Identification of Epigenetic Biomarkers Allowing to Predict the Evolution of Lung Disease Severity in Cystic Fibrosis, in Order to Improve Patient Follow-up and to Move Toward Personalized Medicine (MethylBiomark)
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|ClinicalTrials.gov Identifier: NCT02976714|
Recruitment Status : Recruiting
First Posted : November 29, 2016
Last Update Posted : May 12, 2017
|Condition or disease||Intervention/treatment||Phase|
|Cystic Fibrosis||Other: spontaneous sputum||Not Applicable|
Cystic Fibrosis (CF) is an autosomal recessive disease resulting from mutations in the CFTR gene. CFTR encodes a chloride channel, mainly expressed at the apical membrane of epithelial cells. CFTR dysfunction induces mucus thickening, causing multiple disorders in respiratory, digestive and reproductive tracts. In CF patients, lung disease is the main cause of morbidity and mortality, and its severity is variable among CF patients, even among those with the same genotype. This clinical variability depends on two factors: genetic (complex alleles of CFTR gene and modifier genes) and environmental factors. Genetic factors have been largely explored, and several modifier genes have been identified. By contrast, environmental factors are still poorly known. It is well established that environmental factors modify the phenotype by acting on epigenetic marks (i.e. DNA methylation, histone modification) present in the genome. Epigenetic modifications regulate and modulate gene expression.
In a previous we profiled DNA methylation genome-wide in nasal epithelial cell samples from 32 CF patients and 24 healthy controls. CF patients homozygous for the p.Phe508del mutation and >18-years-old were stratified according to the lung disease severity. Through this study, we identified 187 genomic regions (CpG dinucleotides) differentially methylated between CF patients with mild lung disease and CF patients with severe lung disease. The present project aims at identifying predictive epigenetic biomarkers of lung disease severity, among these 187 regions. While the previous study was carried out on genomic DNA extracted from nasal epithelial cells, in the present project we will use a non-invasive model: spontaneous sputum.
Hypothesis: some differentially methylated genomic regions between mild and severe CF patients can be used as predictive epigenetic biomarkers of lung disease severity in cystic fibrosis.
Objectives: (i) to identify predictive epigenetic biomarkers of lung disease severity among the differentially methylated genomic regions between mild and severe CF patients, (ii) to characterize a non-invasive cellular model, spontaneous sputum, for the analysis of epigenetic biomarkers of lung disease severity in CF, (iii) to analyze the variations in DNA methylation for a same patient over time (at time of inclusion, 6 months, 12 months and 18 months)
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||50 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Identification of Predictive Epigenetic Biomarkers of Lung Disease Severity in Cystic Fibrosis|
|Actual Study Start Date :||December 12, 2016|
|Estimated Primary Completion Date :||November 2018|
|Estimated Study Completion Date :||May 2019|
CF patients carry a spontaneous sputum that is made in the context of bronchial drainage sessions conducted as part of usual care.
Other: spontaneous sputum
CF patients carry a spontaneous sputum that is made in the context of bronchial drainage sessions conducted as part of usual care (inclusion, 6 months, 12 months, 18 months).
The collection of spontaneous sputum is carried out within the bronchial drainage sessions, which are routinely performed at each visit. The spontaneous sputum is collected in a sterile container. In order not to contaminate the sputum with buccal epithelial cells will be asked patients to rinse the mouth before expectorate.
- DNA methylation [ Time Frame: at time of inclusion ]Spontaneous expectoration at baseline
- DNA methylation [ Time Frame: 6 months ]Spontaneous expectoration at 6 months
- DNA methylation [ Time Frame: 12 months ]Spontaneous expectoration at 12 months
- DNA methylation [ Time Frame: 18 months ]Spontaneous expectoration at 18 months
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02976714
|Contact: Albertina De Sario, PhD||4 11 75 98 63 ext email@example.com|
|Contact: Davide CAIMMI, MD|
|Montpellier, France, 34295|
|Contact: Albertina De Sario|
|Principal Investigator:||Davide CAIMMI||University Hospital, Montpellier|