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Can Immune Parameters Predict Acute and Chronic Rejection in Lung Recipients?

This study has been completed.
Sponsor:
Information provided by:
National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier:
NCT00340951
First received: June 19, 2006
Last updated: March 5, 2008
Last verified: April 2007
  Purpose

This study will evaluate the ability of lung transplant recipients to react to the transplanted organs. Previous research indicates that some immune tests can identify whether people are at risk for chronic rejection of transplanted lungs. Certain parameters, that is, physical properties involving the immune system, may cause acute chronic rejection of the lungs, which may lead to chronic rejection, a condition of scarring that worsens lung function. If such parameters can be identified and distinguished from those found in healthy subjects, information gained can help medical professionals to provide individualized treatments that work on the immune system. Short-term and long-term survival of lung transplant recipients may thus be improved.

Patients who will have or have had lung transplants will be recruited by clinical transplant coordinators. Normal control subjects will be recruited through flyers and newspaper advertisements.

Collection of blood samples will be done at Duke University Medical Center. Blood collections will be done of patients undergoing routine pretransplant and posttransplant blood tests, so no extra blood collections will be required. Control subjects will undergo three blood collections over an 8-week period. They will be compensated for their time in participating, at the rate of $5 for the initial blood draw, $10 for the second one, and $15 for the third one. A small amount of blood is involved, about 3 tablespoons. The blood cells and DNA (which contains genetic material) will be isolated for analysis. Patients' DNA samples collected will be identified by a code, and all other identifying information will be removed. The samples may be used in the future as new tests are developed.

This study will not have a direct benefit for participants. However, during the study, if it is found that any patients have an inherited risk for a disease likely to cause early death if the disease is not treated, then the researchers will attempt to notify those patients. Overall, it is hoped that information gathered will enhance researchers' understanding of what tests best identify patients at risk for developing chronic rejection of their transplanted lungs.


Condition
Lung Transplantation

Study Type: Observational
Official Title: Can Immune Parameters Predict Acute and Chronic Rejection in Lung Recipients?

Resource links provided by NLM:


Further study details as provided by National Institutes of Health Clinical Center (CC):

Estimated Enrollment: 400
Study Start Date: June 2005
Estimated Study Completion Date: April 2007
Detailed Description:

The aim of this study is to provide insight into the immune mechanisms involved in the pre- and posttransplant response of lung recipients to determine if short- and long-term graft outcome can be predicted and to allow for potential intervention. We have assembled a panel of assays that will test various functions of the immune response and investigate immune mechanisms involved in acute and chronic rejection (CR). Our overall hypothesis is that measurment of pre- and posttransplant immune response to donor HLA antigens/peptides can predict graft outcome. Our goal is to determine if immune parameters [ELISpot], intracellular T regulatory cells and ATP synthesis can identify lung recipients at high risk for developing AR and sub-clinical rejection. Sub-aim: To determine the correlation of cytokine genotypes with ELISpot results and T regulatory cell level and activity for recipients at high risk for developing acute rejection in comparison to a normal subject cohort. A second hypothesis is that recipients who experience an AR episode and remain responsive to donor antigen and those who show increased reactivity to donor HLA peptides are at high risk for developing CR. Our goal is to determine if the immune parameters (CFSE responder frequencies and response to donor peptides are assayed by CFSE, ELISpot, T regulatory cell level, and ATP synthesis) can identify lung recipients at high risk for developing CR and distinguish these immune parameters from a normal subject cohort. If successful, we will provide clinicians with the information necessary for individualization of immunosuppression intervention aimed at improving short and long-term graft outcome.

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria
  • INCLUSION/EXCLUSION CRITERIA:

Adult patients undergoing transplant at Duke Medical Center are to be recruited as subjects.

In addition, investigators will recruit 80 adult control subjects from individuals who will not have lung disease and will not be on immunosuppression or from pre transplant subjects.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00340951

Locations
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710
NIEHS, Research Triangle Park
Research Triangle Park, North Carolina, United States, 27709
Sponsors and Collaborators
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00340951     History of Changes
Other Study ID Numbers: 999905183, 05-E-N183
Study First Received: June 19, 2006
Last Updated: March 5, 2008
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Regulatory T Cells
Bronchiolitis Obliterans Syndrome
Genetic Polymorphism
Innate Immunity
Transplantation
Lung Transplantation

ClinicalTrials.gov processed this record on November 25, 2014