Involvement of Immune Cells Derived From the Intestine in Sjogren's Syndrome

Sjogren's Syndrome Clinical Trial

— SINGOU  

Official title:

Involvement of Immune Cells Derived From the Intestine in Sjogren's Syndrome

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03841318
• Other study ID #: CHUBX 2018/53
• Status: Recruiting
• Phase: N/A
• Start date: August 3, 2020
• Est. completion date: August 2024

Study information

• Verified date: August 2023
• Source: University Hospital, Bordeaux
• Contact: Pierre DUFFAU, Prof
• Phone: (0)5 56 79 58 28
• Email: pierre.duffau[@]chu-bordeaux.fr
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The study aims at defining the role of immune cells derived from the intestine in the pathogenesis of Sjogren's disease. This research might open new therapeutic approaches for the treatment of autoimmune diseases.

Description:

Autoimmune diseases are characterized by a loss of tolerance of the immune system for self-antigens. One of the feature of autoimmune diseases is the infiltration of lymphoid cells in the tissues damaged by the disease (i.e. kidney in systemic lupus erythematous or brain in multiple sclerosis). However, the origins and properties of the immune cells infiltrating these target tissues are largely unknown.

Studies in mouse models have shown that the composition of the gut microbiota can modify the susceptibility to autoimmune diseases. These studies demonstrated that the microbiota composition can alter the pathogenic properties of T cells in the gut but also in the target tissues. For instance, in the experimental autoimmune encephalomyelitis model, the composition of the gut microbiota has been shown to modulate the susceptibility to the disease and the properties of the pathogenic CD4 T cells in the gut but also in the central nervous system. In human an alteration in the composition of the gut microbiota is observed in numerous autoimmune diseases, including Sjogren's syndrome, suggesting that perturbation of the gut microbiota might be linked to the pathogenicity of immune cells in the target organs. However, the mechanisms by which the microbiota impacts the pathogenicity of immune cells in the target organs is unknown. It is proposed that gut immune cells directly exposed to the microbiota compounds could migrate to the target organs and participate to the buildup of tissue damages. This hypothesis is supported by studies in mouse models showing the migration of gut CD4 T cells in the inflamed kidney (glomerulonephritis model) or in the systemic lymphoid organs (rheumatoid arthritis model). The preliminary data support this hypothesis as the investigators have shown that gut-derived CD4 T cells display pathogenic properties in human autoimmune diseases. To determine whether and how the gut-derived immune cells are involved in the pathogenesis of autoimmune disease, the investigators propose to study the origin and properties of immune cells infiltrated in target tissues in autoimmune diseases.

Sjogren's syndrome is a systemic autoimmune disease in which exocrine gland in particular lacrimal and salivary glands are affected. One of the hallmark of the disease is the infiltration of lymphoid cells in the exocrine glands of the patients. Indeed, the presence of lymphoid infiltrate in the minor labial salivary gland of the patients is one of the most important diagnostic tool for Sjogren's syndrome. The investigation of lymphoid infiltrates requires to perform a biopsy of the labial salivary gland. The investigators propose here to take advantage of this minimally invasive procedure to study the properties of the lymphoid cells present in the minor salivary glands of Sjogren's patients.

The study will recruit 200 patients followed in Bordeaux University Hospital in which a salivary gland biopsy is performed for a clinical suspicion of Sjogren's syndrome. Blood and a biopsy of the minor salivary gland of the lip will be collected during a scheduled visit to study the properties of infiltrated immune cells. Clinical and biological disease activity, treatment and outcomes will be studied in correlation with the properties of infiltrated immune cells. No extra visit will be needed and the biopsy of the minor salivary gland of the lip and the blood samples will be collected at the same times as those collected for clinical purposes.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 200
• Est. completion date: August 2024
• Est. primary completion date: August 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Suspicion of Sjogren's syndrome based on 2016 American College of Rheumatology (ACR) criteria;

• Age = 18 years

• Being affiliated to health insurance

• Willing to participate

Exclusion Criteria:

• Pregnant or breastfeeding women,

• Patient concerned by articles L 1121-5 to L 1121-8 (persons deprived of their liberty by a judicial or administrative decision, minors, persons of legal age who are the object of a legal protection measure or unable to express their consent)

Related Conditions & MeSH terms

• Sjogren's Syndrome
• Syndrome

Intervention

Biological:
• blood sample
36 ml whole blood for Peripheral blood mononuclear cell (PBMC) and monocytes isolation
• biopsy of the labial salivary gland
Part of the biopsy of the labial salivary gland

Locations

Country	Name	City	State
France	CHU de Bordeaux - Service de médecine interne	Bordeaux

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital, Bordeaux

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Quantification of the immune cells infiltrated in the minor salivary glands of Sjogren's patients.		At baseline (Day 0)
Secondary	Quantification of disease activity scores for Sjogren's patients evalued by EULAR Sjögren Syndrome Disease Activity Index	EULAR Sjögren Syndrome Disease Activity Index (ESSDAI) : between 0 and 123, in which higher values indicate higher severity	At baseline (Day 0)