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| ID | Type | Description | Link |
|---|---|---|---|
| 2023-A01088-37 | Other Identifier | ID-RCB |
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Circadian rhythms are characterized by the physiology's adaptation to the alternation of day and night, enabling to adapt to the environment. These rhythms are generated by a molecular clock within each cell. At the molecular level, the circadian clock is based on a complex system of cell-autonomous transcription loops. These exert positive and negative feedback on themselves, generating cyclic transcriptional activity.
Recent studies suggest that many aspects of innate immunity are controlled by circadian rhythm through inhibition of NLRP3 inflammasome activation. Nevertheless, the regulation of the NLRP3 inflammasome by the circadian clock has yet to be elucidated. Inflammasomes are molecular platforms that control caspase-1 activation and consequently the maturation of precursors of (interleukine) IL-1β, pro-IL-18, a pro-inflammatory cytokine. Since its discovery, its functions have been widely characterized as part of the innate immune response as a sensor of pathogens and danger signals (extracellular ATP (Adenosine triphosphate), atmospheric pollutants). NLRP3 (nucleotide-binding domain LRR (leucin-rich repeat ) and pyrin-containing receptor 3) has been described for its genetic association with dominant monogenic hereditary syndromes characterized by recurrent systemic inflammatory episodes in the absence of any infection or autoimmune disease, known as CAPS (cryopyrin-associated periodic syndrome) or cryopyrinopathies which is a continuum of diseases ranging from a moderate to the most severe form of the syndrome: familial cold urticaria syndrome, Muckle-Wells syndrome (MWS), and CINCA/NOMID syndrome.
Interestingly, patients with Muckle-Wells syndrome show a circadian pattern of symptoms, with a recurrent, predominantly vesperal fever peak lasting a few hours, and extreme fatigue on a daily basis. However, a molecular link between the circadian clock and CAPS pathology remains to be determined.
The aim of this protocol is to identify circadian rhythm dysregulation in patients with CAPS confirmed by genetic analysis of NLRP3, to demonstrate a link between circadian clock and CAPS syndrome, and to identify circadian clock regulatory pathways.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with cryopyrin-associated periodic syndrome (CAPS) | Active Comparator | Confirmed by genetic analysis of NLRP3 |
|
| Control group | Placebo Comparator | Healthy participant (absence of CAPS, verified by NLRP3 gene analysis) living in the same household as a CAPS participant included in the protocol |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Genetic analysis of NLRP3 | Genetic | Blood test for genetic analysis of NLRP3 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Description of circadian rhythm deregulation in patients with cryopyrinopathy (CAPS) whose diagnosis was confirmed by genetic analysis of NLRP3, | Concentration of the peak secretion of melatonin in both arms | 6 months after inclusion |
| Description of circadian rhythm deregulation in patients with cryopyrinopathy (CAPS) whose diagnosis was confirmed by genetic analysis of NLRP3, | Concentration of the peak secretion of melatonin in both arms | 12 months after inclusion |
| Description of circadian rhythm deregulation in patients with cryopyrinopathy (CAPS) whose diagnosis was confirmed by genetic analysis of NLRP3, | time of the peak secretion of melatonin in both arms | 6 months after inclusion |
| Description of circadian rhythm deregulation in patients with cryopyrinopathy (CAPS) whose diagnosis was confirmed by genetic analysis of NLRP3, | time of the peak secretion of melatonin in both arms | 12 months after inclusion |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in circadian clock biomarkers between patients and control participants for Circadian Rhythm Characteristics. | Determination of circadian rhythms : amplitude in both arms | 6 th month |
| Difference in circadian clock biomarkers between patients and control participants for Circadian Rhythm Characteristics. |
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---Inclusion Criteria:
Patient with CAPS group :
Control group (healthy participant):
Participant aged 6 and over
Weight greater than or equal to 25 Kg
Participant living in the same household as a subject with CAPS genetically confirmed by NLRP3 analysis and included in the protocol
Participant with no CAPS (a priori) who consents to NLRP3 genetic analysis
Parents/guardians who have been informed of the study and have signed a consent form.
Participant who has been informed of the study and has agreed to take part
Participant affiliated to a social security scheme
Patient with CAPS group :
Control group (healthy participant):
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Alexandre Alexandre, PR | Contact | 04 27 85 61 26 | 33 | Alexandre.belot@chu-lyon.fr |
| Samira Plassart | Contact | 04 27 85 54 42 | 33 | Samira.plassart@chu-lyon.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital Femme-Mère-Enfant (HCL) | Recruiting | Bron | 69677 | France |
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Multicenter, prospective, interventional, comparative, open-label, controlled study with 2 parallel arms.
