AzTrials
AzTrials

ImmunotherapyPhase 4NCT01475188

Regulatory Lymphocytes in Patients Treated With Specific Immunotherapy

A Phase 4 study testing Allergovit in people with Immunotherapy and Seasonal Allergic Rhinitis, run by Ministry of Science and Higher Education, Poland at 1 site in Poland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to determine whether specific subcutaneous immunotherapy affects fractions of regulatory T lymphocytes and histamine H2 receptor expression and ZAP70 in regulatory T lymphocytes. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Immunotherapy, Seasonal Allergic Rhinitis
What is being tested?
Allergovit
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
41 participants
Where
1 sitePoland
Study dates
Mar 2007to Dec 2010
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • seasonal allergic rhinitis with or without allergic conjunctivitis
  • sensitization to grass pollen allergens (confirmed with skin prick tests, conjunctival provocation test, specific IgE)
  • symptoms of allergic rhinitis with or without conjunctivitis for at least 2 years before the study

Who cannot join

  • sensitization to allergens, that could interfere with grass pollen
  • asthma
  • cystic fibrosis
  • ciliary dysmotility syndrome
  • bronchiectasis
  • smoking
Show all 11Show fewer
  • tuberculosis
  • neoplastic disease
  • chronic sinusitis and nasal polyps
  • systemic glucocorticosteroids treatment
  • treatment with immunotherapy in the past

Trial locations and contacts

1 site in 1 country.

Poland1 site
  • Department of Pneumonology and Allergy, Medical University of Lodz

    Lodz, 90-153

Other trials in Poland

About this study

Official title: Regulatory Lymphocytes (Treg) in the Modulation of Allergic Inflammation in Patients Treated With Specific Immunotherapy.

The purpose of this study is to determine whether specific subcutaneous immunotherapy affects fractions of regulatory T lymphocytes and histamine H2 receptor expression and ZAP70 in regulatory T lymphocytes.

Read the detailed description

Allergy constitutes an important problem worldwide thus effective treatment is crucial for the reduction of symptoms severity, patients' activity and quality of life as well as for the reduction of direct and indirect costs of the disease. Specific allergen immunotherapy (SIT) is a potentially curative and specific method of treatment for allergic diseases, particularly for intermittent allergic rhinitis. Specific subcutaneous immunotherapy induce peripheral tolerance and suppress inflammation in tissue. In periphery, effector T cells unresponsiveness to antigens is mediated mainly by allergen specific regulatory T cells. Regulatory T cells induced peripherally comprise IL-10 producing type 1 regulatory T cells (Tr1) and regulatory T cells subset arising in vitro from CD4+CD25- and in vivo from peripheral memory T cells whereas naturally occurring Tregs (nTregs)originate in thymus and represent about 5% of the peripheral CD4 T cells and constitutively express high levels of the high-affinity IL-2 receptor (CD25hi). They coexpress Forkhead Box Protein P3 (Foxp3), glucocorticoid induced tumor necrosis factor receptor (GITR), cytotoxic T lymphocyte associated antigen (CTLA-4), and display low expression of alpha chain of the IL-7 receptor. Although clinical and immunological outcomes of SIT, that are associated with regulatory T cells functions were profoundly studied, little is known about the molecular mechanisms that are crucial for nTregs activation and function in the course of SIT. Since histamine is a key mediator in allergy that exerts its effect through 4 types of histamine receptors we decided to investigate the expression of histamine 2 receptor, that has potent immunomodulatory properties, in regulatory lymphocytes in patients treated with SIT. Furthermore, since T cell receptor activation is essential for T effector lymphocytes activation we wanted to check the expression of zeta chain associated protein (ZAP70), that constitutes a linker between TCR and lower levels of intracellular downstream signal transduction, in regulatory T cells in the course of SIT.

This is a 3-year prospective, placebo controlled, double blind trial of grass SIT. 41 patients with seasonal allergic rhinitis were randomized to receive SIT (n = 21) or placebo (n = 20) and 15 healthy were included as a control. The primary and secondary outcomes were assessed at baseline and during the treatment period - before the start of the pollen season, at the height of the pollen season and after the end of the pollen season.Results were compared between the treatment year and baseline and between the groups treated with SIT, placebo and healthy control.

