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Wgląd w skład mikrobiomu i środowiska w anemii sierpowatokrwinkowej i badaniu owrzodzeń nóg (badanie INSIGHTS)

28 października 2026 zaktualizowane przez: National Human Genome Research Institute (NHGRI)

Wgląd w skład mikrobiomu i środowiska w niedokrwistości sierpowatokrwinkowej i owrzodzeniach nóg

Background:

- People with sickle cell disease and other blood disorders sometimes get chronic leg ulcers. These are wounds that develop on the skin and don t go away. Current treatments do not work very well, so researchers want to learn more about why the ulcers happen. They want to find out which bacteria may cause it, and if external factors play a role.

Objective:

- To study social and environmental factors of sickle cell disease and the causes of sickle cell disease leg ulcers.

Eligibility:

- People age 18 and older who have sickle cell disease or another red cell disorder, with or without an active leg ulcer.

Design:

Participants will have a medical history and clinical evaluation. They will also have blood drawn.
Participants will complete questionnaires about their life, health, environment, stress, and other topics.
Participants may provide a small sample of hair.
Participants will be asked to collect a small amount of saliva.
Participants with leg ulcers will have their skin microbiome sampled. The microbiome is all of the microbes (bacteria and and/or fungi) and their genes in and on the body. Researchers will use swabs to collect skin samples. Photographs will be taken of the skin sample area.
Some participants without leg ulcers also will have their skin microbiome sampled.
Some participants who have their skin microbiome sampled will return for a second visit. At this visit, their microbiome will be resampled. It will take place more than 30 days after the first visit.

Przegląd badań

Status

Zakończony

Warunki

Szczegółowy opis

Study Description:

Leg ulcers are a serious and debilitating complication of sickle cell disease (SCD). This study will explore microbial, genomic, and environmental (social and physical) factors, that may influence the onset and progression of leg ulcer formation and delayed healing in individuals living with SCD. The etiology of SCD-associated leg ulcers is unclear, and we hypothesize that predisposition to developing leg ulcers is multifactorial. This multisite study is an exploratory study of the microbiome and environment of individuals living with sickle cell disease leg ulcers. The study s objective is to identify triggers that may be integral in leg ulcer onset and progression. The central goal of this study is to obtain an improved understanding of the participants clinical phenotype, leg ulcer microbiome and the psychosocial and environmental factors that may impact this complication.

Objectives:

Primary Objective:

Employ genomic approaches to characterize the skin microbiome in individuals living with SCD with and without leg ulcers.

Secondary Objective:

Employ social science research measures to identify psychosocial and physical environmental factors that impact quality of life in individuals living with SCD with and without leg ulcers.
Develop new measure of severity for SCD that integrates clinical outcomes and the quality of life of the participant.
Develop guidelines for researchers to address the needs of diverse and under-resourced groups in genetic research.

Endpoints:

Primary Endpoint:

To characterize the microbiome of leg ulcers in SCD.

Secondary Endpoints:

To characterize the phenotypic variation in SCD.
To identify similarities and differences of the microbial signatures of chronic diabetic foot ulcers and SCD leg ulcers.
To investigate physical and psychosocial environmental indicators that impact quality of life in individuals living with SCD with and without leg ulcers.
To determine if an association exists between the microbiome (microbial diversity) of SCD leg ulcers and the quality of life (psychosocial and physical environment) indicators of individuals with SCD leg ulcers.
To determine if an association exists between the microbiome (microbial diversity) of SCD leg ulcers and clinical phenotype of individuals with SCD leg ulcers.
To determine how leg ulcers influence one s physical function and one s perceptions of stigma and self-esteem.
To identify factors that are indicators of both quality of life and clinical severity of the participant.
To identify specific psychosocial and environmental factors related to resilience in our study population.
To investigate current practices and policies around the return of secondary findings in genome sequencing studies in under-resourced study participant populations, and to explore ethical and clinical policies for returning secondary findings by examining various practices within the research community.
To investigate SCD variation in phenotype, microbiome, physical and psychosocial environments in a cohort in Sierra Leone.
To compare similarities and differences in phenotype, microbiome, physical and psychosocial environments between U.S. and Sierra Leone cohorts.

Typ studiów

Obserwacyjny

Zapisy (Rzeczywisty)

405

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

Sierra Leone
- - Freetown, Sierra Leone
    - University of Sierra Leone, College of Medicine and Allied Health Services
Stany Zjednoczone
- Maryland
  - Bethesda, Maryland, Stany Zjednoczone, 20892
    - National Institutes of Health Clinical Center
- New York
  - The Bronx, New York, Stany Zjednoczone, 10467
    - Montefiore Medical Center/Albert Einstein College of Medicine

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat do 120 lat (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Metoda próbkowania

Próbka bez prawdopodobieństwa

Badana populacja

This is a descriptive study of individuals living with sickle cell diseases (SCD) with and without leg ulcers (accrual goal 550 participants). Leg ulcers are not observed in all individuals with SCD and we are interested in understanding why certain individuals develop leg ulcers. We will seek to include age-matched patients without leg ulcers for the microbiome phase of the study. We will recruit and sample male or female adult participants with ulcers, currently without leg ulcers, and those with no previous history of leg ulcers. To ensure we recruit an adequate number of participants with and without leg ulcers, we will rely on multiple recruiting methods, which will include posting flyers, social media advertisements, and/or referrals.

