Immune Mediators and Metabolites to Stratify Systemic Lupus Erythematosus Patients at High Risk of Cardio Vascular Diseases

Status: Recruiting
Location: See all (6) locations...
Intervention Type: Biological, Other, Behavioral
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Accelerated atherosclerosis is an established complication of systemic autoimmune diseases, particularly SLE. Young female patients with SLE are more likely to develop myocardial infarction than matched healthy controls, and CVD is nowadays one of the most common causes of death (27%) in lupus patients. While traditional CV risk factors cannot explain such increased CV morbidity associated with SLE, common disease factors shared between SLE, atherosclerosis and treatment exposure may be of outmost importance in this process. Our group made 3 findings of particular interest that could link SLE pathogenesis and atherosclerosis-associated immune dysregulation: 1/ the investigators identified specific immunometabolites (circulating nucleotide-derived metabolites adenine and N4-acetylcytidine), which are increased in the circulation of SLE patients. These immunometabolites trigger a constitutive inflammasome activation resulting in aberrant IL1-β production. Given that IL1-β inhibition was reported to significantly reduce CV events without altering lipid levels, the investigators propose that these immunometabolites may represent novel candidate biomarkers of CV risk stratification in SLE. 2/ the investigators identified OX40L as an important costimulatory molecule implicated in follicular helper T cell (Tfh) activation in SLE. Interestingly, OX40L polymorphism has been associated to both SLE and atherosclerosis, and Tfh have been recently shown to accelerate atherosclerosis progression. 3/ Immune complexes-activated platelets sustain aberrant immune response in SLE and block immunosuppressive functions of regulatory T cells (Tregs) in a P-selectin/PSGL1 dependent manner. Selectins and Tregs cell dysfunction are well accepted players in atherosclerosis pathogenesis. Thus there are multiple pathways that are shared between SLE and atherosclerosis and that may results in an increased risk of CV-associated morbidity in SLE patients. Exploring these interconnected pathways in SLE patients together with traditional and other well-established disease-related factors, might lead to a better stratification of CV risk in SLE. The aim of this study is to investigate the accuracy, predictive value and utility of immunological disease-related biomarkers in stratifying CV risk in patients with SLE.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Adult patient aged over 18 years old.

• SLE diagnosis according to the 2019 European League Against Rheumatism (EULAR) / American College of Rheumatology (ACR) Classification Criteria for Systemic Lupus Erythematosus

• Having signed an informed consent (at the latest on the day of inclusion and before any examination required by research).

Locations
Other Locations
France
CHU de Bordeaux - service de médecine interne
RECRUITING
Bordeaux
CHU de Brest - service de rhumatologie
RECRUITING
Brest
CHRU de Lille - service de Médecine Interne
RECRUITING
Lille
AP-HP - Hôpital Cochin - service de Médecine Interne
NOT_YET_RECRUITING
Paris
CHU de Strasbourg - service d'Immunologie Clinique
RECRUITING
Strasbourg
Germany
Universität Freiburg
NOT_YET_RECRUITING
Freiburg Im Breisgau
Contact Information
Primary
Pierre DUFFAU, Prof
pierre.duffau@chu-bordeaux.fr
(0)5 56 79 58 28
Backup
Thomas BARNETCHE, MD
thomas.barnetche@chu-bordeaux.fr
(0)5.57.82.04.93
Time Frame
Start Date: 2021-03-10
Estimated Completion Date: 2027-03
Participants
Target number of participants: 500
Treatments
Experimental: Systemic lupus erythematosus (SLE)
Authors
Guillermo RUIZ-IRASTORZA
Related Therapeutic Areas
Sponsors
Collaborators: Foundation for Research in Rheumatology (FOREUM)
Leads: University Hospital, Bordeaux

This content was sourced from clinicaltrials.gov