Being tested
Allergovit, placebo
Keywords
specific subcutaneous immunotherapy, seasonal allergic rhinitis, regulatory lymphocytes, signal transduction, histamine receptor
Medical subject headings
Rhinitis, Allergic, Seasonal

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AllergovitDrug

    Also called Allergovit, grass pollen 100%, Allergopharma, Germany

    commercially available grass pollen allergoid (100%), concentration A (1000 TU/ml, therapeutic units/ml)concentration B (10000 TU/ml).Patients were given subcutaneous injections with initial dose of 0.1 ml (concentration A) was increased once a 7 (+7) days until the highest tolerated dose (0.6, concentration B) was reached and SIT was continued with injections once every 4 - 6 weeks up to two years.

  • placeboOther

    placebo administered with the same scheme and doses as specific subcutaneous immunotherapy

Study groups in NCT01475188
Study groupRoleWhat they receive
placeboPlacebo comparator20 patients with intermittent allergic rhinitis sensitized to grass pollen allergens
Receives: Other: placebo
Specific subcutaneous immunotherapyActive comparator21 symptomatic patients with intermittent allergic rhinitis sensitized to grass pollen allergens
Receives: Drug: Allergovit

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. numbers of regulatory T lymphocytes (nTregs)

    Numbers of regulatory T cells (nTregs) at baseline year both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen season and in the 2nd year of immunotherapy both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen.

    Measured: Change from the baseline year to the 2nd year of immunotherapy.

Secondary outcomes (6)
  1. Expression of zeta chain associated protein (ZAp70) in regulatory lymphocytes (nTregs)

    Expression of zeta chain associated protein (ZAP70) in regulatory T cells (nTregs) at baseline year both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen season and in the 2nd year of immunotherapy both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen.

    Measured: Change from the baseline year to the 2nd year of immunotherapy

  2. Expression of histamine H2 receptor in regulatory lymphocytes (NTregs)

    Expression of histamine H2 receptor in regulatory T cells (nTregs) at baseline year both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen season and in the 2nd year of immunotherapy both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen.

    Measured: Change from the baseline year to the second year of immunotherapy

  3. Rhinoconjunctivitis symptom score

    Change of the rhinoconjunctivitis symptoms score from the baseline year to the 2nd year of immunotherapy

    Measured: Change from the baseline year to the second year of immunotherapy

  4. Nasal eosinophilia

    Numbers of eosinophils in nasal lavage during the baseline year both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen season and in the 2nd year of immunotherapy both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen.

    Measured: Change from the basline year to the 2nd year of immunotherapy

  5. Concentration of nitric oxide in exhaled air

    Concentration of nitric oxide in exhaled air during the baseline year both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen season and in the 2nd year of immunotherapy both 6 weeks before the start of the pollen season, at the height of pollen season and 6 weeks after the termination of the pollen.

    Measured: Change from the baseline year to the 2nd year of immunotherapy

  6. Consumption of rescue medications

    Comparison of the rescue medication intake during the baseline year and during the treatment

    Measured: Change from the baseline year to the second year of imunotherapy

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Nov 2011 (estimated)
  2. Study startMar 2007
  3. Primary completionOct 2010
  4. Study completionDec 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
41 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01475188
Sponsor's protocol ID
N 402 057 32/1788
Other IDs
1788/PO1/2007/32
Status last verified
Nov 2011
First submitted
16 Nov 2011
Last updated
21 Nov 2011
Results posted
No
Data monitoring committee
No

Publications

  • Dieckmann D, Bruett CH, Ploettner H, Lutz MB, Schuler G. Human CD4(+)CD25(+) regulatory, contact-dependent T cells induce interleukin 10-producing, contact-independent type 1-like regulatory T cells [corrected]. J Exp Med. 2002 Jul 15;196(2):247-53. doi: 10.1084/jem.20020642.

    PubMed 12119349
  • Baecher-Allan C, Viglietta V, Hafler DA. Human CD4+CD25+ regulatory T cells. Semin Immunol. 2004 Apr;16(2):89-98. doi: 10.1016/j.smim.2003.12.005.