Opis

INCLUSION CRITERIA:

We will enroll up to four-hundred and fifty (N=450) participants in the microbiome sampling cohort. In addition to the 300 SCD leg ulcer microbiome participants, we will recruit up to an additional 200-250 SCD participants that will complete the clinical evaluation, (including blood sample) and survey instruments for a total of up to 550 participants at three sites, NIH (n=200) and MMC (n=100), and Sierra Leone (n=250).

Of the total participants, we will resample the microbiome of up to 75 individuals from each of the 3 initial sampling groups: SCD with, without and never had SCD leg ulcers. Of those 75 individuals who are sampled longitudinally, those with clinically interesting cases may be sampled at multiple intervals.

All sampling, surveys, and processing of samples will take place at the NIH Clinical Center the second site, MMC, or in Sierra Leone. All samples will be stored at NIH.

To be eligible to participate in this study, an individual must meet all of the following criteria:

All subjects must have a diagnosis of sickle cell disease (HbSS, HgSC, HbSB 0 or HBSB+)
Be at least 18 years old.
Provide written informed consent.
For the Qualitative phase: must have a recurrent, active, or single-occurrence presentation of a leg ulcer(s).
For the resilience study analysis: cohort will be determined by the research team based on the results of part I of this analysis. For part I, the inclusion criteria are that the individual must have enrolled and completed the INSIGHTS study.

EXCLUSION CRITERIA:

Any individual that meets any of the following criteria during baseline evaluation will be excluded from the study:

Pediatric population (<18 years old)
Participants for microbiome study (only) who have received oral and/or topical antibiotics or antifungals < 2 weeks prior to enrolling in the study for leg ulcers (for those with leg ulcers only)
Subjects presenting with clinically diagnosed bacterial infection (i.e. clinical appearance, clinical judgment, fever, redness around ulcer, purulent drainage etc.) at the site of ulceration. (This can only be diagnosed clinically by the research nurse during sampling

and is only applicable to those with leg ulcers only).

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

Modele obserwacyjne: CASE_ONLY
Perspektywy czasowe: CROSS_SECTIONAL

Kohorty i interwencje

Grupa / Kohorta Grupa / Kohorta Grupa lub podgrupa uczestników badania obserwacyjnego ocenianego pod kątem wyników biomedycznych lub zdrowotnych.
Microbiome with active Leg Ulcer We will recruit and obtain microbiome samples from male or female adult participants with active leg ulcers and sickle cell disease.
Microbiome with no active Leg Ulcer We will recruit and obtain microbiome samples from male or female adult participants without active leg ulcers but do have sickle cell disease.
Non-microbiome participants We will recruit but not obtain microbiome samples from participants with sickle cell disease

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku	Opis środka	Ramy czasowe
The skin microbiome Ramy czasowe: Assessment occurs on date of visit.	Employ genomic approaches to characterize the skin microbiome in individuals living with SCD with and without leg ulcers	Assessment occurs on date of visit.
The factors that impact quality of life Ramy czasowe: Assessment occurs on date of visit.	Employ social science research measures to identify psychosocial and physical environmental factors that impact quality of life in individuals living with SCD with and without leg ulcers	Assessment occurs on date of visit.
Sickle Cell disease severity measure Ramy czasowe: Assessment occurs on date of visit.	Develop new measure of severity for SCD that integrates clinical outcomes and the quality of life of the participant	Assessment occurs on date of visit.

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

National Human Genome Research Institute (NHGRI)

Śledczy

Główny śledczy: Laura M Koehly, Ph.D., National Human Genome Research Institute (NHGRI)

Publikacje i pomocne linki

Osoba odpowiedzialna za wprowadzenie informacji o badaniu dobrowolnie udostępnia te publikacje. Mogą one dotyczyć wszystkiego, co jest związane z badaniem.

Publikacje ogólne

Przydatne linki

<p>NIH Clinical Center Detailed Web Page</p>

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

16 czerwca 2014

Zakończenie podstawowe (Rzeczywisty)

1 października 2024

Ukończenie studiów (Rzeczywisty)

1 października 2024

Daty rejestracji na studia

Pierwszy przesłany

4 czerwca 2014

Pierwszy przesłany, który spełnia kryteria kontroli jakości

4 czerwca 2014

Pierwszy wysłany (Szacowany)

5 czerwca 2014

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

29 października 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

28 października 2026

Ostatnia weryfikacja

9 września 2026

Więcej informacji

Terminy związane z tym badaniem

Słowa kluczowe

Dodatkowe istotne warunki MeSH

Inne numery identyfikacyjne badania

140125
14-HG-0125

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .