Protective Immunity Project 01 - Full Text View

Sponsored by:	Emory University
Information provided by:	Emory University
ClinicalTrials.gov Identifier:	NCT00788021

Purpose

Patients who undergo kidney transplant must take medications to prevent organ rejection. There are standard immunosuppressant medications such as prednisone, tacrolimus (Prograf), mycophenolate mofetil(Cellcept) or sirolimus (Rapamune) that are given to patients to prevent rejection. It is well known that patients on immunosuppressant medications are at increased risk from viral infections, such as influenza. However, it is not well understood how immunosuppressive medications may uniquely affect the immune response to infection. This study will determine whether there are unique differences in the effects on the immune system by these different immunosuppressive medications, particularly differences between tacrolimus and sirolimus.

Condition
Kidney Transplantation Immunity Immunosuppression

MedlinePlus related topics: Kidney Transplantation

U.S. FDA Resources

Study Type:	Observational
Study Design:	Cohort, Prospective
Official Title:	Characterization of the Impact of Chronic Immunosuppressive Regimens on Protective Immunity Over Time in Renal Transplant Recipients

Further study details as provided by Emory University:

Primary Outcome Measures:

To determine the effects of chronic immunosuppressive therapies on adaptive immunity [ Time Frame: 2 years ] [ Designated as safety issue: No ]
To determine the effects of chronic immunosuppressive therapies on innate immunity, dendritic cell phenotype and function and TLR signaling [ Time Frame: 2 years ] [ Designated as safety issue: No ]
To define the transcriptional signatures associated with specific immunosuppressive regimens [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Biospecimen Retention: Samples Without DNA

Biospecimen Description:

Whole blood, serum, PBMCs

Estimated Enrollment:	120
Study Start Date:	September 2006
Estimated Study Completion Date:	November 2010
Estimated Primary Completion Date:	November 2010 (Final data collection date for primary outcome measure)

Groups/Cohorts
Tacrolimus Recipients of deceased or living donor renal transplant maintained on immunosuppressive regimen utilizing tacrolimus
Sirolimus Recipients of deceased or living donor renal transplants maintained on immunosuppressive regimen using sirolimus
Healthy controls Age, race and gender-matched individuals not on immunosuppressive regimens. Whenever possible an transplant recipient's donor may be recruited to serve as healthy control

Detailed Description:

While the benefits of transplantation to society are substantial, the ever-growing population of immunosuppressed recipients poses a unique challenge in development of immunization and containment strategies to protect the population from communicable pathogens and weaponized infectious agents. The immunosuppressive regimens that have allowed the emergence of successful transplant therapy not only inhibit T cell-dependent rejection but also cause systemic immunosuppression, which attenuates the response to vaccines in general and precludes the use of live attenuated vaccines. To date, there has been relatively little detailed systematic study of the immune alterations that accompany either the short- or long-term immunosuppressive regimens used in clinical organ transplantation. Despite the recent development of increasingly effective, but also increasingly complex, regimens using drugs with very distinct molecular targets, current policies on vaccination of transplant recipients are generic and remain based on old concepts rather than on any new understanding of the cellular and molecular effects of these therapies on the human immune system. This proposal seeks to improve our understanding of the biological mechanisms that underlie the distinct immunosuppressive regimens in practice today (calcineurin-inhibitor, or CNI, and sirolimus-based regimens) and in emerging regimens that employ agents with novel mechanisms of action, such as the CD28 costimulation blockers, and/or JAK3 kinase inhibitors. Such knowledge will be critical to strategies for enhancing desirable immune responses while not precipitating rejection.

Eligibility

Ages Eligible for Study:	18 Years to 59 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes
Sampling Method:	Non-Probability Sample

Study Population

Patients undergoing deceased or living donor renal transplant

Criteria

Inclusion Criteria:

Male or female patients between 18 and 59 years of age
Patients capable of understanding the purposes and risks of the study, who can give written informed consent and who are willing to participate in and comply with the study.
Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to enrollment and must not be breast-feeding.

Exclusion Criteria:

Patients with any prior organ transplant or multi-organ transplant recipients
Patients that require induction immunosuppression beyond the immunosuppressive regimen proposed in this study. For example, patients that receive anti-lymphocyte antibody therapy or plasmapheresis as a result of pre-formed immunologic reactivity to the transplanted organ.
Patients with evidence of an active systemic infection requiring the continued use of antibiotics, evidence of an HIV infection, or the presence of a chronic active hepatitis B or C.
Patients with history of malignancy in the last 5 years (except successfully treated localized non-melanotic skin cancer)
Patients with severe anemia (hemoglobin < 8 g/dL), leukopenia (WBC < 3000/mm3). -

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00788021

Contacts

Contact: Rivka S. Elbein, RN	404-712-1114	rivka.elbein@emoryhealthcare.org
Contact: Beth Begley, RN	404-712-1114	beth.begley@emoryhealthcare.org

Locations

United States, Georgia
Emory University	Recruiting
Atlanta, Georgia, United States, 30322

Sponsors and Collaborators

Emory University

Investigators

Principal Investigator:	Christian P. Larsen, MD, DPhil	Emory University
Principal Investigator:	Kenneth E. Kokko, MD, PhD	Emory University

More Information

Responsible Party:	Emory University ( Christian P. Larsen, MD, DPhil )
Study ID Numbers:	PIP-01
Study First Received:	November 7, 2008
Last Updated:	November 7, 2008
ClinicalTrials.gov Identifier:	NCT00788021
Health Authority:	United States: Institutional Review Board

Keywords provided by Emory University:

Transplant
Immunity
Immunosuppression

ClinicalTrials.gov processed this record on January 16, 2009