Lupus Erythematosus
Conditions
Keywords
Flare, Therapeutic adjustments, Biological Marker, Immunologic Marker, Prognosis
Brief summary
Given that GADD34 has been described as a potential key regulator of pro-inflammatory cytokine production in human and elevated blood marker in SLE patients, this study aim to prove that the GADD34 RNA level in mononuclear blood cells can be used as a prognostic marker to assess the risk of SLE flare.
Detailed description
Systemic lupus erythematosus (SLE) has a prevalence estimated between 1 and 6 per 10000 individuals and concerns over 30 000 patients in France for example. As of today, there isn't any reliable specific blood analysis that can be used to assess the prognosis of SLE, that means predict a SLE flare. The discovery of such a blood test could allow a better patients' monitoring in order to help doctors to better adapt treatments (lowering background treatments when they are not needed and increase them ahead of a potential flare when the risk assessment raises). In SLE patients, a recent study shows elevated levels of GADD34 RNA in mononuclear blood cells : higher than twice the control levels for 36 of the 60 SLE patients and ten times higher than the control levels for 13 of the 60 SLE patients. Given that GADD34 has been described as a potential key regulator of pro-inflammatory cytokine production in human and elevated blood marker in SLE patients, this study aim to prove that the GADD34 RNA level in mononuclear blood cells can be used as a prognostic marker to assess the risk of SLE flare.
Interventions
OTHERGADD34 RNA level measurement.
Blood analysis including GADD34 RNA level measurement is performed every 3 months up to 1 year for SLE patients. A modal including physical exam, standard biological results and GADD34 RNA level is correlated to a SLE flare occurence in the next 3 months.
Sponsors
University Hospital, Grenoble
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Inclusion Criteria: * man and women over 18 Years old. * suffering from SLE (American College of Rheumatology criteria). * without SLE flare for 3 months. * with a signed consent and social security affiliation (required in France). *
Exclusion criteria
* Viral infection within 15 days. * Other chronic inflammatory disease. * People with special protection (defined in articles : L1121- §5-8 et articles L3212-§1-3 of French health care law).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| GADD34 RNA level | Measured every 3 months, up to 1 year (5 blood samples).The Last result before a SLE flare occurence will be used. | GADD34 RNA level in mononuclear blood cells in the last 3 months before a SLE flare occurence. RNA levels have no unit,they are rates compared with a housekeeping gene RNA level as unit. To avoid any bias in primary outcome, SLE Flare occurence is assessed with both patient and investigator blinded from Gadd34 RNA level. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Prognosis score of SLE flare occurence | Measured every 3 months, up to 1 year (5 blood samples).The Last result before a SLE flare occurence will be used. | Prognosis score of SLE flare occurence using a modal including GADD34 RNA increase, SLEDAI score and Physician Global Assessment (PGA). This modal is compared to the gold standard modal which use only PGA and SLEDAI Score in term of sensibility and specificity. |
| Pro-inflammatory cytokine blood level. | Measured every 3 months, up to 1 year (5 blood samples). | Correlation between GADD34 RNA increase or decrease and interferon-alpha, interferon-beta, interleukin-6 and interleukine-17 levels. |
Other
| Measure | Time frame | Description |
|---|---|---|
| GADD34 RNA level in each mononuclear blood cells (B cells, T cells and monocytes). | Measured once at the 2nd visit (3 months after the inclusion). | GADD34 RNA level is measured respectively in B cells, T cells and monocytes and is compared with each other. RNA levels have no unit,they are rates compared with a housekeeping gene RNA level as unit. This outcome is measured only for 30 patients. |
| GADD34 RNA level in non-mononuclear blood cells | Measured once at the 2nd visit (3 months after the inclusion). | GADD34 RNA level is measured respectively in non-mononuclear blood cells and is compared with GADD34 RNA level in mononuclear blood cells. RNA levels have no unit,they are rates compared with a housekeeping gene RNA level as unit. This outcome is measured only for 30 patients. |
Countries
France
Outcome results
None listed