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História Natural, Patogênese e Resultado de Doenças Autoinflamatórias (NOMID/CAPS, DIRA, CANDLE, SAVI, NLRC4-MAS, Doenças do tipo Still's e Outras Doenças Autoinflamatórias Indiferenciadas)

Estudos da história natural, patogênese e desfecho de doenças autoinflamatórias (NOMID/CAPS, DIRA, CANDLE, SAVI, NLRC4-MAS, doenças semelhantes a Still's e outras doenças autoinflamatórias indiferenciadas)

Background:

Some diseases cause chronic inflammation with intermittent flares in the body. These are called autoinflammatory diseases. They can cause fevers, rashes, ulcers, and other problems. Researchers want to learn more about the causes and effects of these diseases. They hope this will improve how the disease is managed in the future.

Objectives:

To understand the underlying immune dysregulation

To identify the genetic cause

To translate our findings into novel treatments that improve patients disease outcomes

Eligibility:

Patients with known NOMID/CAPS, DIRA, CANDLE, SAVI, NLRC4-MAS, Still's Disease, and with other yet undifferentiated autoinflammatory diseases.

Unaffected relatives of participants with a known or undifferentiated autoinflammatory disease

Healthy adult volunteers at least 18 years of age

Design:

Participants will be screened with blood sample and medical history. They may provide copies of their medical records.

Enrolled participants will be evaluated at the NIH for 2-5 days. All participants will have a detailed medical history, physical exam, blood tests, and other evaluations depending on the extent of their autoinflammatory disease.

Participants may also expect the following assessments:

  1. Clinical tests that help assess organ damage and function such as hearing, vision, memory, and learning tests.
  2. Imaging studies to characterize organ involvement of the inflammatory disease including: X-rays, CT scans, special MRIs, and bone scans.
  3. Laboratory evaluations including clinical markers of disease activity, research samples for genetic studies, blood samples for cytokine/biomarker assessment, and gene expression profiling.
  4. Questionnaires to assess disease activity and quality of life.
  5. If indicated, other procedures may be administered that include: a lumbar puncture if CNS inflammation is suspected, a skin biopsy if skin inflammation is present, and/or gastrointestinal and pulmonary procedures if they are clinically indicated.

Participants may return for a single follow-up visit or for long-term follow-up visits depending on their disease and willingness to return. Long-term follow-up may occur for up to 15 years on this protocol.

Visão geral do estudo

Status

Recrutamento

Condições

Descrição detalhada

Autoinflammatory diseases are a group of immune dysregulatory diseases that are characterized by recurrent episodes of systemic as well as organ-specific inflammation that can involve the skin, eyes, joints, bones, muscles, lungs, serosal surfaces, inner ear, brain, and other organs. The prominent role of IL-1 in the pathogenesis of these disorders first became evident through the discovery of mutations in the gene NLRP3 and IL1RN. Since then, we have identified additional mutations that cause autoinflammatory diseases, including mutations in proteasome components and STING1 that suggest a role of increased type I IFN signaling as a contributor to the disease pathogenesis of autoinflammatory diseases and in NLRC4 and CDC42 that suggest a role of IL-18 in some autoinflammatory diseases. In this natural history study, we seek to comprehensively evaluate people with autoinflammatory diseases that include clinical, genetic, immunologic, andendocrinologic characterizations. Other rare diseases not mediated by IL-1, IL-18 or type I IFN and presumed to be autoinflammatory diseases with unknown genetic causes may also be eligible under this protocol. In addition, we intend to evaluate long-term outcomes and biomarkers over time in selected diseases. We plan to follow most participants for the duration of this study (15 years). Relatives who do not have autoinflammatory diseases as well as healthy volunteers will also be recruited to serve as controls for biomarker, genetic, and other molecular analyses.

Tipo de estudo

Observacional

Inscrição (Estimado)

3200

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

  • Nome: Katsiaryna Uss
  • Número de telefone: (240) 292-4709
  • E-mail: kat.uss@nih.gov

Estude backup de contato

  • Nome: Raphaela T Goldbach-Mansky, M.D.
  • Número de telefone: (301) 761-7553
  • E-mail: goldbacr@mail.nih.gov

Locais de estudo

    • Maryland
      • Bethesda, Maryland, Estados Unidos, 20892
        • Recrutamento
        • National Institutes of Health Clinical Center
        • Contato:
          • For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)
          • Número de telefone: TTY8664111010 800-411-1222
          • E-mail: prpl@cc.nih.gov

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

Não mais velho que 99 anos (Filho, Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Sim

Gêneros Elegíveis para o Estudo

Tudo

Método de amostragem

Amostra Não Probabilística

População do estudo

Study population is quite diverse as affected participants are from all over the world, different age ranges, and all race/ethnic groups.

