Adversity and Its Association With the Development and Expression of Rheumatic Diseases

NCT ID: NCT06386380

Last Updated: 2024-05-03

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

NOT_YET_RECRUITING

Total Enrollment

110 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-06-01

Study Completion Date

2026-02-01

Brief Summary

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Epidemiological evidence shows that adverse experiences, particularly, but not exclusively in childhood, are predictors of poor long-term health outcomes and certain social domains. In the field of rheumatic diseases, traumatic events, not only in childhood, have been associated with hospitalization, chronic pain, inflammation, worse outcomes, severity of the disease, and mortality. Some mechanisms proposed to explain the association between the experience of adversity and the development of chronic diseases include an impact on the physiology of immune system cells, gene expression due to DNA modification, and cellular senescence.

With this background, the investigators wonder if, for patients with rheumatoid arthritis, the presence of adversity understood as a history of violence in childhood and abuse due to suffering from rheumatoid arthritis is associated with markers of cellular senescence and with the severity of illness.

Detailed Description

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To answer this question, the investigators proposed conducting a study on outpatients diagnosed with rheumatoid arthritis treated at the INCMNSZ.

Patients who agree to participate will be asked to answer some questionnaires to report their perception of child abuse and abuse derived from suffering from rheumatoid arthritis, disease activity, disability, quality of life, anxiety, stress, depression, and resilience.

Additionally, a peripheral blood sample will be taken to evaluate cellular senescence through CD27, CD28, and CD57 expression, the relative expression of the p16INK4a gene in CD3+ lymphocytes, HLA-DR, CD25, and CD69, and telomere length. Finally, the expression of the severity of the disease will be determined.

Conditions

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RhA - Rheumatoid Arthritis

Study Design

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Observational Model Type

CASE_CROSSOVER

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Patients with rheumatoid arthritis

Patients with rheumatoid arthritis outpatients from the National Institute of Medical Sciences

Rheumatic diseases Mistreatment Scale (RDMS)

Intervention Type OTHER

In 2012, Giraldo-Rodríguez developed and validated the Geriatric Mistreatment Scale (GAS); translation, cultural adaptation, and validation were performed prior to its application.

Routine assessment of patient index data 3 (RAPID-3)

Intervention Type OTHER

RAPID- 3 measures: function, pain, and patient global status estimate. Each of the three individual measures is scored 0 to 10, for a total of 30

Health Assessment Questionnaire (HAQ)

Intervention Type OTHER

The HAQ is based on five patient-centered dimensions: disability, pain, medication effects, costs of care, and mortality.

WHOQOL-BREF

Intervention Type OTHER

WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health, psychological health, social relationships, and environmental health; it also contains QOL and general health items

Depression, Anxiety and Stress Scale (DASS-21)

Intervention Type OTHER

DASS-21 is a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. Each of the three DASS-21 scales contains seven items, divided into subscales with similar content.

Brief Resilient Coping Scale

Intervention Type OTHER

The Brief Resilient Coping Scale is a 4-item measure designed to capture tendencies to cope with stress in a highly adaptive manner.

Expression of CDKN2A /p16INK4a

Intervention Type GENETIC

CDKN2A/p16INK4a expression will be measured using the Taqman qPCR assay (TaqMan Universal Master Mix II, with UNG, Applied Biosystems, Foster City, USA) according to the manufacturer's specifications.

Immunophenotype of leukocyte subpopulations

Intervention Type OTHER

CD4+ and CD8+ subpopulations will be analyzed. Blood samples will be analyzed by 8-color flow cytometry (Becton Dickinson Canto II cytometer) using fluorescently labeled antibodies from Biolegend Inc. (San Diego, USA).

Telomere length

Intervention Type GENETIC

The rLTL will be estimated by quantitative monochromatic multiplex PCR (MM-qPCR). Integrated DNA Technologies, Inc. (IDT, Coralville, IA, USA) will synthesize the primers used for telomere measurements.

Cellular senescence

Intervention Type OTHER

Expression of co-stimulatory molecules and surface receptors CD27- and CD28-

Interventions

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Rheumatic diseases Mistreatment Scale (RDMS)

In 2012, Giraldo-Rodríguez developed and validated the Geriatric Mistreatment Scale (GAS); translation, cultural adaptation, and validation were performed prior to its application.

Intervention Type OTHER

Routine assessment of patient index data 3 (RAPID-3)

RAPID- 3 measures: function, pain, and patient global status estimate. Each of the three individual measures is scored 0 to 10, for a total of 30

Intervention Type OTHER

Health Assessment Questionnaire (HAQ)

The HAQ is based on five patient-centered dimensions: disability, pain, medication effects, costs of care, and mortality.

Intervention Type OTHER

WHOQOL-BREF

WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health, psychological health, social relationships, and environmental health; it also contains QOL and general health items

Intervention Type OTHER

Depression, Anxiety and Stress Scale (DASS-21)

DASS-21 is a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. Each of the three DASS-21 scales contains seven items, divided into subscales with similar content.

Intervention Type OTHER

Brief Resilient Coping Scale

The Brief Resilient Coping Scale is a 4-item measure designed to capture tendencies to cope with stress in a highly adaptive manner.

Intervention Type OTHER

Expression of CDKN2A /p16INK4a

CDKN2A/p16INK4a expression will be measured using the Taqman qPCR assay (TaqMan Universal Master Mix II, with UNG, Applied Biosystems, Foster City, USA) according to the manufacturer's specifications.

Intervention Type GENETIC

Immunophenotype of leukocyte subpopulations

CD4+ and CD8+ subpopulations will be analyzed. Blood samples will be analyzed by 8-color flow cytometry (Becton Dickinson Canto II cytometer) using fluorescently labeled antibodies from Biolegend Inc. (San Diego, USA).

Intervention Type OTHER

Telomere length

The rLTL will be estimated by quantitative monochromatic multiplex PCR (MM-qPCR). Integrated DNA Technologies, Inc. (IDT, Coralville, IA, USA) will synthesize the primers used for telomere measurements.

Intervention Type GENETIC

Cellular senescence

Expression of co-stimulatory molecules and surface receptors CD27- and CD28-

Intervention Type OTHER

Other Intervention Names

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RD-MS RAPID-3 HAQ DASS-21 BRCS

Eligibility Criteria

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Inclusion Criteria

* Patients with a rheumatoid arthritis diagnosis, according to their primary rheumatologist who agrees to participate

Exclusion Criteria

* Patients with a not confirmed rheumatoid arthritis diagnosis
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Medical Sciences and Nutrition, Salvador Zubiran

OTHER

Sponsor Role lead

Responsible Party

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Virginia Pascual Ramos

Dr

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Virginia MD Pascual-Ramos, MD

Role: PRINCIPAL_INVESTIGATOR

IInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Central Contacts

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Virginia MD Pascual-Ramos, MD

Role: CONTACT

525555734111 ext. 533

Irazu MD Contreras-Yáñez, MD

Role: CONTACT

525555734111 ext. 533

References

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Baumer Y, Powell-Wiley TM. Interdisciplinary approaches are fundamental to decode the biology of adversity. Cell. 2021 May 27;184(11):2797-2801. doi: 10.1016/j.cell.2021.04.010.

Reference Type RESULT
PMID: 34048701 (View on PubMed)

Other Identifiers

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IRE-4906

Identifier Type: -

Identifier Source: org_study_id

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