Ignite Creation Date:
2024-05-05 @ 11:34 PM
Last Modification Date:
2024-10-26 @ 10:36 AM
Study NCT ID:
NCT01362569
Status:
COMPLETED
Last Update Posted:
2017-10-11
First Post:
2011-05-23
Brief Title:
Endotoxin Neutrophil Function and Albumin in Renal Insufficiency
Sponsor:
Vanessa Stadlbauer-Koellner MD
Organization:
Medical University of Graz
Study Overview
Official Title:
Endotoxin Neutrophil Function and Albumin in Renal Insufficiency
Status:
COMPLETED
Status Verified Date:
2017-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
ENARI
Brief Summary:
Chronic kidney disease is widespread in the western world with bacterial infection and sepsis as common complication It has been shown that innate immune defence represented by dysfunction of neutrophil granulocytes is impaired in chronic kidney disease Another impact of chronic kidney disease on innate immunity is the chronic activation of neutrophils leading to high levels of inflammatory cytokines thus contributing to protein oxidation Oxidation of human serum albumin HSA the major plasma protein occurs in chronic kidney disease and leads to further activation of neutrophils Another important impact of HSA oxidation is the decrease of its binding capacity leading to impaired detoxification ability of albumin This includes reduced clearance of endotoxin a major component of the gram negative bacterial cell wall Circulating endotoxin is recognized by complex formation with lipopolysaccharide binding protein LBP followed by binding to CD14 and toll-like receptor TLR 4 High systemic endotoxin levels occur in chronic kidney disease and may be the result of decreased clearance ability of HSA and increased gut permeability in combination with intestinal bacterial overgrowth High systemic endotoxin is associated with worse outcome in several diseases and could be used as predictor for mortality in chronic kidney disease patients
Endotoxemia in renal insufficiency leads to impaired neutrophil function and to increased albumin oxidation Oxidized albumin is not able to bind endotoxin adequately any more which leads to a further increase in oxidative stress and neutrophil dysfunction resulting in a vicious cycle
195 patients with renal dysfunction will be enrolled and divided into 5 groups Additionally samples of 25 age and sex-matched healthy controls will be collected
This concept will change the understanding of several aspects of chronic kidney disease and will potentially help to stratify patients into different groups at risk according to their endotoxin status and their immune and albumin dysfunction The results of this study will have important implications into the development of novel therapeutic strategies
Endotoxemia in renal insufficiency leads to impaired neutrophil function and to increased albumin oxidation Oxidized albumin is not able to bind endotoxin adequately any more which leads to a further increase in oxidative stress and neutrophil dysfunction resulting in a vicious cycle
195 patients with renal dysfunction will be enrolled and divided into 5 groups Additionally samples of 25 age and sex-matched healthy controls will be collected
This concept will change the understanding of several aspects of chronic kidney disease and will potentially help to stratify patients into different groups at risk according to their endotoxin status and their immune and albumin dysfunction The results of this study will have important implications into the development of novel therapeutic strategies
Detailed Description:
Laboratory methods Endotoxin will be detected by an adapted limulus amoebocyte lysate assay LBP and sCD14 will be determined by means of ELISA HPLC will be used to determine nitrate nitrite albumin fractions albumin binding capacity iNOS expression and energy status of neutrophils For investigation of oxidation driven by leukocyte derived myeloperoxidase mass spectrometry analysis will be used Carbonyl contents of proteins will be detected by ELISA Neutrophil function and TLR2 4 and 9 expression will be studied by flow cytometrical analysis For cell culture tests freshly isolated neutrophils or differentiated HL60 cells will be used and incubated with albumin andor endotoxin Stool samples will be used for 16srDNA sequencing of the gut microbiome
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None