Unravelling the Measles Paradox in Children

Not yet recruiting

• Conditions: MEASLES DISEASE

• Registration Number: NCT06923631
• Lead Sponsor: Erasmus Medical Center

Brief Summary

Measles is caused by measles virus (MeV). The disease is associated with lymphopenia and immune suppression, which is an important cause of measles-associated morbidity and mortality. Measles-induced immune suppression can last several years, whereas measles lymphopenia is usually resolved within two weeks. At the same time, measles induces lifelong immunity. This apparent contradiction, known as the 'measles paradox', was partially solved when investigators demonstrated that MeV infects and depletes pre-existing memory cells, thereby causing 'immune amnesia'. This model is supported by observations in animal models and clinical studies, but several questions remain to be addressed, like the duration of measles-induced amnesia and changes in the immune repertoire after measles. to address the immunological questions regarding MeV infection.

Detailed Description

Measles is caused by measles virus (MeV). The disease is associated with lymphopenia and immune suppression, which is an important cause of measles-associated morbidity and mortality. Measles-induced immune suppression can last several years, whereas measles lymphopenia is usually resolved within two weeks. At the same time, measles induces lifelong immunity. This apparent contradiction, known as the 'measles paradox', was partially solved when investigators demonstrated that MeV infects and depletes pre-existing memory cells, thereby causing 'immune amnesia'. This model is supported by observations in animal models and clinical studies, but several questions remain to be addressed, like the duration of measles-induced amnesia and changes in the immune repertoire after measles. Recently, investigators have acquired permission to address these remaining questions in 18-25 years old adults (MEC-2024-0230). However, investigators have reservations about the feasibility of including enough participants between 18 and 25 years old that have not been vaccinated against or infected with MeV; it is possible that investigators will not reach sufficient inclusions to address the immunological questions regarding MeV infection in that protocol. Therefore, investigators propose to additionally study these questions in children in the age of 4 up to and including 17.

Study Timeline

• Study First Submitted: 2025-03-27
• Status Verified: 2025-04
• Study Start: 2025-04-01
• Study First Submitted QC: 2025-04-04
• Last Update Submitted: 2025-04-04
• Study First Posted: 2025-04-11
• Last Update Posted: 2025-04-11
• Primary Completion: 2029-04-01
• Study Completion: 2029-04-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

Group A

• Aged 4 - 17 years old
• Susceptible to measles
• No pre-existing immunity against measles (vaccination or earlier infection)

Group B

• Aged 4 - 17 years old
• Protected against measles due to vaccination or earlier infection

Exclusion Criteria

A potential subject who meets any of the following criteria will be excluded from participation in this study:

• Diagnosed chronic disease that lasted over 3 months
• Immune suppression (due to medication or underlying disease)
• Group A; Detectable MeV-antibodies in the T1 blood sample

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Compare measles-induced loss of pathogen-specific antibodies	36 months	The investigators will measure changes in the immune repertoire using longitudinal samples obtained from children who are infected with MeV. To this end, they will measure pathogen-specific antibody responses (titers) pre- and post-measles and compare these to determine whether measles led to a loss of pathogen-specific antibodies.
Compare measles-induced loss of pathogen-specific T-cells	36 months	The investigators will measure changes in the immune repertoire using longitudinal samples obtained from children who are infected with MeV. To this end, they will measure pathogen-specific T-cell responses (frequencies) pre- and post-measles and compare these to determine whether measles led to a loss of pathogen-specific T-cells.