MedPath

Local and Systemic Immunoprofiling of Patients Diagnosed With Ulcerative Colitis

Recruiting
Conditions
Ulcerative Colitis Flare
Registration Number
NCT05680883
Lead Sponsor
Radboud University Medical Center
Brief Summary

Immune-mediated diseases are extremely diverse - patients with the same diagnosis may see the disease progress in very different ways, and respond differently to treatments. This is because the course of the disease is influenced by multiple factors, including the patient's genes, immune system, environment, and the microbes living in their gut. Furthermore, all of these factors interact with and impact on one another. As a result, it is very hard to predict how the disease will develop in a specific patient, and which treatments will be effective. Hence, mechanistic understanding of this heterogeneity and biomarkers predictive for disease control and therapy response over time are important prerequisites of a future precision medicine in IMIDs. ImmUniverse has been formed as a European transdisciplinary consortium to tackle these unmet needs and to understand the role of the crosstalk between tissue microenvironment and immune cells in disease progression and response to therapy of ulcerative colitis (UC) and atopic dermatitis (AD).

The consortium will combine analysis of tissue-derived signatures with "circulating signatures" detectable in liquid biopsies, employing state-of-the-art profiling technologies to provide new validated diagnostics in IMID that are expected to improve patient management, lead to increased patient well-being and will significantly reduce the socioeconomic burden of these diseases. This study, being Immuniverse work package 5 (WP5), will verify the disease pathway -and mechanism signatures identified in the multi omic discovery WP2 in immune cells in affected tissue and peripheral blood. WP5 aims to further substantiate our understanding of the immune-mediated intestinal disease ulcerative colitis (UC). It will use liquid biopsies (peripheral blood) and affected UC gut inflamed and non-inflamed biopsies to generate transcriptome, proteome, DNA-methylome and miRNA signatures of immune cell subsets and analyse the association between immune cells circulating in peripheral blood and the microenvironment of affected colonic tissue.

Also this WP aims to develop a protocol to analyse and sort living immune cells from cryopreserved tissue. Ultimately, the project's findings should contribute to a better, more precise diagnosis for patients; and better information on how severe the disease is likely to be for each individual patient and how it will progress over time. Finally, the project will make it easier for doctors and patients to monitor how well a treatment is working in the future.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
40
Inclusion Criteria
  • Diagnosis of Ulcerative Colitis
  • Age ≥ 18 years
  • Present in the hospital for a regular outpatient visit
  • Willing and able to comply with the study related procedures
  • Provide signed informed consent
Exclusion Criteria
  • Age ≤ 18 years
  • Unable to give informed consent
  • Unable or unwilling to comply with study-related procedures
  • Crohn's Disease or IBD undiagnosed

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Comparing immune cells in blood, inflamed and uninflamed colonic biopsies by means of flow cytometryThrough study completion, an average of 1.5 years

Assessed by differences in percentages of cell populations in whole blood sampels vs. inflamed and uninflamed biopsies

Comparing gene expression profiles in blood, inflamed and uninflamed colonic biopsiesThrough study completion, an average of 1.5 years

Assessment of mean expression of genes in blood vs. inflamed and uninflamed biopsies by means of single cell RNA sequencing

Localizing immune cells of interest of inflamed and uninflamed biopsiesThrough study completion, an average of 1.5 years

By using immunohistochemistry: quantified by cells per field

Secondary Outcome Measures
NameTimeMethod
For 40 patients: SCCAI-scoreThrough study completion, an average of 1.5 years

Based on 6 variables:

1. Bowel frequency (day)

2. Bowel frequency (night)

3. Urgency of defecation

4. Blood in stool

5. General well-being

6. Extracolonic features

For 40 patients: smoking statusThrough study completion, an average of 1.5 years

1. Current/active smoker

2. Previous smoker

3. Never smoked

4. Not described

For 40 patients: Feacel calprotectinThrough study completion, an average of 1.5 years

mg/kg feces

For 40 patients: heightThrough study completion, an average of 1.5 years

Height in centimeter, combined with weight to get to BMI (kg/m\^2)

For 40 patients: Medication history and current medicationThrough study completion, an average of 1.5 years

anti-TNF, Vedolizumab, Janus kinase inhibitors, thiopurine, methotrexate, aminosalicylates, corticosteroids (grams of medication/day)

For 40 patients: weightThrough study completion, an average of 1.5 years

Weight in kilograms, combined with height to get to BMI (kg/m\^2)

For 40 patients: AlbuminThrough study completion, an average of 1.5 years

g/L

For 40 patients: montreal classificationThrough study completion, an average of 1.5 years

1. E1: ulcerative proctitis

2. E2: left-sided UC (distal to splenic flexure)

3. E3: Entensive UC (pancolitis)

For 40 patients: Mayo score (based on physician rating of endoscopic disease activity)Through study completion, an average of 1.5 years

0: normal or inactive disease

1: mild disease (erythema, decreased vascular pattern, mild friability) 2. Moderate disease (marked erythema, absent vascular pattern, friability, erosions) 3. Severe disease (spontaneous bleeding, ulcerations)

For 40 patients: infections in stoolThrough study completion, an average of 1.5 years

yes/no

Blood parametersThrough study completion, an average of 1.5 years

WBC count (\*10\^9/L), RBC count (\*10\^12/L), PLT (\*10\^9/L), Lymphocytes (\*10\^9/L), Monocytes (\*10\^9/L), Neutrophils (\*10\^9/L), Eosinophils (\*10\^9/L), Basiphils (\*10\^9/L)

Trial Locations

Locations (1)

RadboudUMC

🇳🇱

Nijmegen, Gelderland, Netherlands

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