Deciphering a Specific Signature of the Immunosenescence Induced in COVID-19+ Patients Versus Rheumatoid Arthritis Patients

NCT ID: NCT04880720

Last Updated: 2023-01-05

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 43 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2021-07-19
• Study Completion Date: 2022-11-16

Brief Summary

Immune aging or immunosenescence is characterized by a loss of T cell clonal diversity and a contraction of naïve T cells with proliferative capacity associated with the functional impairment of many others immune cells as well as a chronic low degree of inflammation. A restrictive T cell repertoire is likely more prone to antigen-mediated exhaustion observed during chronic viral infections. Notably, lymphopenia is the most consistent laboratory abnormality in COVID-19 infected patients and both lung-resident and circulating T cells potently up-regulate markers of T cell exhaustion. It is not clear today if the association of COVID-19 disease severity with age is mainly related with the immunosenescence of infected patients. Interestingly, T cell exhaustion and premature immunosenescence have also been observed in chronic inflammatory diseases such as rheumatoid arthritis (RA). To better understand the immunological mechanisms involved in SARS-Cov-2 pathophysiology, the investigators propose to compare the immunosenescence patterns observed during RA, aging and SARS-Cov-2 infected patients in order to design improved therapeutic interventions.

Conditions

SARS-Cov-2 Infection; Rheumatoid Arthritis

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: PROSPECTIVE

Study Groups

COVID-19 Patients

Blood sampling

Intervention Type: OTHER

Blood sampling - 10mL

Rheumatoid Arthritis Patients

Blood sampling

Intervention Type: OTHER

Blood sampling - 10mL

Healthy Comparator

Blood sampling

Intervention Type: OTHER

Blood sampling - 10mL

Interventions

Blood sampling

Blood sampling - 10mL

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patients with rheumatoid arthritis (RA) meeting the 2010 ACR/EULAR diagnostic criteria
• Patients in inflammatory flare of RA (DAS28 > 3.2)
• Patients who have been off biological disease-modifying antirheumatic drugs (bDMARDs) or targeted synthetic antirheumatic drugs (tsDMARDs) for RA for at least 2 weeks (except for rituximab, where a delay of at least 12 months is required)
• Conventional synthetic DMARDs (Methotrexate, Hydroxychloroquine, Leflunomide, Sulfasalazine) are allowed
• Beneficiary of a social security system
• Informed consent

• Absence of chronic diseases and current infection
• Beneficiary of a social security system
• Informed consent

• Patients with ongoing SARS-Cov-2 infection (PCR+)
• Patients hospitalized at D7-D14 of symptoms onset
• Patients with two or more SARS-Cov-2 symptoms (including fever, cough, dyspnea, sore throat, chest pain, anosmia, diarrhea)
• Membership in or beneficiary of a social security scheme
• Collection of free and informed consent

Exclusion Criteria

• Subjects under 18 years of age
• HIV positive patients
• Diabetic patients
• Morbidly obese patients (BMI > 40kg/m2)
• Use of senolytic drugs in the week prior to inclusion (azithromycin, metformin, cyclosporine, JAK inhibitors)
• Use of steroids in doses greater than 10 mg/day in the week prior to inclusion
• Subjects unable to give consent
• Pregnant, breastfeeding, or non-menopausal women not taking effective contraception
• Vulnerable subjects protected by law
• Subjects under guardianship or curatorship

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University Hospital, Montpellier

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

CHU Montpellier

Montpellier, , France

Countries

France

References

Wang R, Pan M, Zhang X, Han M, Fan X, Zhao F, Miao M, Xu J, Guan M, Deng X, Chen X, Shen L. Epidemiological and clinical features of 125 Hospitalized Patients with COVID-19 in Fuyang, Anhui, China. Int J Infect Dis. 2020 Jun;95:421-428. doi: 10.1016/j.ijid.2020.03.070. Epub 2020 Apr 11.

Reference Type: BACKGROUND

PMID: 32289565 (View on PubMed)

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648. No abstract available.

