Susceptibility to Infections, Tumor Risk and Liver Disease in Patients With Ataxia Telangiectasia

NCT ID: NCT03357978

Last Updated: 2017-11-30

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-10-01

Study Completion Date

2019-09-30

Brief Summary

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Ataxia telangiectasia (A-T) is a rare devastating human recessive disorder characterized by progressive cerebellar ataxia, immunodeficiency, chromosomal instability and cancer susceptibility. The immunodeficiency is expressed by recurring infections. It's characterised by decreased lymphocytes data as well as lack of immunglobulin A, immunglobulin G subclasses and specific antibodies against pneumococcus. Aim of the present clinical trial is to investigate frequency-, intensity- and duration of the infections as well as changes oft immune status, dimension of liver disease and tumor risk in patients with A-T, with and without immunoglobulin G substitution therapy. Transient elastography (FibroScan) will be performed in order to measure liver stiffness as an indication of fatty liver and liver fibrosis. A bioelectrical impedance analysis (BIA) is conducted to investigate the exact body composition. Ataxia Score is determined to define neurological problems. Every subject receives a diary to compile symptoms of infection.

Detailed Description

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Ataxia teleangiectasia (A-T) is a rare devastating human recessive disorder characterized by progressive cerebellar ataxia, immunodeficiency, chromosomal instability and cancer susceptibility. The immunodeficiency is expressed by recurring infections. It's characterised by decreased lymphocytes data as well as lack of immunglobulin A, immunglobulin G subclasses and specific antibodies against pneumococcus as shown in many trials. Additionally the patients suffer from a fatty liver with increased transaminases and have the risk for a cirrhosis of the liver and a hepatocellular carcinoma. It's known that the dimension of the liver disease affects susceptibility to infection. Nevertheless there are only a few studies treating this problem.

Despite the proof of the immunodeficiency polyvalent immunoglobulins (IgG) are not given regularly. Own observations show that in spite of the treatment with immunoglobulins the progression of a chronic destructive lung disease with development of bronchiectasis hardly can prohibited.

Up to now it isn't cleared if a substitution therapy with immunoglobulins reduces the susceptibility to infection. Therefore the aim oft the present clinical trial ist to explore frequency-, intensity, and duration oft the infections as well as changes oft the immune status, measure of liver disease and tumor risk in patients with A-T, with and without immunoglobulin therapy. The study includes five visits, which are performed in all A-T patients. Visit 1, 3, 5 are realized in the context of annual follow ups:

* To evaluate weight and length of all subjects
* To analyze the exact structure of single body compartments such as the lean mass, the water compartment or the fat compartment using bioelectrical impedance analysis
* To define the neurological status by ataxia score
* To get a detailed immune status, vaccination status and liver values as well as special tumor markers in blood
* To check the lung function using spirometry
* To measure liver stiffness using transient elastography (FibroScan)
* To compile any symptoms of infection by diary
* To investigate the ataxia status and physical condition by means of the Five-Times-Sit-to-Stand Test

Visit 2 and 4 are additionally conducted as study visits:

* To get a detailed immune status in blood
* To check the lung function using spirometry

Conditions

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Ataxia Telangiectasia

Keywords

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immunodeficiency liver disease cancer risk

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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A-T patients

A-T patients aged 2 to 45 years with and without immunoglobulin G Substitution

* bioelectrical impedance Analysis
* blood draw
* transient elastography (FibroScan)
* ataxia score
* Five-Times-Sit-to-Stand Test

Group Type OTHER

bioelectrical impedance analysis

Intervention Type DIAGNOSTIC_TEST

Electrophysical measurement that allows to determine the exact composition of single body compartments by producing a magnetic field and detecting the potential difference through the body

blood draw

Intervention Type DIAGNOSTIC_TEST

Blood samples are taken from sober patients

transient elastography (FibroScan)

