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| ID | Type | Description | Link |
|---|---|---|---|
| 2019-A03087-50 | Other Identifier | ID-RCB |
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Rheumatoid arthritis (RA) is a common chronic systemic autoimmune relapsing disease characterized by joint inflammation. Beside arthritis leading to progressive joint damage and loss of function, RA is also associated to extraarticular inflammatory conditions such as interstitial lung disease (ILD). This one develops in 30% of all RA patients with a median survival expectancy of 3 to 10 years once symptomatic. Unfortunately, there is no medical care recommendation so far as the pathophysiology is unknown. However, ILD share many similarities with idiopathic pulmonary fibrosis (IPF).
Autotaxin (ATX), due to its lysophospholipase activity, produces a bioactive lipid, lysophosphatidic acid (LPA) under inflammation. LPA has pleiotropic actions inducing cell proliferation, survival, motility and differentiation. Increased ATX and LPA levels have been detected in synovial fluid of RA patients and in IPF patients. ATX is also currently the target for a phase 3 clinical trial in IPF.
Given the previous described role of ATX/LPA axis in arthritis and inflammation-induced bone loss in RA and the similarities between RA-ILD and IPF, the investigators hypothesized that ATX/LPA axis may be also an attractive drug target for this pulmonary condition in RA and therefore that ATX and LPA may be increased in sputum from RA patients with ILD in comparison with sputum from RA patients without ILD.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Controls | Other | Patients with RA and without ILD |
|
| Cases | Other | Patients with RA and ILD |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quantitative ATX and LPA determination in plasma and sputum | Other | Determination of ATX and LPA levels in plasma and sputum from RA-ILD patients ("cases") and in plasma and sputum from RA patients without ILD ("controls") after sputum induction using hypertonic saline inhalation |
| Measure | Description | Time Frame |
|---|---|---|
| ATX and LPA levels in sputum from RA patients with ILD in comparison with sputum from RA patients without ILD | All the samples will be frozen and ATX and LPA levels will be assessed in the plasma and sputum at the same time, at the end of the recruitment. | Month 30 |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation between ATX and LPA levels and severity of RA-ILD estimated by tomodensitometry | Determine the correlation between ATX and LPA levels and the severity of CT scan pulmonary involvement*. *Diffuse interstitial lung disease is defined as an attack compatible with the thoracic scanner in thin sections according to international criteria with or without associated clinical signs. | Month 24 |
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Inclusion Criteria:
General inclusion criteria
Subject aged ≥ 18 and ≤ 70 years
Patient with RA with ACPA in the state phase, meeting ACR / EULAR 2010 criteria
For female subjects:
Subject having given written consent to participate in the study
Subject affiliated to the Social Security scheme or benefiting from an equivalent scheme
Additional inclusion criteria for cases (RA patients with PID):
- PID is defined as damage compatible with the thoracic scanner in thin sections according to international criteria with or without associated clinical signs.
Additional inclusion criteria for control patients (RA patients without symptomatology without PID)
- No functional lung complaints
Exclusion Criteria:
General exclusion criteria
Non-inclusion criteria for cases (RA patients with PID):
- Patient with a history of asthma, COPD or any other pulmonary pathology or pulmonary symptom unrelated to PID
Non-inclusion criteria for control patients (RA patients without PID)
- Patient with a history of asthma, COPD, any other pulmonary pathology, any pulmonary symptom or any pulmonary CT abnormality.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fabienne COURY-LUCAS, MD | Contact | 04 78 86 56 95 | +33 | fabienne.coury@chu-lyon.fr |
| Name | Affiliation | Role |
|---|---|---|
| Fabienne COURY-LUCAS, MD | Hospices Civils de Lyon | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital Lyon Sud | Recruiting | Pierre-Bénite | France |
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| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| D017563 | Lung Diseases, Interstitial |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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|
| D003240 |
| Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |