Investigating Immune Mechanisms in Atopic Eczema

NCT ID: NCT02102841

Last Updated: 2021-04-30

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2014-05-31

Study Completion Date

2017-05-31

Brief Summary

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The aim of this study is to investigate the mechanisms behind the immune dysfunction that occurs in atopic eczema (or atopic dermatitis).

Detailed Description

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Atopic eczema is a chronic inflammatory skin disease that affects 15-20% of children and 12% of adults and leads to significant loss of quality of life. It results from a complex interaction of genetic and environmental factors, and is characterised by dysregulation of the cutaneous immune system. Specifically, in the skin of eczema patients there is a persistence of T lymphocytes (a crucial cell involved in regulating the immune system), and an overproduction of certain cytokines (signalling molecules that are essential in producing inflammatory responses).

The study intends to investigate the causes of atopic eczema by examining the number, characteristics and function of T lymphocytes in the skin and the blood of eczema patients, as well as the types of cytokine they produce. To achieve this the investigators aim to take skin biopsies, tissue fluid (from induced skin suction blisters) and blood samples from adult eczema patients and healthy controls for analysis. Additionally, in these groups a cutaneous immune response will be initiated by injecting tuberculin protein purified derivative (the Mantoux test) into the skin, to further investigate how the behaviour of T lymphocytes varies between eczema patients and healthy controls.

This research is important in view of the high prevalence of atopic eczema in the population. An improved understanding of its causes will hopefully lead to more effective treatments for this condition in future.

Conditions

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Atopic Dermatitis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Skin biopsy

5mm skin punch biopsy on forearm

Group Type EXPERIMENTAL

Skin biopsy

Intervention Type PROCEDURE

Skin suction blister

Skin suction blister induced on forearm

Group Type EXPERIMENTAL

Skin suction blister

Intervention Type PROCEDURE

Mantoux, skin biopsy, suction blister

0.1ml tuberculin purified protein derivative (PPD) is injected intradermally into an area of non-lesional skin on the volar aspect of each of the patient's forearms. This is followed by a skin biopsy on one arm and induction of a skin suction blister on the other arm.

Group Type EXPERIMENTAL

Skin biopsy

Intervention Type PROCEDURE

Skin suction blister

Intervention Type PROCEDURE

Mantoux test

Intervention Type BIOLOGICAL

Interventions

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Skin biopsy

Intervention Type PROCEDURE

Skin suction blister

Intervention Type PROCEDURE

Mantoux test

Intervention Type BIOLOGICAL

Other Intervention Names

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Tuberculin PPD (SSI)

Eligibility Criteria

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Inclusion Criteria

* History of atopic dermatitis (according to United Kingdom Working Party's diagnostic criteria)
* Previous Bacillus Calmette-Guerin vaccination

Exclusion Criteria

* Unable to give written informed consent
* Previous history of hypersensitivity to local anaesthetic (for skin biopsy) or tuberculin PPD (for skin test)
* Pregnancy or breast feeding
* History of tuberculosis
* Recent infection or immunisation (within last month)
* Known immunodeficiency e.g. HIV infection, primary immunodeficiency, any history of chemotherapy or radiotherapy
* Systemic steroids within the last month or any other immunosuppressive medications (eg. methotrexate, ciclosporin or azathioprine) within the previous 3 months
* Phototherapy within the previous 28 days
* Treatment with potent topical corticosteroids or tacrolimus ointment within the previous 7 days
* Significant co-morbidity (diabetes, renal failure, liver failure, heart failure)
* On warfarin or known bleeding disorder
* History of neoplasm in last 10 years (not including basal cell carcinoma)
* Previous keloid scarring
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Dermatrust

UNKNOWN

Sponsor Role collaborator

University College, London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Malcolm Rustin, MBBS MRCP MD

Role: PRINCIPAL_INVESTIGATOR

Royal Free London NHS Foundation Trust

Locations

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Royal Free London NHS Foundation Trust

London, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Williams HC, Burney PG, Hay RJ, Archer CB, Shipley MJ, Hunter JJ, Bingham EA, Finlay AY, Pembroke AC, Graham-Brown RA, et al. The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis. Br J Dermatol. 1994 Sep;131(3):383-96. doi: 10.1111/j.1365-2133.1994.tb08530.x.

Reference Type BACKGROUND
PMID: 7918015 (View on PubMed)

Other Identifiers

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14/LO/0243

Identifier Type: OTHER

Identifier Source: secondary_id

13/0410

Identifier Type: -

Identifier Source: org_study_id

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