Intervention Type DIAGNOSTIC_TEST

FibroScan is a noninvasive tool to measure liver stiffness as an indication of fatty liver and liver fibrosis using ultrasound

ataxia score

Intervention Type DIAGNOSTIC_TEST

Klockgether ataxia score ranges from 0 to 35 points in which 0 means no symptoms and 35 stands for final stage of disease. It includes seven ataxia associated symptoms: dysarthria, intention tremor, ataxia of gait, stance, dysdiadochokinesia, upper limb and lower limb

Five-Times-Sit-to-Stand Test

Intervention Type DIAGNOSTIC_TEST

The test measures the complete time which is necessary for an individual to stand up and sit down on a chair five times in series

Interventions

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bioelectrical impedance analysis

Electrophysical measurement that allows to determine the exact composition of single body compartments by producing a magnetic field and detecting the potential difference through the body

Intervention Type DIAGNOSTIC_TEST

blood draw

Blood samples are taken from sober patients

Intervention Type DIAGNOSTIC_TEST

transient elastography (FibroScan)

FibroScan is a noninvasive tool to measure liver stiffness as an indication of fatty liver and liver fibrosis using ultrasound

Intervention Type DIAGNOSTIC_TEST

ataxia score

Klockgether ataxia score ranges from 0 to 35 points in which 0 means no symptoms and 35 stands for final stage of disease. It includes seven ataxia associated symptoms: dysarthria, intention tremor, ataxia of gait, stance, dysdiadochokinesia, upper limb and lower limb

Intervention Type DIAGNOSTIC_TEST

Five-Times-Sit-to-Stand Test

The test measures the complete time which is necessary for an individual to stand up and sit down on a chair five times in series

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* aim group: genetically and/or clinically diagnosed A-T
* age 2-45 years
* written informed consent

Exclusion Criteria

* age \< 2 or \> 45 years
* other diseases with influence on the immune system (i.e. diabetes mellitus, malignoma, dialysis-dependent renal failure)
Minimum Eligible Age

2 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Johann Wolfgang Goethe University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Stefan Zielen

Prof. Dr. med. Stefan Zielen

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Stefan Zielen, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital, Allergology, Pneumology and Cystic Fibrosis, Goethe-University

Locations

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Children's Hospital, Allergology, Pneumology and Cystic Fibrosis, Goethe University Frankfurt

Frankfurt am Main, Hesse, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Sandra Woelke, Dr.

Role: CONTACT

Phone: 00496930183063

Email: [email protected]

Stefan Zielen, Prof. Dr.

Role: CONTACT

Phone: 00496930183063

Email: [email protected]

Facility Contacts

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Sandra Wölke, Dr.

Role: primary

Stefan Zielen, Prof. Dr.

Role: backup

References

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Zielen S, Duecker RP, Woelke S, Donath H, Bakhtiar S, Buecker A, Kreyenberg H, Huenecke S, Bader P, Mahlaoui N, Ehl S, El-Helou SM, Pietrucha B, Plebani A, van der Flier M, van Aerde K, Kilic SS, Reda SM, Kostyuchenko L, McDermott E, Galal N, Pignata C, Perez JLS, Laws HJ, Niehues T, Kutukculer N, Seidel MG, Marques L, Ciznar P, Edgar JDM, Soler-Palacin P, von Bernuth H, Krueger R, Meyts I, Baumann U, Kanariou M, Grimbacher B, Hauck F, Graf D, Granado LIG, Prader S, Reisli I, Slatter M, Rodriguez-Gallego C, Arkwright PD, Bethune C, Deripapa E, Sharapova SO, Lehmberg K, Davies EG, Schuetz C, Kindle G, Schubert R. Simple Measurement of IgA Predicts Immunity and Mortality in Ataxia-Telangiectasia. J Clin Immunol. 2021 Nov;41(8):1878-1892. doi: 10.1007/s10875-021-01090-8. Epub 2021 Sep 3.

Reference Type DERIVED
PMID: 34477998 (View on PubMed)

Other Identifiers

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InfectionandLiver_AT2016

Identifier Type: -

Identifier Source: org_study_id