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自己抗体または遺伝的欠陥による I 型 IFN 免疫障害: 将来の全国コホート (COVIFERON)

2026年9月15日 更新者：Institut National de la Santé Et de la Recherche Médicale, France

The major role of human genetic factors in the immune response to infections is now well established, particularly for viral infections. In the context of the COVID-19 pandemic, the following results have identified 1) several inborn errors of immunity (IEI) affecting the response or production of type I interferons (type I IFNs) in around 4% of adult patients with severe clinical disease, and 2) the presence of type I IFN-neutralizing autoantibodies (auto-Abs) in around 15% of severe cases, and 20% of deaths. The investigators would like to carry out a longitudinal immunological and clinical follow-up study on a prospective cohort of patients with either a genetic defect affecting the type I IFN-dependent immune response, or anti-IFN-I auto-Abs, to monitor the incidence of infectious and/or autoimmune events in these individuals, the evolution of neutralizing power, and the kinetics of auto-Abs. This should lead to a better understanding of the prevention and management of these patients.

The research design is a national multicenter prospective cohort of adults with 1) anti-IFN-I auto-Abs or 2) IEI- IFN-I, with follow-up from 1 to 4 years. These individuals may be: 1) patients who have or have had clinical disease (related to COVID-19, other viral infections, autoimmune disorders); or 2) "healthy" participants (e.g. blood donors, relatives of an IEI patient).

Follow-up will include:

  • yearly visits to the Clinical Investigation Center (CIC) or a clinical department with blood sampling;
  • specific visit in case of hospitalization for infectious events or adverse effects of vaccination, exacerbation or new diagnosis of auto-immune disease, new diagnosis of cancer, or SARS-CoV-2 infection whether or not patients are admitted to hospital, with blood sampling.

In addition, a retrospective "passive" follow-up will be implemented through matching with the data from the SNDS (National Health Data System), in order to collect clinical events of and healthcare resource consumption. Moreover, matching with controls adults from the national CONSTANCES cohort, not carrying auto-Abs against type I IFNs nor IEI-IFN-I, will be performed. (ratio 3:1; matching on age (+/- 5 years), gender and geographic region of recruitment). Individuals under long-lasting immunosuppressive or immunomodulatory drugs will not be eligible. Follow-up of controls, which will be carried out as part of the CONSTANCES cohort, will include web-based questionnaires, every 12 months, in addition to linking with SNDS data as already done in this cohort.

Inclusion visit:

After signing the consent form, the following tests will be performed:

  • Demographic characteristics (sex, age, country of birth)

  • Medical history from participant and family member(s) including infectious and auto-immune diseases, cancers and vaccination status and side effects

  • Blood samples for:

    • full blood cell count;

    • classical autoimmune investigations (anti-nuclear, anti-ENA, native anti-DNA, anti- thyroid antibodies, rheumatoid factor);

    • immunophenotyping*;

    • auto-Abs against type I IFNs, other cytokines*, or other target proteins* (dosage and neutralization activity);

    • Genetic explorations by whole-exome or whole-genome sequencing*;

    • Biobanking (DNA, plasma/sera; cryopreserved peripheral blood mononuclear cells (PBMCs).

      • these biological analyses will be carried out as part of dedicated COVIFERON RHU5 workpackages.

In addition, vaccination against SARS-CoV-2 and influenza will be offered to these subjects as a priority, as part of their usual care.

Follow-up visits :

Annual visits to the CIC :

  • Medical history since last visit, including infectious, auto-immune and oncologic events, vaccination status and side effects

  • Blood samples for:

    • full blood cell count;
    • classical autoimmune investigation (anti-nuclear, anti-ENA, native anti- DNA, anti-thyroid antibodies, rheumatoid factor);
    • immunophenotyping;
    • Auto-Abs against type I IFNs, other cytokines, or other target proteins (dosage and neutralization)
    • Biobanking (DNA, plasma, cryopreserved peripheral blood mononuclear cells (PBMCs))

Additional specific visit in the event of a clinical event of interest, at any time during follow-up:

  • In case of SARS-CoV-2 infection, whatever the severity of the disease: blood sampling for determination and neutralization of type I anti-IFN autoAbs, CBC, and biobanking (plasma and PBMC) and teleconsultation with the CIC in charge of patients, as soon as possible.
  • In the event of hospitalization for infectious events or exacerbation or new diagnosis of an auto-immune disease: blood sampling for determination and neutralization of anti-IFN-I autoAbs, CBC, and biobanking (plasma and PBMCs) and collection of the hospitalization report in the case report form on a dedicated page.

調査の概要

状態

募集

条件

介入・治療

研究の種類

観察的

入学 (推定)

500

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

  • フランス
      • Lille、フランス
        • 募集
        • Cic Lille
        • コンタクト：
        • 副調査官：
          • Dominique DEPLANQUE, PU-PU
      • Lyon、フランス
        • 募集
        • LYON HCL
        • コンタクト：
        • 副調査官：
          • Alexandre BELOT, PU-PU
      • Montpellier、フランス
        • 募集
        • Cic Montpellier
        • コンタクト：
        • 副調査官：
          • Florence GALTIER, PH
      • Paris、フランス
        • 募集
        • Cic Bichat
        • コンタクト：
        • 主任研究者：
          • Xavier-Marie DUVAL, PU-PU
      • Paris、フランス
        • 募集
        • Cic Creteil
        • コンタクト：
        • 副調査官：
          • Philippe LE CORVOISIER, PU-PU
      • Paris、フランス
        • 募集
        • Cic La Salpetriere
        • コンタクト：
        • 副調査官：
          • Joe-Elie SALEM, PU-PU
      • Paris、フランス
        • 募集
        • Cic Necker
        • コンタクト：
        • 副調査官：
          • Michaela SEMERARO, PH
      • Paris、フランス
        • 募集
        • Cic St Louis
        • コンタクト：
        • 副調査官：
          • Jean-Jacques KILADJIAN, PU-PU
      • Tours、フランス
        • 募集
        • Cic Tours
        • コンタクト：
        • 副調査官：
          • Valérie GISSOT, PH

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

はい

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

Adults with auto-Abs against IFN-I or an IEI-IFN-I who: 1) either have or have had a clinical disease (COVID-19 related, other viral infections, adverse effect of vaccination, auto-immune disorders); or 2) are healthy (e.g. blood donor, relatives of a participant).

