocytes for infection control. Furthermore, the investigators propose to identify better diagnostic and prognostic makers.
調査の概要
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Nantes、フランス、44000
- Nantes' Univeristy hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Kidney-transplanted patient, since less than 30 days
- Older than 18 years old
- Treatment with tacrolimus and mycophénolate mofetil
Exclusion Criteria:
- No informed consent
- Pregnant women
- Patient under legal guardianship
- Treated by ciclosporin or mTOR-inhibitor
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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kidney-transplanted patients
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blood sample at M1, M2, M3; M4; M5, M6, M7, M8 and M9 after kidney transplantation
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Comparison of the level of response between patient with a "non-controlled infection" and patients for who the blood viral load is under 103 copBKv/ml.
時間枠：at 1month, 2months, 3months, 4, 5, 6, 7, 8 and 9 months after kidney transplantation
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Analyse the role of T-lymphocytes response in the control of BKv infection
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at 1month, 2months, 3months, 4, 5, 6, 7, 8 and 9 months after kidney transplantation
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Analyse of the other causes that could influence the occurence of a viremia higher than 103 copBKv/ml
時間枠：at 1month, 2months, 3months, 4, 5, 6, 7, 8 and 9 months after kidney transplantation
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Other causes for abnormal viremia
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at 1month, 2months, 3months, 4, 5, 6, 7, 8 and 9 months after kidney transplantation
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Measurement of histological consequences of a BKv non-controlled infection during the first year post-graft
時間枠：at 12 months after kidney transplantation
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Determine the frequence of occurence of nephropathy due to BKv for the population with a non-controlled infection
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at 12 months after kidney transplantation
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Measurement of increase of immune response due to modifications of immunosuppressive treatment for patient with a non-controlled infection
時間枠：at 1, 3 et 6 months after modification of immunosuppressive treatment
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Comparision between the level of immune response and the time when the first viremia is higher than 103 copBKv/ml and 1, 3 et 6 months after modification of immunosuppressive treatment.
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at 1, 3 et 6 months after modification of immunosuppressive treatment
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- BRD/10/03-ZF
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