Descrição

  • INCLUSION CRITERIA - AFFECTED PARTICIPANTS:

    1. Be 2 to 99 years old for participants who will be seen at the NIH CC; be 0 (newborn) to 99 years old for participants who participate remotely via a virtual protocol visit and will submit mail-in samples. Participants younger than 3 years will be seen in the outpatient clinic at the NIH CC if approved by the Pediatric

      Consult Service as per NIH CC policy and guidelines.

    2. Is willing to allow storage of biological specimens for future use in medical research.

    3. Is willing to allow genetic testing on collected biological samples.

    4. Has a primary care or other physician who will manage all health conditions related or unrelated to the study objectives.

    5. Fulfills one of the following criteria:

      • Has a known disease-causing genetic mutation associated with NOMID/CAPS, DIRA, CANDLE, SAVI, or NLRC4-MAS.

      • Has clinical signs or symptoms not explained by any other disorder (eg, infections, malignancies) and are consistent with a possible IL-1 mediated autoinflammatory disease. Participants must meet both of the following criteria:

        • Clinical characteristics strongly consistent with an IL-1 mediated autoinflammatory disease per the following criteria and at the discretion of the principal investigator (PI). Individuals must have a past or present history of one of the following to be considered for study enrollment:

          • Recurrent fever that has gone undiagnosed after reasonable attempts, and that is consistent with the conditions under study in this protocol
          • Neutrophilic urticaria, pustular dermatitis, erysipelas-like erythema, or urticarial rash
          • Epiphyseal and/or patella enlargement, periostitis, myalgias, arthralgias, arthritis, or recurrent multifocal aseptic osteomyelitis
          • Sensorineural hearing loss
          • Chronic aseptic meningitis or CNS vasculitis
          • Conjunctivitis, episcleritis, uveitis, papilledema, pleuritis, pericarditis, aseptic peritonitis, early onset enterocolitis, hepatosplenomegaly, or lymphadenopathies
        • Laboratory characteristics strongly consistent with an IL-1mediated autoinflammatory disease per the following criteria. Individuals must havepast or present history of evidence of systemic inflammation (eg, elevation of C-reactive protein [CRP] and/or erythrocyte sedimentation rate [ESR], anemia, thrombocytosis).

      • Has clinical signs or symptoms not explained by any other disorder (eg, infections, malignancies) and are consistent with a possible IFN-mediated, autoinflammatory disease.1,36 Participants must meet both of the following criteria:

        • Clinical characteristics strongly consistent with an IFN-mediated autoinflammatory disease per the following criteria and at the discretion of the PI. Individuals must have a past or present history of one of the following to be considered for study enrollment:

          • Recurrent fevers that has gone undiagnosed after reasonable attempts, and that is consistent with the conditions under study in this protocol
          • Panniculitis, ischemic ulcerative skin lesions, chilblain lesions, or livedo reticularis
          • Lipodystrophy
          • Myositis, arthralgias, arthritis, or joint contractures
          • Basal ganglia calcifications or white matter CNS disease
          • Interstitial lung disease, lung fibrosis, or pulmonary hypertension
          • Conjunctivitis, episcleritis, cortical blindness, glaucoma, papilledema, or hepatosplenomegaly
          • Laboratory characteristics strongly consistent with an IFN-mediated autoinflammatory disease per the following criteria. Individuals must have past or present history one or more of the following to be considered for study enrollment:
          • Evidence of systemic inflammation (eg, ESR or CRP)
          • Cytopenias (eg. leukopenia, anemia, or thrombocytopenia)
          • Dyslipidemia or insulin resistance
          • Abnormal liver function test, creatinine kinase (CK), or LDH
      • Has clinical signs or symptoms consistent with an undifferentiated autoinflammatory disease (including but not limited to dysregulation in other proinflammatory cytokines such as IL-17, TNF, IL-18, and others). Participants must meet one of the following criteria:

        • Clinical characteristics strongly consistent with an undifferentiated autoinflammatory disease. Individuals must have a past or present history of one of the clinical and one of the laboratory characteristics mentioned above to be considered for study enrollment.
        • Individuals with defined organ inflammation associated with past or current evidence of systemic inflammation.
    6. Alternatively to #5, had been enrolled in the past as an affected participant on NIAMS study 03-AR-0173 and or had samples collected on 03-AR-0173.

INCLUSION CRITERIA - UNAFFECTED RELATIVES OF AFFECTED PARTICIPANTS:

  1. Be 2 to 99 years old for participants who will be seen at the NIH CC; be 0 (newborn) to 99 years old for participants who participate remotely via a virtual protocol visit and will submit mail-in samples. Participants younger than 3 years will be seen in the outpatient clinic at the NIH CC if approved by the Pediatric Consult Service as per NIH CC policy and guidelines.)
  2. Be related by blood to an affected participant.
  3. Is willing to allow storage of biological samples for future use in medical research.
  4. Is willing to allow genetic testing on collected biological samples.
  5. Does not fulfill any of inclusion criterion #5 for affected participants.
  6. Is able to provide informed consent.

