Improvement of Humoral Immune Response With Hemodialysis on BK-F Membrane: Correlation to Soluble CD40 Clearing

NCT ID: NCT01066559

Last Updated: 2015-06-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-04-30

Study Completion Date

2015-01-31

Brief Summary

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The aim of this study is to improve the humoral immune response efficiency of hemodialyzed patient by the use of PMMA membrane (BK-F) able to clear the soluble form of CD40 in a model of anti-HBV vaccination

Detailed Description

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Chronic renal failure is associated with humoral immune alterations characterized by a diminished vaccine response notably against hepatitis B virus (HBV). Defects in cellular contact between immunological cells have been hypothesized to explain this observation but the precise mechanism leading to this "immunocompromised" status is not clear. The soluble form of CD40 (sCD40) is dramatically increased in the serum of uremic patients, particularly in the hemodialyzed patients. This molecule acts like an inhibitor of the CD40/CD154 contact, which is pivotal in the establishment of a proper humoral immune response. It has been shown that the most elevated sCD40 levels are associated with a lack of response to HBV vaccination in the hemodialyzed patients. The majority of the hemodialysis membranes, including high flux polysulfone membranes are unable to clear sCD40 from the sera. However, we found that the high flux polymethylmetacrylate (PMMA) membrane (BK-F Toray Medical Company, Japan) allows for sCD40 clearing.

The aim of this study is to assess the effect of dialysis on PMMA membrane on the improvement of humoral immune response through the efficiency of HBV vaccination in hemodialysed patients who were non responders to one ore more previous vaccination and its link to sCD40 clearing.

Conditions

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Chronic Renal Failure Humoral Immune Alterations

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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High flux polymethylmetacrylate membrane

Group Type EXPERIMENTAL

High flux polymethylmetacrylate membrane

Intervention Type PROCEDURE

Patients will be hemodialysed with high flux polymethylmetacrylate membranes

Hepatitis B serological control

Intervention Type BIOLOGICAL

It will be assessed at week 16, week 20 and week 40

Seric sCD40 level

Intervention Type BIOLOGICAL

Ir will be measured at inclusion and week 12 by ELISA test according to the manufacturer instructions.

Polysulfone membranes

Group Type ACTIVE_COMPARATOR

Polysulfone membrane

Intervention Type PROCEDURE

Patients be hemodialysed with polysulfone membranes

Hepatitis B serological control

Intervention Type BIOLOGICAL

It will be assessed at week 16, week 20 and week 40

Seric sCD40 level

Intervention Type BIOLOGICAL

Ir will be measured at inclusion and week 12 by ELISA test according to the manufacturer instructions.

Interventions

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High flux polymethylmetacrylate membrane

Patients will be hemodialysed with high flux polymethylmetacrylate membranes

Intervention Type PROCEDURE

Polysulfone membrane

Patients be hemodialysed with polysulfone membranes

Intervention Type PROCEDURE

Hepatitis B serological control

It will be assessed at week 16, week 20 and week 40

Intervention Type BIOLOGICAL

Seric sCD40 level

Ir will be measured at inclusion and week 12 by ELISA test according to the manufacturer instructions.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Age 18 to 80 years, male or female
* Patient not immunized against hepatitis B despite complete well done anterior vaccination according to recommendations
* Hemodialyzed patients with hemodialysed sessions performed three times a week
* Patient able to give informed consent and affiliated to the medical insurance

Exclusion Criteria

* Pregnant woman
* Patient never vaccinated against HBV
* Previous known hepatitis B even without anti HBs antibody (anti HBc antibody or HBs antigenemia positive)
* Active neoplasia or plasma cell dyscrasia
* VIH infection
* Known allergy to vaccine or to PMMA membrane
* Patient dialysed with PMMA membrane within three months before screening
* Necessity of acetate free biofiltration or hemodiafiltration as the technique of extrarenal epuration
* Vascular access problem with necessity of unipuncture for more than 30% of dialysis sessions.
* Patient under judicial protection
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Valérie de PRECIGOUT, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Bordeaux, France

Pierre BORIES, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Toulouse, France

Michel RINCE, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Limoges, France

Caroline DELCLAUX, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital, Libourne, France

Antoine POMMEREAU, MD

Role: PRINCIPAL_INVESTIGATOR

Clinic Saint-Augustin, Bordeaux, France

Benjamin DEROURE, MD

Role: PRINCIPAL_INVESTIGATOR

Clinic Delay, Bayonne, France

Hervé BONAREK, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital, Saintes, France

Antoine BENARD, MD

Role: STUDY_CHAIR

University Hospital, Bordeaux, France

Locations

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CH Annonay

Annonay, , France

Site Status

CH de la côte Basque

Bayonne, , France

Site Status

CHU de Besançon

Besançon, , France

Site Status

Saint-Augustin Clinic, Dialyze Unit

Bordeaux, , France

Site Status

Pellegrin Hospital, Nephrology Unit

Bordeaux, , France

Site Status

Larrey Hospital, Dialyze Unit

Toulouse, , France

Site Status

Countries

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France

References

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de Precigout V, Germain C, Benard A, Lacraz A, Chauveau P, Deprele C, Seigneuric B, Pommereau A, Courivaud C, Douillet M, Taton B, Combe C, Contin-Bordes C. No Improvement of Hepatitis B Vaccination Response in Patients Dialysed with a Polymethylmethacrylate Membrane Compared to High-Flux Polysulfone: Results of the HEPADIAL Study. Blood Purif. 2020;49(3):265-271. doi: 10.1159/000504035. Epub 2019 Nov 13.

Reference Type DERIVED
PMID: 31722332 (View on PubMed)

Other Identifiers

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CHUBX 2009/11

Identifier Type: -

Identifier Source: org_study_id

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