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Prospective Descriptive Study of the Angiogenic T Cell Population in Subjects With Hereditary Hemorrhagic Telangiectasia (HHT)

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StatusRecruiting
Sponsors
Centre Hospitalier Universitaire Dijon

Keywords

Abstract

Hereditary hemorrhagic telangiectasia (HHT) results from genetic deregulation of angiogenesis. It is characterized by mucocutaneous telangiectasia responsible for recurrent epistaxis affecting quality of life (anaemia, iron deficiency, social distress). More rarely, HHT is complicated by the appearance of pulmonary, hepatic or cerebral arteriovenous malformations that can lead to serious complications: cerebrovascular accidents, cerebral abscesses, high output heart failure, and massive hemoptysis (1). The intensity of symptoms increases with age but with significant individual variability, even for the same mutation in the same family. Thus, while the mutations responsible for the disease have been identified, the pathophysiology is not fully understood because these mutations do not explain the great diversity of clinical presentations. Other factors not yet identified probably play an important role. Angiogenic T cells (TANG) are a newly individualized T cell population, defined by a CD4+CXCR4+CD31+ phenotype, which plays a key role in differentiating endothelial progenitors (2).
In an earlier study, the investigators showed that patients with HHT had a decrease in CD4+ and CD8+ LT compared to a cohort of healthy subjects (3).
They hypothesize that the lymphopenia mainly involves TANG, whose quantification could make it possible to assess the individual level of angiogenesis during HHT. The evaluation of the TANG levels could thus make it possible to personalize HHT management.

Dates

Last Verified: 10/31/2019
First Submitted: 06/07/2018
Estimated Enrollment Submitted: 06/26/2018
First Posted: 06/27/2018
Last Update Submitted: 02/16/2020
Last Update Posted: 02/17/2020
Actual Study Start Date: 06/27/2018
Estimated Primary Completion Date: 11/30/2020
Estimated Study Completion Date: 02/28/2021

Condition or disease

Hereditary Hemorrhagic Telangiectasia

Intervention/treatment

Biological: Blood samples

Other: Patients

Phase

-

Arm Groups

ArmIntervention/treatment
Patients
Hereditary hemorrhagic telangiectasia patients
Other: Patients
Three monthly epistaxis charts to be completed
Controls
Matched for age (+/- 5 ans) and sex.

Eligibility Criteria

Ages Eligible for Study 18 Years To 18 Years
Sexes Eligible for StudyAll
Sampling methodNon-Probability Sample
Accepts Healthy VolunteersYes
Criteria

Inclusion Criteria:

- Person who has given consent

- Adult

- Person capable of understanding spoken and written French

"Patient" group:

- Certain HHT (3 or 4 Curacao criteria - Appendix 2):

- Recurring epistaxis

- Telangiectasia of the skin or mouth

- Family hereditary context

- Arteriovenous visceral malformations

- Causal mutation identified

- Person capable of completing monthly epistaxis charts

"Control" group :

- Control subjects will be matched to patients for age (+/- 6 years) and sex.

Exclusion Criteria:

- Person not affiliated to a national health insurance scheme

- Pregnant or breastfeeding woman

- Protected adult

- Hemoglobin levels less than 9 g/dl in the last 15 days

- Progressive or recent infectious disease, autoimmune disease or cancer (less than 6 months)

- Immunosuppressive treatment in progress or recent (less than 6 months), including systemic steroid therapy. The use of inhaled or topical steroids is not an exclusion criterion.

- Treatment in progress or stopped less than 6 months ago or to be introduced within the next 3 months of the following medications:

- bevacizumab

- tranexamic acid

- dipeptidyl peptidase 4 inhibitors (diabetic patient)

- beta-blockers (hypertensive patient)

Outcome

Primary Outcome Measures

1. Average monthly duration (in minutes) of epistaxis over the 3 months following inclusion [Through study completion, an average of 3 months]

2. Number/mm3 of circulating TANG (CD3+CXCR4+CD31+) at inclusion. [At inclusion]

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