説明

Inclusion Criteria:

  • Age >18 years
  • History of carrying 1) auto-Abs against type I IFNs or 2) IEI impairing the response to, or the production of, type I IFNs (IFN-I-IEI)
  • Affiliated to social security
  • Written informed consent

Exclusion Criteria:

  • Participation to an interventional clinical trial on a pharmacological treatment
  • Clinical condition leading to life expectancy less than 1 year
  • Subject to a legal protection measure (safeguard of justice, curatorship, tutorship)
  • Individuals deprived of freedom

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 観測モデル：COHORT
  • 時間の展望：PROSPECTIVE

コホートと介入

グループ/コホート
介入・治療
Subjects with auto-Abs against type I IFNs or inborn errors of immunity

The study examines how autoantibodies (auto-Abs) against type I interferons (IFNs) and inborn errors of immunity affect susceptibility to infectious diseases, especially COVID-19. Individuals with auto-Abs against type I IFNs have impaired immune responses to viral infections, putting them at higher risk for severe COVID-19, leading to worse outcomes like pneumonia or cytokine storms. Those with inborn errors of immunity have genetic defects that weaken immune function, increasing vulnerability to infections, including COVID-19. The study compares these groups to understand immune dysfunctions and identify potential therapeutic targets.
他の：blood sample

After signature of consent form,blood samples will be collected for full blood cell count;classical autoimmune investigations, immunophenotyping;auto-Abs against type IIFNs, other cytokines, or other target proteins ,Genetic explorations by whole-exome or whole-genome sequencing;Biobanking

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
primary endpoint n°1 : quantitative dosage of auto-Abs against type I IFNs
時間枠：year 0, year 1, year 2 and year 3

Method: Quantitative trait will be measured by Gyros using commercially available internal control antibodies.
year 0, year 1, year 2 and year 3
primary endpoint n°2 : neutralization capacity evaluation of auto-Abs against type I IFNs
時間枠：year 0, year 1, year 2 and year 3

The neutralization capacity will be performed as previously reported using an in vitro luciferase system in HEK293 cells
year 0, year 1, year 2 and year 3

二次結果の測定

結果測定
メジャーの説明
時間枠
Cumulative incidence of clinical events of interest, i.e. infectious events, autoimmune diseases or cancers
時間枠：Year 0, year 1, year 2 and year 3

Method: annual medical visits, SNDS (PMSI, DCIR). Incidence density rate is defined as the number of newly disease individuals on the sum of time periods for all disease-free individual-at-risk
Year 0, year 1, year 2 and year 3
Clinical and biological factors associated with clinical outcomes
時間枠：Year 0, year 1, year 2 and year 3

the potential predictor variables will be assessed by bivariate logistic regressions where occurrence of clinical events is the variable to be explained. Factors associated with a p-value less than 0.20 will be included in the multivariate logistic model. Backward selection on pvalue will be applied. Internal validity of the final model will be estimated by cross-validation (Leave-One-Out Cross-Validation method). Discrimination will be assessed by the area under the ROC curve and its 95% confidence interval.
Year 0, year 1, year 2 and year 3
Cumulative incidence of the same clinical events of interest, in control participants who are negative for auto-Abs, matched by age and sex followed through the large CONSTANCES cohort
時間枠：Year 0, year 1, year 2 and year 3

Cumulative incidence of the same clinical events of interest, in control participants who are negative for auto-Abs, matched by age and sex followed through the large CONSTANCES cohort (Constances database), and its 95% confidence interval: Incidence density rate is defined as the number of newly disease individuals on the sum of time periods for all disease-free individual-at-risk.
Year 0, year 1, year 2 and year 3
Genetic factors associated with the development of auto-Abs against type I IFNs
時間枠：Year 0, year 1, year 2 and year 3

searching for homozygous deletions using in-house HMZDelFinder-opt method of imagine institue
Year 0, year 1, year 2 and year 3
Genetic factors associated with the development of auto-Abs against type I IFNs
時間枠：year 0, year 1, year 2 and year 3

Searching for rare candidate coding variants in patients by following an optimal filtering strategy that imagine have optimized over the last 10 years based on multiple variant-level and gene-level criteria to select the candidate variants
year 0, year 1, year 2 and year 3
Genetic factors associated with the development of auto-Abs against type I IFNs
時間枠：year 0, year 1, year 2 and year 3

Using gene-level criteria to select candidate variants such as the negative selection level measured by the CoNeS approach.
year 0, year 1, year 2 and year 3

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

Institut National de la Santé Et de la Recherche Médicale, France

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

一般刊行物

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2025年4月9日

一次修了 (推定)

2029年1月1日

研究の完了 (推定)

2029年1月1日

試験登録日

最初に提出

2024年11月14日

QC基準を満たした最初の提出物

2025年1月6日

最初の投稿 (実際)

2025年1月7日

学習記録の更新

投稿された最後の更新 (実際)

2026年9月18日

QC基準を満たした最後の更新が送信されました

2026年9月15日

最終確認日

2026年9月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • C22-73
  • 2023-A02663-42 (その他の識別子：ANSM ID-RCB)

個々の参加者データ (IPD) の計画

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いいえ

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