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

31 augustus 2021 bijgewerkt door: 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.

Studie Overzicht

Toestand

Voltooid

Conditie

Studietype

Observationeel

Inschrijving (Werkelijk)

150

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Verenigde Staten
    • Colorado
      • Denver, Colorado, Verenigde Staten, 80206
        • National Jewish Health

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Bemonsteringsmethode

Kanssteekproef

Studie Bevolking

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.

Beschrijving

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.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Observatiemodellen: Cohort
  • Tijdsperspectieven: Prospectief

Cohorten en interventies

Groep / Cohort
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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Difference in neutrophil CD64 expression
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Correlation of primary outcome measurements with lung function tests
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

National Jewish Health

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

10 september 2014

Primaire voltooiing (Werkelijk)

23 mei 2019

Studie voltooiing (Werkelijk)

31 augustus 2021

Studieregistratiedata

Eerst ingediend

18 mei 2020

Eerst ingediend dat voldeed aan de QC-criteria

18 mei 2020

Eerst geplaatst (Werkelijk)

21 mei 2020

Updates van studierecords

Laatste update geplaatst (Werkelijk)

2 september 2021

Laatste update ingediend die voldeed aan QC-criteria

31 augustus 2021

Laatst geverifieerd

1 augustus 2021

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 14BGF-10

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

Nee

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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