The Role of Immune Semaphorins in NAFLD

NCT ID: NCT04573543

Last Updated: 2023-08-30

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

COMPLETED

Total Enrollment

160 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-09-01

Study Completion Date

2022-03-01

Brief Summary

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To goal is to identify semaphorins that are associated with NAFLD and to investigate their relationship with variable degrees of steatosis and fibrosis.

Detailed Description

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Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease associated with systemic changes in immune response. Semaphorins were recently recognized as one of the key regulators of immune responses; while some suppress immune cells activation, proliferation, and production of inflammatory cytokines, others stimulate immune responses. We have previously shown that semaphorins are associated with pathogenesis of viral hepatitis and progression of fibrosis. However, their role in NAFLD is unknown. The hypothesis of this project is that semaphorins are regulators of inflammation in patients with NAFLD. This study is designed as a prospective, non-interventional study. The main aims are: (1) to analyze serum concentration of semaphorins in patients with NAFLD; (2) to analyze tissue expression of semaphorins in patients with NAFLD; (3) to analyze semaphorin gene polymorphisms associated with NAFLD. Semaphorins could be a novel diagnostic and prognostic biomarker as well as targets for immune modulation.

Conditions

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Non-Alcoholic Fatty Liver Disease Immune Response Biomarkers Liver Fibrosis Non Alcoholic Steatohepatitis

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with Non-alcoholic fatty liver disease

120 patients diagnosed with NAFLD

Evaluation of the degree of fibrosis and steatosis

Intervention Type DIAGNOSTIC_TEST

The degree of steatosis will be estimated using the controlled attenuation parameter (CAP), a method for grading steatosis by measuring the degree of ultrasound attenuation by hepatic fat using a process based on simultaneous transient elastography (TE) which measures the degree of fibrosis.

Screening for the components of metabolic syndrome

Intervention Type DIAGNOSTIC_TEST

Anthropometric measures including body mass index (BMI), waist circumference (WC), waist hip ratio (WHR), and waist height ratio (WHtR) will be measured in all patients.

Results of the routine laboratory tests as part of the standard diagnostic procedure will be collected: bilirubin, AST, ALT, GGT, ALP, albumins, WBC, neutrophil-to-lymphocyte ratio, hemoglobin, platelet count, fasting glucose, triglycerides, cholesterol, HDL and LDL. Non-invasive scores of steatosis/fibrosis will be calculated (APRI, FIB4, NAFLD score). Patients will be screened for the components of metabolic syndrome.

Measurement of serum semaphorin concentrations

Intervention Type DIAGNOSTIC_TEST

Semaphorin concentration will be measured in patient sera by ELISA.

Identification of semaphorin gene polymorphisms

Intervention Type DIAGNOSTIC_TEST

Semaphorin genes will be sequenced to identify semaphorin gene polymorphisms associated with NAFLD.

Controls

40 healthy controls

Evaluation of the degree of fibrosis and steatosis

Intervention Type DIAGNOSTIC_TEST

The degree of steatosis will be estimated using the controlled attenuation parameter (CAP), a method for grading steatosis by measuring the degree of ultrasound attenuation by hepatic fat using a process based on simultaneous transient elastography (TE) which measures the degree of fibrosis.

Screening for the components of metabolic syndrome

Intervention Type DIAGNOSTIC_TEST

Anthropometric measures including body mass index (BMI), waist circumference (WC), waist hip ratio (WHR), and waist height ratio (WHtR) will be measured in all patients.

Results of the routine laboratory tests as part of the standard diagnostic procedure will be collected: bilirubin, AST, ALT, GGT, ALP, albumins, WBC, neutrophil-to-lymphocyte ratio, hemoglobin, platelet count, fasting glucose, triglycerides, cholesterol, HDL and LDL. Non-invasive scores of steatosis/fibrosis will be calculated (APRI, FIB4, NAFLD score). Patients will be screened for the components of metabolic syndrome.

Measurement of serum semaphorin concentrations

Intervention Type DIAGNOSTIC_TEST

Semaphorin concentration will be measured in patient sera by ELISA.

Identification of semaphorin gene polymorphisms

Intervention Type DIAGNOSTIC_TEST

Semaphorin genes will be sequenced to identify semaphorin gene polymorphisms associated with NAFLD.

Interventions

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Evaluation of the degree of fibrosis and steatosis

The degree of steatosis will be estimated using the controlled attenuation parameter (CAP), a method for grading steatosis by measuring the degree of ultrasound attenuation by hepatic fat using a process based on simultaneous transient elastography (TE) which measures the degree of fibrosis.

Intervention Type DIAGNOSTIC_TEST

Screening for the components of metabolic syndrome

Anthropometric measures including body mass index (BMI), waist circumference (WC), waist hip ratio (WHR), and waist height ratio (WHtR) will be measured in all patients.

Results of the routine laboratory tests as part of the standard diagnostic procedure will be collected: bilirubin, AST, ALT, GGT, ALP, albumins, WBC, neutrophil-to-lymphocyte ratio, hemoglobin, platelet count, fasting glucose, triglycerides, cholesterol, HDL and LDL. Non-invasive scores of steatosis/fibrosis will be calculated (APRI, FIB4, NAFLD score). Patients will be screened for the components of metabolic syndrome.

Intervention Type DIAGNOSTIC_TEST

Measurement of serum semaphorin concentrations

Semaphorin concentration will be measured in patient sera by ELISA.

Intervention Type DIAGNOSTIC_TEST

Identification of semaphorin gene polymorphisms

Semaphorin genes will be sequenced to identify semaphorin gene polymorphisms associated with NAFLD.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Patients diagnosed with NAFLD according to current guidelines (AASLD, EASL)

Exclusion Criteria

* Immunosuppression
* Malignancies
* Autoimmune diseases
* Pregnancy
* HIV
* Chronic viral hepatitis
* Presence of other chronic liver disease (hemochromatosis, Wilson's disease, toxic hepatitis, deficiency of alpha-1-antitrypsin, liver autoimmune disease)
* Consumption of alcohol \> 20 g/day
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Croatian Science Foundation

OTHER_GOV

Sponsor Role collaborator

University Hospital for Infectious Diseases, Croatia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Neven Papic, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital for Infectious Diseases Zagreb

Locations

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University Hospital for Infectious Diseases Zagreb

Zagreb, , Croatia

Site Status

Countries

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Croatia

References

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Samadan L, Papic N, Mijic M, Knezevic Stromar I, Gasparov S, Vince A. Do Semaphorins Play a Role in Development of Fibrosis in Patients with Nonalcoholic Fatty Liver Disease? Biomedicines. 2022 Nov 23;10(12):3014. doi: 10.3390/biomedicines10123014.

Reference Type RESULT
PMID: 36551769 (View on PubMed)

Other Identifiers

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UHID-05

Identifier Type: -

Identifier Source: org_study_id

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