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- Ensaio Clínico NCT07610538
Low-dose Interleukin-2 After Myocardial Infarction to Investigate Effects on Tissue-resident Regulatory T Cells (Leuk-ALIVE)
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
So far, our lab has looked at Tregs and immune cells in the blood. The question remained whether ld-IL-2 can have the desired effect on Tregs in tissues, particularly the vasculature and cardiac tissues, where they could promote tissue repair and potentially improve clinical outcomes for patients after a myocardial infarction which causes significant tissue damage. Clinically, this could lead to lower rates of heart failure.
In both the LILACS and IVORY trials, the effect measured was on circulating Tregs, whilst the effect of ld-IL-2 on tissue resident immune cells remains unknown.
Therefore, the aims of the study are to understand the effect of treatment with ld-IL-2 on tissue-resident immune cells in the context of ischaemic heart disease and acute MI where there has been acute tissue damage. This includes:
- Assessment if ld-IL-2, given systemically to patients at our proposed doses, can alter Tregs in the vasculature and cardiac tissues to exhibit a tissue repair and anti-inflammatory phenotype
- Studying the relationship between the vasculature, cardiac tissues and circulating immune cells after systemic ld-IL-2 administration.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Cambridgeshire
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Cambridge, Cambridgeshire, Reino Unido, CB2 0QQ
- Recrutamento
- Addenbrooke's Hospital
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Contato:
- Ali Al-Hadithi, MB BChir
- Número de telefone: 01223768678
- E-mail: abaka2@cam.ac.uk
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Cambridge, Cambridgeshire, Reino Unido, CB2 0AY
- Recrutamento
- Royal Papworth Hospital NHS Foundation Trust
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Contato:
- Ali Al-Hadithi, MB BChir
- Número de telefone: 01223768678 Royal Papworth Hospital NHS Fo
- E-mail: abaka2@cam.ac.uk
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Aged over 18 years old
- Undergoing CABG surgery
Exclusion Criteria:
- Critical left main stem coronary disease
- Severe valvular disease (for example 'severe' aortic stenosis as classified on echocardiogram report)
- Haemodynamic instability caused by arrhythmia requiring cardioversion in the current admission
- Non-sustained ventricular tachycardia of >10 beats in the last 48 hours
- Autoimmune disease
- Any regular immunosuppressive treatment [Inhaled or topical steroids are permissible]
- Known active hepatic disease or alanine aminotransferase (ALT) > 3xULN
- Severe chronic kidney disease (defined as eGFR < 30 ml/min/1.73m2)
- Allergy or intolerance to aldesleukin
- Signs and symptoms of active infection
- History of human immunodeficiency virus (HIV), hepatitis B or C
- Current malignancy requiring active treatment
- Vaccine within 4 weeks prior to screening
- Women of child-bearing potential and pregnancy (women must be either postmenopausal (defined as being amenorrhoeic for greater than 2 years with an appropriate clinical profile (e.g. age appropriate (>55 years old), history of vasomotor symptoms) or having documented hysterectomy and/or bilateral oophorectomy)
- Women who are breast-feeding
- Clinically relevant medical or surgical conditions that, in the opinion of the investigator, would put the subject at risk by participating in the study
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Ciência básica
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Comparador Ativo: Ao controle
Padrão de tratamento de cuidados
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Standard care for patients with coronary artery disease undergoing CABG surgery
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Experimental: Low dose interleukin-2 at dose 1.5MIU
Commercially available aldesleukin with a UK marketing authorisation will be used and will be initially prepared as per SmPC.
Dose of 1.5MIU will be used for all daily and, if needed, weekly doses
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5 sequential days of treatment (1.5MIU/day subcutaneously) and, if needed, 1.5MIU/week doses until CABG surgery completed
Outros nomes:
Standard care for patients with coronary artery disease undergoing CABG surgery
5 sequential days of treatment (2.0MIU/day subcutaneously) and, if needed, 2.0MIU/week doses until CABG surgery completed
Outros nomes:
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Experimental: Low dose interleukin-2 at dose 2.0MIU
Commercially available aldesleukin with a UK marketing authorisation will be used and will be initially prepared as per SmPC.
