Role of the Nuclear Pore Component RANBP2 in Inflammatory Responses to Viral Infections

NCT ID: NCT06731790

Last Updated: 2026-02-05

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

Clinical Phase

NA

Total Enrollment

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-24

Study Completion Date

2025-09-01

Brief Summary

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The goal of this controlled, pathophysiological, exploratory interventional study is to compare the inflammatory phenotype of circulating immune cells, basal and following stimulation, from Acute Necrotizing Encephalopathy Type 1 (ANE1) patients with those from sex- and age-matched donors who do not carry the mutation.To date, no study has investigated the molecular mechanisms regulating the inflammatory response in ANE1 disease directly on patient samples.

The primary endpoint in individuals in the "mutated RANBP2" arm is an inflammatory phenotype (hyperinflammatory monocytes, secretion of pro-inflammatory cytokines, anti-glycoprotein autoantibodies), significantly exacerbated basal and/or post-stimulation production of pro-inflammatory cytokines compared with the control arm.

The secondary objective is to examine the allelic expression of mutant RANBP2 and characterize genetic variants by whole-exome sequencing, in order to associate them with RANBP2 protein localization and ANE crisis severity

The researchers will compare the group of ANE1 patients with age- and sex-matched control groups, divided into two subgroups: unrelated controls and controls with familial ties. The aim is to study the different types of inflammatory responses and correlate them with the localization of the RANBP2 protein and the severity of ANE episodes.

Participants will participate in a single visit during which demographic data, clinical history and a blood test will be collected with one (unrelated control) or two blood tubes (ANE1 and related control).

Detailed Description

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The nucleoporin RANBP2, also known as Nup358, is a component of the cytoplasmic filaments of nuclear pore complexes (NPCs), which regulate the transport of macromolecules between the cytoplasm and the nucleus. Mutations in the RANBP2 gene are associated with a rare genetic predisposition to acute necrotizing encephalopathy (ANE1), a predominantly pediatric disease characterized by multiple, symmetrical hemorrhagic lesions of the brain following febrile infection, most often with influenza A virus (IAV). Given the presumed inflammatory nature of ANE1, first-line treatment includes intravenous administration of high-dose pharmacological corticosteroids with or without immunoglobulins. In addition, two clinical cases report that IL-6 inhibition by tocilumizab may have a beneficial role.

The research team have recently demonstrated that loss or mislocalisation of RANBP2, as seen with ANE-linked mutations, boosts influenza virus replication and triggers excessive inflammation.

The researchers hypothesis is that mutation of RANBP2 in ANE1 patients weakens nuclear pore control of innate immune signaling pathways, leading to an exacerbated inflammatory response to infections.

Conditions

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Rare Genetic Disease Acute Necrotizing Encephalopathy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Controlled, pathophysiological, exploratory interventional pilot study
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Mutant RANBP2 associated with predisposition to ANE1

Subjects aged 1 to 90 with a T585M mutation in RANBP2 for the "RANBP2 mutation" arm. During a single visit, 2 tubes of blood will be sampled, demographic data and clinical history collected, and a clinical examination performed.

Group Type EXPERIMENTAL

Blood sampling for genetic analysis

Intervention Type GENETIC

Collection of a blood tube for whole exome sequencing, , long-read sequencing of the RANBP2 gene and analysis of the presence of the mutation by RTqPCR.

Blood sampling for inflammatory phenotype analysis

Intervention Type OTHER

Blood sampling for basal and post-stimulation inflammatory phenotype analysis

Healthy control subjects

For healthy control subjects related to a person from the "mutant RANBP2" arm: During a single visit, 2 tubes of blood will be sampled, demographic data and clinical history collected, and a clinical examination performed. Healthy control subjects related to a person from the "mutant RANBP2" arm will be included in the third Secondary Outcome (whole exome sequencing).

For healthy control subjects unrelated to a person from the "mutant RANBP2" arm: During a routine epilepsy consultation for children, or a family disease screening for adults, an additional blood tube will be sampled, demographic data collected and a clinical examination performed. Healthy control subjects unrelated to a person from the "mutant RANBP2" arm will not be included in the third Secondary Outcome (whole exome sequencing).

Group Type ACTIVE_COMPARATOR

Blood sampling for genetic analysis

Intervention Type GENETIC

Collection of a blood tube for whole exome sequencing, , long-read sequencing of the RANBP2 gene and analysis of the presence of the mutation by RTqPCR.

Blood sampling for inflammatory phenotype analysis

Intervention Type OTHER

Blood sampling for basal and post-stimulation inflammatory phenotype analysis

Interventions

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Blood sampling for genetic analysis

Collection of a blood tube for whole exome sequencing, , long-read sequencing of the RANBP2 gene and analysis of the presence of the mutation by RTqPCR.