Reference Type: BACKGROUND

PMID: 32091533 (View on PubMed)

Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, Shi J, Zhou M, Wu B, Yang Z, Zhang C, Yue J, Zhang Z, Renz H, Liu X, Xie J, Xie M, Zhao J. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020 Jul;146(1):110-118. doi: 10.1016/j.jaci.2020.04.006. Epub 2020 Apr 12.

Reference Type: BACKGROUND

PMID: 32294485 (View on PubMed)

Rockx B, Baas T, Zornetzer GA, Haagmans B, Sheahan T, Frieman M, Dyer MD, Teal TH, Proll S, van den Brand J, Baric R, Katze MG. Early upregulation of acute respiratory distress syndrome-associated cytokines promotes lethal disease in an aged-mouse model of severe acute respiratory syndrome coronavirus infection. J Virol. 2009 Jul;83(14):7062-74. doi: 10.1128/JVI.00127-09. Epub 2009 May 6.

Reference Type: BACKGROUND

PMID: 19420084 (View on PubMed)

Maringer K, Fernandez-Sesma A. Message in a bottle: lessons learned from antagonism of STING signalling during RNA virus infection. Cytokine Growth Factor Rev. 2014 Dec;25(6):669-79. doi: 10.1016/j.cytogfr.2014.08.004. Epub 2014 Aug 24.

Reference Type: BACKGROUND

PMID: 25212897 (View on PubMed)

Nikolich-Zugich J. The twilight of immunity: emerging concepts in aging of the immune system. Nat Immunol. 2018 Jan;19(1):10-19. doi: 10.1038/s41590-017-0006-x. Epub 2017 Dec 14.

Reference Type: BACKGROUND

PMID: 29242543 (View on PubMed)

Fulop T, Larbi A, Dupuis G, Le Page A, Frost EH, Cohen AA, Witkowski JM, Franceschi C. Immunosenescence and Inflamm-Aging As Two Sides of the Same Coin: Friends or Foes? Front Immunol. 2018 Jan 10;8:1960. doi: 10.3389/fimmu.2017.01960. eCollection 2017.

Reference Type: BACKGROUND

PMID: 29375577 (View on PubMed)

Tachikart Y, Malaise O, Mumme M, Jorgensen C, Brondello JM. Seno-suppressive molecules as new therapeutic perspectives in rheumatic diseases. Biochem Pharmacol. 2019 Jul;165:126-133. doi: 10.1016/j.bcp.2019.03.017. Epub 2019 Mar 13.

Reference Type: BACKGROUND

PMID: 30878551 (View on PubMed)

Oh SJ, Lee JK, Shin OS. Aging and the Immune System: the Impact of Immunosenescence on Viral Infection, Immunity and Vaccine Immunogenicity. Immune Netw. 2019 Nov 14;19(6):e37. doi: 10.4110/in.2019.19.e37. eCollection 2019 Dec.

Reference Type: BACKGROUND

PMID: 31921467 (View on PubMed)

Vicente R, Mausset-Bonnefont AL, Jorgensen C, Louis-Plence P, Brondello JM. Cellular senescence impact on immune cell fate and function. Aging Cell. 2016 Jun;15(3):400-6. doi: 10.1111/acel.12455. Epub 2016 Feb 22.

Reference Type: BACKGROUND

PMID: 26910559 (View on PubMed)

Campos C, Pera A, Sanchez-Correa B, Alonso C, Lopez-Fernandez I, Morgado S, Tarazona R, Solana R. Effect of age and CMV on NK cell subpopulations. Exp Gerontol. 2014 Jun;54:130-7. doi: 10.1016/j.exger.2014.01.008. Epub 2014 Jan 17.

Reference Type: BACKGROUND

PMID: 24440462 (View on PubMed)

Appay V, Almeida JR, Sauce D, Autran B, Papagno L. Accelerated immune senescence and HIV-1 infection. Exp Gerontol. 2007 May;42(5):432-7. doi: 10.1016/j.exger.2006.12.003. Epub 2007 Jan 8.