Dose of 2.0MIU will be used for all daily and, if needed, weekly doses
|
5 sequential days of treatment (1.5MIU/day subcutaneously) and, if needed, 1.5MIU/week doses until CABG surgery completed
Outros nomes:
Standard care for patients with coronary artery disease undergoing CABG surgery
5 sequential days of treatment (2.0MIU/day subcutaneously) and, if needed, 2.0MIU/week doses until CABG surgery completed
Outros nomes:
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Compare the differences in tissue-resident Treg gene signature in patients treated with ld-IL-2 compared to control
Prazo: Time of surgery
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Assessing Tregs from the various tissue beds and comparing differential gene expression markers for tissue healing and inflammation using sc/snRNA-sequencing technologies
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Time of surgery
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Comparing tissue-resident Tregs to peripheral blood Tregs from the same patient to assess the differential effect of ld-IL-2
Prazo: Time of surgery
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Comparing the tissue Tregs against blood Tregs from the same patient by comparing differential gene expression markers for tissue healing and inflammation using sc/snRNA-sequencing technologies and looking for differences between the two compartments.
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Time of surgery
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Difference in inflammatory T effector cells
Prazo: Time of surgery
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Comparing differential gene expression using sc/snRNA-sequencing technologies from isolated effector T cells between the 3 patient groups (control, 1.5MIU and 2.0MIU)
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Time of surgery
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Difference in other immune cells
Prazo: Time of surgery
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Comparing differential gene expression using sc/snRNA-sequencing technologies from other immune cells (e.g.
B cells) between the 3 patient groups (control, 1.5MIU and 2.0MIU)
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Time of surgery
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Comparing T cell receptor repertoire
Prazo: Time of surgery
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Comparing differences in T cell receptor (TCR) repertoire using TCR sequencing technologies between the 3 patient groups (control, 1.5MIU and 2.0MIU)
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Time of surgery
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Comparing tissue-resident immune cells to circulating immune cells
Prazo: Time of surgery
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Tissue-resident immune cells will be compared to peripheral/circulating immune cells from the same patient using sc/snRNA-seq technologies to compare the differential effect of ld-IL-2 on the two compartments.
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Time of surgery
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Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Systemc biomarkers of inflammation and tissue damage
Prazo: Time of surgery
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Compare blood-based inflammation markers and assays between the three patient groups (control, 1.5MIU, 2.0MIU)
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Time of surgery
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Non-immune cells and cardiomyocytes
Prazo: Time of surgery
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Compare stromal and myocardial cells on sc/snRNA-seq technologies between the three patient groups (control, 1.5MIU, 2.0MIU)
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Time of surgery
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Characterise tissue-level gene signatures
Prazo: Time of surgery
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Tissue-level RNA expression will be evaluated on sc/snRNA-sequencing technologies
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Time of surgery
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Gut microbiota
Prazo: Time of surgery
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Compare stool-based analysis of microbiota between the three patient groups (control, 1.5MIU, 2.0MIU)
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Time of surgery
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Safety and tolerability of IL-2 in patients after acute MI undergoing CABG
Prazo: Time of surgery
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Safety and tolerability will be assessed by recording adverse events (AEs) and reviewing patient notes.
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Time of surgery
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doenças Vasculares
- Doenças cardiovasculares
- Processos Patológicos
- Doenças cardíacas
- Infarte
- Necrose
- Arteriosclerose
- Doenças Arteriais Oclusivas
- Doença cardíaca
- Isquemia do miocárdio
- Isquemia
- Condições Patológicas, Sinais e Sintomas
- Doença arterial coronária
- Infarto do miocárdio
- Administração de Serviços de Saúde
- Qualidade, acesso e avaliação da assistência médica
- Qualidade de assistência médica
- Indicadores de qualidade, assistência médica
- Padrão de atendimento
- Aldesleucina
Outros números de identificação do estudo
- A097309
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