Study of Cytokines in Children With Opsoclonus-Myoclonus Syndrome (OMS)
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Purpose
The purpose of this study is to determine if cytokines, inflammatory mediators, are increased in spinal fluid and blood, correlate with disease activity, and could serve as biomarkers or therapeutic targets in children with opsoclonus-myoclonus syndrome (OMS), an autoimmune complication of the tumor neuroblastoma.
| Condition |
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Opsoclonus-myoclonus Syndrome |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control |
| Official Title: | Cytokines as Biomarkers and Therapeutic Targets in Paraneoplastic Opsoclonus-Myoclonus Syndrome (OMS) |
- Reduction in inflammatory cytokines [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Correlation of cytokine concentration and clinical severity score. [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples Without DNA
serum, plasma, cerebrospinal fluid
| Estimated Enrollment: | 400 |
| Study Start Date: | January 2008 |
| Estimated Study Completion Date: | December 2016 |
| Estimated Primary Completion Date: | December 2016 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
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Pediatric case-controls
These are children who underwent lumbar puncture and blood drawing for diagnostic testing for non-inflammatory neurological or non-neurological disorders, and whose samples were retrieved from the clinical lab under a linked Institutional Review Board (IRB) protocol.
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Pediatric OMS
These are patients treated by the P.I. based on clinical decision making, not a clinical trial (this is an observational study). The types of treatments are varied, and, on the initial evaluation, the patients may be untreated or already tried on various immunotherapies. They range from monotherapy with steroids, ACTH, or IVIg, to disease modifying agents, such as rituximab, cyclophosphamide, and other chemotherapy, typically adjunctively or as combination therapy.
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Detailed Description:
In this translational research, immunological mechanisms that underlie the assault of the immune system on the brain in paraneoplastic opsoclonus-myoclonus syndrome (OMS) are under evaluation. To test our principal hypothesis that there is an imbalance of pro-inflammatory (Th1) and anti-inflammatory (Th2) cytokines in OMS, a comprehensive cytokine panel will be measured by enzyme-linked immunosorbent assay (ELISA) and multiplexed fluorescent bead-based immunoassay detection (LUMINEX 100 Lab MAP system)in blood and cerebrospinal fluid (CSF) of 400 children. To test the second hypothesis that cytokines could serve as biomarkers of disease activity in OMS, cytokine concentrations will be correlated with clinical variables, such as disease severity, OMS duration, prior relapses, and remissions, as well as immunological variables, such as lymphocyte subset analysis. The cytokine 'biomarker profile' could aid decision making for early intervention by identifying children at high risk for relapse and poor outcome and allow targeting of the most implicated inflammatory cytokines by cytokine therapies. To test our third hypothesis that lack of response to immunotherapy is due in part to failure to increase the expression of anti-inflammatory Th2 cytokines, we will make paired pre/post comparisons of the impact of immunotherapies given in the course of clinical care [steroids, adrenocorticotropin (ACTH), intravenous immunoglobulins (IVIg), rituximab, chemotherapy, other drugs, combinations] on the cytokine and clinical profile. This research could lead to the application of commercially-available cytokines and cytokine blockers or to the development of new ones for OMS.
Eligibility| Ages Eligible for Study: | 1 Year to 18 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Probability Sample |
Referrals to National Pediatric Myoclonus Center Website, www.omsusa.org
Inclusion Criteria:
- Clinical diagnosis of OMS
Exclusion Criteria:
- Equivocal diagnosis
- Contraindications to lumbar puncture
- Treatment with agents outside the scope of the study
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT00806182
| Contact: Michael R Pranzatelli, MD | 2175450836 | mpranzatelli@siumed.edu | |
| Contact: Elizabeth D Tate, M.N., FNP-BC | 2175457365 | etate@siumed.edu |
| United States, Illinois | |
| National Pediatric Myoclonus Center, Dept. of Neurology, Southern Illinois University School of Medicine | Recruiting |
| Springfield, Illinois, United States, 62702 | |
| Contact: Michael R Pranzatelli, MD 217-545-0836 mpranzatelli@siumed.edu | |
| Contact: Elizabeth D Tate, M.N., FNP-BC 2175457365 etate@siumed.edu | |
| Principal Investigator: Michael R Pranzatelli, MD | |
| Sub-Investigator: Elizabeth D Tate, FNP, MN | |
| Principal Investigator: | Michael R Pranzatelli, MD | National Pediatric Myoclonus Center | |
| Study Director: | Elizabeth D Tate, FNP, MN | National Pediatric Myoclonus Center |
More Information
Additional Information:
Publications:
| Responsible Party: | Michael R. Pranzatelli, M.D., Director, National Pediatric Myoclonus Center |
| ClinicalTrials.gov Identifier: | NCT00806182 History of Changes |
| Other Study ID Numbers: | Thrasher Award 02826-2 |
| Study First Received: | December 8, 2008 |
| Last Updated: | January 24, 2014 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by National Pediatric Myoclonus Center:
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paraneoplastic neuroblastoma Kinsbourne syndrome |
autoimmune disease immunotherapy ataxia |
Additional relevant MeSH terms:
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Opsoclonus-Myoclonus Syndrome Paraneoplastic Syndromes Paraneoplastic Syndromes, Nervous System Myoclonus Central Nervous System Diseases Cranial Nerve Diseases Dyskinesias Eye Diseases |
Neoplasms Neoplasms by Site Nervous System Diseases Nervous System Neoplasms Neurodegenerative Diseases Neurologic Manifestations Ocular Motility Disorders Signs and Symptoms |
ClinicalTrials.gov processed this record on March 03, 2015