Systemic Lupus Erythematosus and Chlordecone Impregnation in Martinique

NCT ID: NCT06365359

Last Updated: 2025-03-31

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

RECRUITING

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-01-02

Study Completion Date

2026-09-02

Brief Summary

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Chlordecone, an organochlorine pesticide, was widely used on banana farms in the French West Indies. Studies by Inserm and health authorities have confirmed the contamination of the food chain and the majority of the population of the French West Indies by chlordecone.

Epidemiological studies conducted in the French West Indies have shown that exposure to chlordecone at the levels observed is associated with an increased risk of developing several diseases, including premature birth and prostate cancer. Many of the adverse effects associated with chlordecone could be explained by its estrogenic hormonal properties, and systemic lupus erythematosus (SLE) is an autoimmune disease whose sensitivity to estrogen is well known and is reflected by 1) its clear predominance in women, 2) its predominance in women of childbearing age, 3) its risk of exacerbation in the event of pregnancy.

Chlordecone has the potential to modify the activity of SLE through mechanisms other than its pro-estrogenic effects. In rats, chlordecone was observed to induce alterations such as a reduction in lymphocyte count, thymic atrophy, and a decrease in splenic germinal centers and NK cells.

In a mouse model of systemic lupus erythematosus (SLE), exposure to chlordecone results in increased production of immune complexes and anti-DNA antibodies, which are markers of disease activity and monitoring.

Chlordecone also has a cellular effect that reduces the apoptosis of potentially auto-reactive lymphocytes and stimulates the production of GM-CSF, IL-2, TNF-alpha, and IFN-gamma. The latter is central to the pathophysiology of SLE. While experimental studies suggest a potential impact of chlordecone on SLE, no human studies have been conducted to date, and the chlordecone impregnation of lupus patients in Martinique remains unknown.

The most serious and feared complication of SLE is kidney damage. Kidney damage from the disease and the necessary immunosuppressive treatments can lead to significant morbidity and mortality, including death and end-stage chronic renal failure. Therefore, it is important to manage the disease carefully. Suspected lupus nephritis is confirmed by a renal biopsy, which allows for formal diagnosis and categorization into several classes. Suspected cases are identified by a proteinuria to creatininuria ratio greater than 0.5 g/g (or 24-hour proteinuria greater than 0.5g).

The objective of this project is to determine whether there is a positive association between lupus nephritis occurrence in patients followed by the internal medicine department of the Martinique University Hospital and organochlorine pesticide chlordecone impregnation.

Detailed Description

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Conditions

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Systemic Lupus Erythematosus Renal Disease

Keywords

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Systemic Lupus Erythematosus Chlordecone impregnation Organochlorine pesticide (chlordecone, p,p'-DDE, βHCH, γHCH, PCB 153) Renal Disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Lupus patients who consult the Martinique University Hospital

Blood sample for analysis of plasma of organochlorine pesticides concentration

Intervention Type OTHER

A 20 mL blood sample will be taken up to 6 months after inclusion of the patient for the analysis of chlordecone and the following organochlorine compounds: p,p'-DDE, βHCH, γHCH, PCB 153. This analysis will be carried out at the Institut Pasteur of Guadeloupe (IPG).

Blood sample for cell collection

Intervention Type OTHER

A 20 mL blood sample will be taken up to 6 months after inclusion of the patient for the cell collection which will be kept at the CeRBiM.

This collection will be used for subsequent studies on the immunotoxicity of chlordecone, by studying the cytokine, apoptotic and autoreactive functions of PBMC (Peripheral Blood Mononuclear Cells).

Interventions

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Blood sample for analysis of plasma of organochlorine pesticides concentration

A 20 mL blood sample will be taken up to 6 months after inclusion of the patient for the analysis of chlordecone and the following organochlorine compounds: p,p'-DDE, βHCH, γHCH, PCB 153. This analysis will be carried out at the Institut Pasteur of Guadeloupe (IPG).

Intervention Type OTHER

Blood sample for cell collection

A 20 mL blood sample will be taken up to 6 months after inclusion of the patient for the cell collection which will be kept at the CeRBiM.

This collection will be used for subsequent studies on the immunotoxicity of chlordecone, by studying the cytokine, apoptotic and autoreactive functions of PBMC (Peripheral Blood Mononuclear Cells).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients with systemic lupus erythematosus according to the ACR 1997 or ACR/EULAR 2019 criteria,
* Present in the active line of the internal medicine department of the Martinique University Hospital since 2005,
* Whose illness has been progressing for at least 3 years,
* Living in Martinique or Guadeloupe for at least 1 year,
* Patients who have given their free, informed and written consent.

Exclusion Criteria

* Patients for whom kidney disease cannot be authenticated or ruled out (refusal, contraindication or impossibility of renal biopsy),
* Patients without social security coverage,
* Current legal protection,
* Patients who have not given their consent to the use of their data,
* Pregnant or breastfeeding women.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Pasteur de Guadeloupe

UNKNOWN

Sponsor Role collaborator

Centre de Ressources Biologiques de la Martinique (CeRBiM)

UNKNOWN

Sponsor Role collaborator

University Hospital Center of Martinique

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Benoît SUZON, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital Center of Martinique

Locations

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University Hospital Center of Martinique

Fort-de-France, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Benoît SUZON, PhD

Role: CONTACT

Phone: 05 96 55 97 05

Email: [email protected]

Facility Contacts

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Yann MOPSUS, MSc

Role: primary

Other Identifiers

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23_RIPH2-12

Identifier Type: -

Identifier Source: org_study_id