    PubMed 15036232
  • Fontenot JD, Gavin MA, Rudensky AY. Foxp3 programs the development and function of CD4+CD25+ regulatory T cells. Nat Immunol. 2003 Apr;4(4):330-6. doi: 10.1038/ni904. Epub 2003 Mar 3.

    PubMed 12612578
  • Cao D, Malmstrom V, Baecher-Allan C, Hafler D, Klareskog L, Trollmo C. Isolation and functional characterization of regulatory CD25brightCD4+ T cells from the target organ of patients with rheumatoid arthritis. Eur J Immunol. 2003 Jan;33(1):215-23. doi: 10.1002/immu.200390024.

    PubMed 12594850
  • Sakaguchi S. Naturally arising CD4+ regulatory t cells for immunologic self-tolerance and negative control of immune responses. Annu Rev Immunol. 2004;22:531-62. doi: 10.1146/annurev.immunol.21.120601.141122.

    PubMed 15032588
  • Jordan MS, Riley MP, von Boehmer H, Caton AJ. Anergy and suppression regulate CD4(+) T cell responses to a self peptide. Eur J Immunol. 2000 Jan;30(1):136-44. doi: 10.1002/1521-4141(200001)30:13.0.CO;2-0.

    PubMed 10602035
  • Apostolou I, Sarukhan A, Klein L, von Boehmer H. Origin of regulatory T cells with known specificity for antigen. Nat Immunol. 2002 Aug;3(8):756-63. doi: 10.1038/ni816. Epub 2002 Jul 1.

    PubMed 12089509
  • Hori S, Nomura T, Sakaguchi S. Control of regulatory T cell development by the transcription factor Foxp3. Science. 2003 Feb 14;299(5609):1057-61. doi: 10.1126/science.1079490. Epub 2003 Jan 9.

    PubMed 12522256
  • Shevach EM. CD4+ CD25+ suppressor T cells: more questions than answers. Nat Rev Immunol. 2002 Jun;2(6):389-400. doi: 10.1038/nri821.

    PubMed 12093005
  • Thornton AM, Shevach EM. CD4+CD25+ immunoregulatory T cells suppress polyclonal T cell activation in vitro by inhibiting interleukin 2 production. J Exp Med. 1998 Jul 20;188(2):287-96. doi: 10.1084/jem.188.2.287.

    PubMed 9670041
  • Fontenot JD, Rasmussen JP, Williams LM, Dooley JL, Farr AG, Rudensky AY. Regulatory T cell lineage specification by the forkhead transcription factor foxp3. Immunity. 2005 Mar;22(3):329-41. doi: 10.1016/j.immuni.2005.01.016.

    PubMed 15780990
  • Jutel M, Akdis M, Blaser K, Akdis CA. Mechanisms of allergen specific immunotherapy--T-cell tolerance and more. Allergy. 2006 Jul;61(7):796-807. doi: 10.1111/j.1398-9995.2006.01175.x.

    PubMed 16792576
  • Jutel M, Watanabe T, Klunker S, Akdis M, Thomet OA, Malolepszy J, Zak-Nejmark T, Koga R, Kobayashi T, Blaser K, Akdis CA. Histamine regulates T-cell and antibody responses by differential expression of H1 and H2 receptors. Nature. 2001 Sep 27;413(6854):420-5. doi: 10.1038/35096564.

    PubMed 11574888
  • Liu H, Rhodes M, Wiest DL, Vignali DA. On the dynamics of TCR:CD3 complex cell surface expression and downmodulation. Immunity. 2000 Nov;13(5):665-75. doi: 10.1016/s1074-7613(00)00066-2.

    PubMed 11114379
  • Ciebiada M, Kasztalska K, Gorska-Ciebiada M, Gorski P. ZAP70 expression in regulatory T cells in allergic rhinitis: effect of immunotherapy. Clin Exp Allergy. 2013 Jul;43(7):752-61. doi: 10.1111/cea.12124.

    PubMed 23786282

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Allergovit in people with Immunotherapy and Seasonal Allergic Rhinitis, run by Ministry of Science and Higher Education, Poland at 1 site in Poland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Nov 2011. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Poland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

numbers of regulatory T lymphocytes (nTregs) (time frame: Change from the baseline year to the 2nd year of immunotherapy.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01475188, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Nov 2011.

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