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| Circadian rhythm measurement | Device | Wear a Withings Pulse HR (heart rate) actigraphic watch 24 hours a day for 1 month to define circadian rhythm |
|
| Saliva sampling | Biological | Saliva sampling for salivary melatonin determination |
|
| Questionnaire | Other | Questionnaire to determine chronotype |
|
| AIDAI score | Other | Disease activity score using AIDAI score (only for patients in the CAPS group) AIDAI : AUTO-INFLAMMATORY DISEASE ACTIVITY INDEX |
|
| Blood sampling | Biological |
|
|
Determination of circadian rhythms : period in both arms |
| 6 th month |
| Difference in circadian clock biomarkers between patients and control participants for Circadian Rhythm Characteristics. | Determination of circadian rhythms : phase in both arms | 6 th month |
| Chronotype determination | Number of patients in each chronotype for the 2 arms based on the specific questionnaire in both arm | 6 th month |
| sleep duration | sleep duration in both arms | 6 th month |
| number of steps | Daily activity in both arms | 6 th month |
| Comparison of inflammatory state | basal levels of IL1β in patient monocytes in both arms | 6 months after inclusion |
| Comparison of inflammatory state | basal levels of IL1β in patient monocytes in both arms | 12 months after inclusion |
| Comparison of inflammatory state | basal levels of IL18 in patient monocytes in both arms | 6 months after inclusion |
| Comparison of inflammatory state | basal levels of IL18 in patient monocytes in both arms | 12 months after inclusion |
| Disease activity measurement | Number of patient with active disease ie AIDAI (AUTO-INFLAMMATORY DISEASE ACTIVITY INDEX) score >9 in CAPS patient arm | 6 months after inclusion |
| Disease activity measurement | Number of patient with active disease ie AIDAI (AUTO-INFLAMMATORY DISEASE ACTIVITY INDEX) score >9 in CAPS patient arm | 12 months after inclusion |
| presence or absence of an abnormality in the NLRP3 signalling pathway in CAPS arm compared control arm | Biochemical characterization of the NLRP3 inflammasome protein regulatory pathway in both arms | 6 months after inclusion |
| presence or absence of an abnormality in the NLRP3 signalling pathway in CAPS arm compared to control arm | Biochemical characterization of the NLRP3 inflammasome protein regulatory pathway in both arms | 12 months after inclusion |
| presence or absence of ASC inflammasome protein regulatory pathway in CAPs arm compared to control arm | Biochemical characterization of the ASC inflammasome protein regulatory pathway in both arms | 6 months after inclusion |
| presence or absence of ASC inflammasome protein regulatory pathway in CAPS arm compared to control arm | Biochemical characterization of the ASC inflammasome protein regulatory pathway in both arms | 12 months after inclusion |
| presence or absence of the CASPASE-1 inflammasome protein regulatory pathway in CAPS arm compared to control arm | Biochemical characterization of the CASPASE-1 inflammasome protein regulatory pathway in both arms | 6 months after inclusion |
| presence or absence of the CASPASE-1 inflammasome protein regulatory pathway in CAPS arm compared to control arm | Biochemical characterization of the CASPASE-1 inflammasome protein regulatory pathway in both arms | 12 months after inclusion |
| presence or absence of REV-ERBα inflammasome protein regulatory pathway in CAPS arm compared to control arm | Biochemical characterization of the REV-ERBα inflammasome protein regulatory pathway in both arms | 6 months after inclusion |
| presence or absence of REV-ERBα inflammasome protein regulatory pathway in CAPS arm compared to control arm | Biochemical characterization of the REV-ERBα inflammasome protein regulatory pathway in both arms | 12 months after inclusion |
| Hôpital Claude Huriez (CHU de Lille) | Not yet recruiting | Lille | 59037 | France |
|
| Hôpital de la Croix-Rousse (HCL) | Not yet recruiting | Lyon | 69004 | France |
|
| Hôpital Edouard Herriot (HCL) | Not yet recruiting | Lyon | 69437 | France |
|
| Hôpital Tenon (AP-HP) | Not yet recruiting | Paris | 75020 | France |
|
| Hôpital Kremlin-Bicêtre (AP-HP) | Not yet recruiting | Paris | 94270 | France |
|
| ID | Term |
|---|---|
| D056587 | Cryopyrin-Associated Periodic Syndromes |
| ID | Term |
|---|---|
| D056660 | Hereditary Autoinflammatory Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D012873 | Skin Diseases, Genetic |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D000094482 | Chronic Inducible Urticaria |
| D000080223 | Chronic Urticaria |
| D014581 | Urticaria |
| D017445 | Skin Diseases, Vascular |
| D000096703 | Cold Urticaria |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| D001800 | Blood Specimen Collection |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
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