Intervention Type GENETIC

Blood sampling for inflammatory phenotype analysis

Blood sampling for basal and post-stimulation inflammatory phenotype analysis

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Obtaining written consent from adult participants
* Obtaining written consent from legal guardians of minors with their assent
* Subjects aged 1 to 90
* Subject with a T585M mutation in RANBP2 for the RANBP2 mutation arm.
* Subjects matched on age (+/- 10 years) and gender for the "control" arm.

Exclusion Criteria

* Patient not affiliated to a social security scheme or not a beneficiary of such a scheme. (for example, a European Health Insurance Card (EHIC))
* Absence of written informed consent
* Person unable to give consent
* legally protected adult (guardianship, curatorship)
* Person deprived of liberty
* Person participating in another research study with an exclusion period still in progress
Minimum Eligible Age

1 Year

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Institut de Recherche en Infectiologie de Montpellier (CNRS)

UNKNOWN

Sponsor Role collaborator

A*STAR Infectious Diseases Labs

INDUSTRY

Sponsor Role collaborator

University Hospital, Montpellier

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pierre MEYER, MD

Role: PRINCIPAL_INVESTIGATOR

Montpellier University Hospital

Locations

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CHU Gui de Chauliac

Montpellier, Hérault, France

Site Status

Countries

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France

References

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Koh JC, Murugasu A, Krishnappa J, Thomas T. Favorable Outcomes With Early Interleukin 6 Receptor Blockade in Severe Acute Necrotizing Encephalopathy of Childhood. Pediatr Neurol. 2019 Sep;98:80-84. doi: 10.1016/j.pediatrneurol.2019.04.009. Epub 2019 Apr 25.

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Li J, Huo F, Wang S, Fan Y, Wu J, Zhang Z, Liu S, Wang Q. Recurrent infection triggered encephalopathy syndrome in a pediatric patient with RANBP2 mutation and severe acute respiratory syndrome coronavirus 2 infection. Pediatr Investig. 2023 Nov 19;7(4):290-296. doi: 10.1002/ped4.12406. eCollection 2023 Dec.

Reference Type BACKGROUND
PMID: 38050538 (View on PubMed)

Jiang J, Wang YE, Palazzo AF, Shen Q. Roles of Nucleoporin RanBP2/Nup358 in Acute Necrotizing Encephalopathy Type 1 (ANE1) and Viral Infection. Int J Mol Sci. 2022 Mar 24;23(7):3548. doi: 10.3390/ijms23073548.

Reference Type BACKGROUND
PMID: 35408907 (View on PubMed)

Levine JM, Ahsan N, Ho E, Santoro JD. Genetic Acute Necrotizing Encephalopathy Associated with RANBP2: Clinical and Therapeutic Implications in Pediatrics. Mult Scler Relat Disord. 2020 Aug;43:102194. doi: 10.1016/j.msard.2020.102194. Epub 2020 May 15.

Reference Type BACKGROUND
PMID: 32426208 (View on PubMed)

Denier C, Balu L, Husson B, Nasser G, Burglen L, Rodriguez D, Labauge P, Chevret L. Familial acute necrotizing encephalopathy due to mutation in the RANBP2 gene. J Neurol Sci. 2014 Oct 15;345(1-2):236-8. doi: 10.1016/j.jns.2014.07.025. Epub 2014 Jul 18.

Reference Type BACKGROUND
PMID: 25128471 (View on PubMed)

Neilson DE, Adams MD, Orr CM, Schelling DK, Eiben RM, Kerr DS, Anderson J, Bassuk AG, Bye AM, Childs AM, Clarke A, Crow YJ, Di Rocco M, Dohna-Schwake C, Dueckers G, Fasano AE, Gika AD, Gionnis D, Gorman MP, Grattan-Smith PJ, Hackenberg A, Kuster A, Lentschig MG, Lopez-Laso E, Marco EJ, Mastroyianni S, Perrier J, Schmitt-Mechelke T, Servidei S, Skardoutsou A, Uldall P, van der Knaap MS, Goglin KC, Tefft DL, Aubin C, de Jager P, Hafler D, Warman ML. Infection-triggered familial or recurrent cases of acute necrotizing encephalopathy caused by mutations in a component of the nuclear pore, RANBP2. Am J Hum Genet. 2009 Jan;84(1):44-51. doi: 10.1016/j.ajhg.2008.12.009.

Reference Type BACKGROUND
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Mizuguchi M, Abe J, Mikkaichi K, Noma S, Yoshida K, Yamanaka T, Kamoshita S. Acute necrotising encephalopathy of childhood: a new syndrome presenting with multifocal, symmetric brain lesions. J Neurol Neurosurg Psychiatry. 1995 May;58(5):555-61. doi: 10.1136/jnnp.58.5.555.

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Other Identifiers

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RECHMPL23_0455

Identifier Type: -

Identifier Source: org_study_id

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