Histiocytosis
Conditions
Keywords
intravenous, drug abuse, polyvinylpyrrolidone, PVP
Brief summary
The goal of this observational study is to describe a new disease condition of histiocytosis related to injecting drug use, its preconditions, symptoms, signs, findings, and prognosis in a detailed and systematic patient series in one referral center. The main question\[s\] it aims to answer are: * to find specific histologic features in different tissues to help the differential diagnosis from other histiocytoses * to describe the value of chitotriosidase activity to screen this condition * to describe the value of various tissue biopsies in confirming the diagnosis * to describe the nature of polyvinylpyrrolidone accumulation in tissue macrophages by novel special microscopic techniques * to find new tandem mass spectrometry methodology to prove polyvinylpyrrolidone accumulation in macrophages * to show that polyvinylpyrrolidone treatment activates macrophages to histiocytes and causes povidone accumulation within the cells in in vitro experiments * to evaluate the pathology of macrophage activation to histiocytes by transcriptomics The patient history will be collected from the data produced by follow-up of cases followed up in a single center. A subgroup of participants will be given an opportunity to sign informed consent to give access to/donate blood and tissue samples to search for techniques to prove polyvinylpyrrolidone storage within histiocytes, and to search for transcriptomics signal(s) in histiocytes. Researchers will compare blood and tissue samples from the biobank as controls.
Detailed description
Comprehensive patient data (disease history, findings, complications, laboratory findings, histopathology, and imaging) will be obtained from patient records of a single university hospital. Coded histiocytosis-positive tissue samples will be compared to biobank samples from corresponding tissues from healthy and other histiocytosis tissue samples to show polyvinylpyrrolidone storage with novel methodologies. In addition, if a study participant who is followed up clinically, signs informed consent, monocytes are separated from a blood sample, differentiated to macrophages, and exposed to polyvinylpyrrolidone. Various novel methods will be utilized to explore polyvinylpyrrolidone within histiocytes.
Interventions
DIAGNOSTIC_TESTChitotriosidase
The amount of patients with increased chitotriosidase, and the extent of elevation of chitotriosidase
DIAGNOSTIC_TESTMass spectrometry
to show polyvinylpyrrolidone presence in histiocytes of injecting drug users compared to controls
DIAGNOSTIC_TESTscanning electron microscope with energy-dispersive X-ray spectroscopy
to show polyvinylpyrrolidone presence in histiocytes of injecting drug users compared to controls
DIAGNOSTIC_TESTFluorescence microscopy
to show polyvinylpyrrolidone presence in histiocytes of injecting drug users compared to controls
DIAGNOSTIC_TESTTranscriptomics
To describe pathologic signals of polyvinylpyrrolidone-exposed in vitro histiocytes of injecting drug users compared to control samples
Sponsors
Tampere University
University of Oulu
University of Turku
University of Helsinki
Tampere University Hospital
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Inclusion criteria
* All identified adult patients in our records with a history of injecting drug use by dissolving tablets containing polyvinylpyrrolidone and (suspected) PVP-histiocytosis
Exclusion criteria
* Other histiocytosis diagnosed by tissue samples and clinical information
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of disease manifestations | 10 years | To describe phenotype |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | 10 years | Mortality |
| Microscopic fluorescence positive tissue | 10 years | Search for specific polyvinylpyrrolidone fluorescence signal |
| Frequency of elevated chitotriosidase activity | 10 years | Is chitotriosidase activity associated with polyvinylpyrrolidone histiocytosis |
| Pyrolysis mass spectrometry | 10 years | search for specific polyvinylpyrrolidone signal within cells |
| Transcriptomics analysis | 10 years | Search for immunologic pathway-specific abnormalities to guide treatment in cases compared with controls |
| Scanning electron microscope with energy-dispersive X-ray spectroscopy | 10 years | search for specific polyvinylpyrrolidone signal within cells |
Countries
Finland
Outcome results
None listed