Reference Type: BACKGROUND

PMID: 17307327 (View on PubMed)

Goronzy JJ, Lee WW, Weyand CM. Aging and T-cell diversity. Exp Gerontol. 2007 May;42(5):400-6. doi: 10.1016/j.exger.2006.11.016. Epub 2007 Jan 10.

Reference Type: BACKGROUND

PMID: 17218073 (View on PubMed)

Lin L, Lu L, Cao W, Li T. Hypothesis for potential pathogenesis of SARS-CoV-2 infection-a review of immune changes in patients with viral pneumonia. Emerg Microbes Infect. 2020 Dec;9(1):727-732. doi: 10.1080/22221751.2020.1746199.

Reference Type: BACKGROUND

PMID: 32196410 (View on PubMed)

de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016 Aug;14(8):523-34. doi: 10.1038/nrmicro.2016.81. Epub 2016 Jun 27.

Reference Type: BACKGROUND

PMID: 27344959 (View on PubMed)

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24.

Reference Type: BACKGROUND

PMID: 31986264 (View on PubMed)

D'Antiga L. Coronaviruses and Immunosuppressed Patients: The Facts During the Third Epidemic. Liver Transpl. 2020 Jun;26(6):832-834. doi: 10.1002/lt.25756. Epub 2020 Apr 24. No abstract available.

Reference Type: BACKGROUND

PMID: 32196933 (View on PubMed)

Giacalone VD, Margaroli C, Mall MA, Tirouvanziam R. Neutrophil Adaptations upon Recruitment to the Lung: New Concepts and Implications for Homeostasis and Disease. Int J Mol Sci. 2020 Jan 28;21(3):851. doi: 10.3390/ijms21030851.

Reference Type: BACKGROUND

PMID: 32013006 (View on PubMed)

Biswas SK, Mantovani A. Macrophage plasticity and interaction with lymphocyte subsets: cancer as a paradigm. Nat Immunol. 2010 Oct;11(10):889-96. doi: 10.1038/ni.1937. Epub 2010 Sep 20.

Reference Type: BACKGROUND

PMID: 20856220 (View on PubMed)

Nicolas-Avila JA, Adrover JM, Hidalgo A. Neutrophils in Homeostasis, Immunity, and Cancer. Immunity. 2017 Jan 17;46(1):15-28. doi: 10.1016/j.immuni.2016.12.012.

Reference Type: BACKGROUND

PMID: 28099862 (View on PubMed)

Cloke T, Munder M, Bergin P, Herath S, Modolell M, Taylor G, Muller I, Kropf P. Phenotypic alteration of neutrophils in the blood of HIV seropositive patients. PLoS One. 2013 Sep 9;8(9):e72034. doi: 10.1371/journal.pone.0072034. eCollection 2013.

Reference Type: BACKGROUND

PMID: 24039734 (View on PubMed)

Bowers NL, Helton ES, Huijbregts RP, Goepfert PA, Heath SL, Hel Z. Immune suppression by neutrophils in HIV-1 infection: role of PD-L1/PD-1 pathway. PLoS Pathog. 2014 Mar 13;10(3):e1003993. doi: 10.1371/journal.ppat.1003993. eCollection 2014 Mar.

Reference Type: BACKGROUND

PMID: 24626392 (View on PubMed)

Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal. 2020 Apr;10(2):102-108. doi: 10.1016/j.jpha.2020.03.001. Epub 2020 Mar 5.

Reference Type: BACKGROUND

PMID: 32282863 (View on PubMed)

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, Xie C, Ma K, Shang K, Wang W, Tian DS. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020 Jul 28;71(15):762-768. doi: 10.1093/cid/ciaa248.

Reference Type: BACKGROUND

PMID: 32161940 (View on PubMed)

Zheng M, Gao Y, Wang G, Song G, Liu S, Sun D, Xu Y, Tian Z. Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cell Mol Immunol. 2020 May;17(5):533-535. doi: 10.1038/s41423-020-0402-2. Epub 2020 Mar 19. No abstract available.

Reference Type: BACKGROUND

PMID: 32203188 (View on PubMed)

Other Identifiers

RECHMPL20_0454

Identifier Type: -

Identifier Source: org_study_id