INCLUSION CRITERIA - HEALTHY VOLUNTEERS:

  1. Be at least 18 years old.
  2. Not be related to an affected participant.
  3. s willing to allow storage of biological samples for future use in medical research.
  4. Is willing to allow genetic testing on collected biological samples.
  5. Does not fulfill any of inclusion criterion #5 for affected participants.
  6. Is able to provide informed consent.

PARTICIPANT EXCLUSION CRITERIA:

  1. Presence of conditions that, in the judgment of the investigator, may put the participant at undue risk or make them unsuitable for participation in the study.
  2. Oncological evaluation suggestive of lymphoma, leukemia or multiple myeloma, except for participants with a known primary diagnosis of an autoinflammatory disease who subsequently developed a malignancy. These patients will not be excluded from the study.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Modelos de observação: COHORT
  • Perspectivas de Tempo: PROSPECTIVE

Coortes e Intervenções

Grupo / Coorte
Affected Participants

Individuals with undifferentiated autoinflammatory diseases or genetically defined conditions, such as NOMID/CAPS, DIRA, CANDLE, SAVI, and NLRC4 MAS.

Healthy Volunteer

Volunteers without known autoinflammatory disease who consent to providing blood specimen for genetic testing.

Unaffected Relatives

Blood relatives of the affected patients without known autoinflammatory disease who consent to providing specimen for genetic testing.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
To study the pathogenesis of patients affected with auto-inflammatory diseases, including their clinical, immunological, genetic and metabolic/endocrinological characteristics.
Prazo: 1-2 years, 3-5 years, 10 years

To study the pathogenesis of patients affected with autoinflammatory diseases, including their clinical, immunological, genetic and metabolic/endocrinological characteristics.

1-2 years, 3-5 years, 10 years

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Longitudinal fluctuations in clinical and biomarker characteristics of autoinflammatory diseases
Prazo: 1-2 years, 3-5 years, 10 years

To evaluate clinical characteristics/disease manifestations and blood, body fluids, and tissue biomarkers during disease flares and quiescence.

1-2 years, 3-5 years, 10 years
Long term Organ specific outcome (clinical and biomarker evidence of both inflammation and damage accrual)
Prazo: 1-2 years, 3-5 years, 10 years

To collect long-term clinical and laboratory outcome parameters of the multiorgan inflammatory involvement and/or organ damage in patients with genetically defined or undifferentiated autoinflammatory (immune-dysregulatory) diseases.

1-2 years, 3-5 years, 10 years

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Investigadores

  • Investigador principal: Raphaela T Goldbach-Mansky, M.D., National Institute of Allergy and Infectious Diseases (NIAID)

Publicações e links úteis

A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.

Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

9 de dezembro de 2016

Conclusão Primária (Estimado)

31 de agosto de 2031

Conclusão do estudo (Estimado)

30 de setembro de 2032

Datas de inscrição no estudo

Enviado pela primeira vez

23 de novembro de 2016

Enviado pela primeira vez que atendeu aos critérios de CQ

23 de novembro de 2016

Primeira postagem (Estimado)

28 de novembro de 2016

Atualizações de registro de estudo

Última Atualização Postada (Real)

22 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

19 de setembro de 2026

Última verificação

7 de janeiro de 2026

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

SIM

Descrição do plano IPD

As outlined in our approved GDS Plan (dated 09/27/2019): Whole exome and whole genome sequencing data

Prazo de Compartilhamento de IPD

As outlined in our approved GDS Plan (dated 09/27/2019) and protocol: Following genetic testing, the data will be shared in a controlled-access public database for other investigators to benefit from it (eg, dbGaP, the Database of Genotypes and Phenotypes).

Critérios de acesso de compartilhamento IPD

Other NIH and non-NIH investigators may use these data/specimens for research purposes. @@@IRB review and approval will be obtained for all research involving identifiable data/specimen, including any coded and linked samples or data that can be linked back to the respective subjects.@@@@@@We will share human data generated in this study for future research through:@@@Our NIH-funded and approved public repository for genetic and RNA sequence data: De-identified data will be shared per our approved Genetic Data Sharing Plan. @@@BTRIS (Biomedical Translational Research Information System) sharing activities in the NIH Clinical Center (CC): includes Identifiable data generated in CC. @@@Appropriate individual regulatory approvals will govern sharing of data/specimens with outside collaborators.@@@Data will be shared with medical professionals involved in clinical care of each patient to assist with medical care of the patient. @@@Publication and/or public presentations. @@@

Tipo de informação de suporte de compartilhamento de IPD

  • PROTOCOLO DE ESTUDO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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