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Autistic DisorderNCT02168868

Proteomic Biomarker Tests in Blood Samples from Children with Autism Spectrum Disorder (ASD)

An observational study of Autistic Disorder, run by Benjamin Gesundheit at 1 site in Israel.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Behavioral testing is the gold standard for diagnosing autism spectrum disorder (ASD). These tests, including ADOS and ADI-R, are subjective, require trained staff to administer, are time-consuming, and can only be administered at a later age. Read more about this study

Who is it for?
Ages 10 months to 19 yearsHealthy volunteers can take part
Conditions the study is for
Autistic Disorder
What is being tested?
Blood draw, Stool Sample Collection and Urine Sample Collection
Type of treatment
Injection or infusion
How many people
900 participants
Where
1 siteIsrael
Study dates
May 2013to Dec 2030
How long will I take part?
1 Day
Phase
Observational
Are there results?
Not yet: the study is under way

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 10 months to 19 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Study population: 1. Up to a total of 350 male and female children, aged 2-12 years, diagnosed with ASD according to DSM-IV (299.00) or DSM-V (299.00) 2. Up to a total of 350 male and female typically developing (TD) children aged 2-12 years with no signs of ASD or history of ASD in the immediate family who will serve as controls for the main subset of children with ASD 3. Up to 50 infants aged 10-19 months not diagnosed with ASD but with a sibling diagnosed with ASD according to DSM-IV (299.00) or DSM-V (299.00) (herein, high-risk infants) 4. Up to 50 mothers of the high-risk infants participating in the study 5. Up to 50 male and female children, aged 2-12 years, diagnosed with ASD according to DSM-IV (299.00) or DSM-V (299.00) scheduled to undergo stem cell therapy (SCT) 6. Up to 50 male and female children, aged 12-18 years, diagnosed with ASD according to DSM-IV (299.00) or DSM-V (299.00) scheduled to undergo SCT

Who may be able to join

  • Male and female children
  • Child aged 2-12 years with diagnosed ASD according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV (299.00) or DSM-V (299.00) OR Child aged 2-18 years diagnosed ASD according to DSM-IV (299.00) or DSM-V (299.00) AND scheduled to undergo stem cell transplantation OR Child aged 10-19 months not diagnosed with ASD but with a sibling diagnosed with ASD according to (DSM)-IV (299.00) or DSM-V (299.00) (herein termed "high-risk infants") OR Mothers of recruited high-risk infants OR A typically developing child aged 2-12 years with no signs of ASD or history of ASD in the immediate family
  • Informed consent signed by the parent/legal guardian

Who cannot join

  • Child and/or mother completed treatment with systemic steroids or immune suppressants less than 4 weeks before the screening visit
  • Child and/or mother diagnosed with severe infectious diseases or sepsis over the last 6 months
  • Child with ASD treated for a severe convulsive disorder (intractable seizures)
  • Child and/or mother with hematological or malignant disorder
  • For children in the SCT cohort: No new planned immune-modulating treatment (other than SCT) for at least 6 months before or after planned stem cell transplantation date
  • If the PI suspects that the participant will not comply with study requirements, the participant may be excluded.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Benjamin Gesundheit, M.D. contact

gesundheitmd@cell-el.com

Leah Hochbaum contact

leah@cell-el.com

Israel1 site, 1 recruiting
  • Shaare Zedek Medical Center

    Jerusalem, 91031

    Avraham Steinberg, MD, avraham@steinberg.onmicrosoft.com

    Avraham Steinberg, MD

    Recruiting

Other trials in Israel

About this study

Behavioral testing is the gold standard for diagnosing autism spectrum disorder (ASD). These tests, including ADOS and ADI-R, are subjective, require trained staff to administer, are time-consuming, and can only be administered at a later age. Blood-, urine- or stool-based diagnostic biomarker test for ASD would enable objective early diagnosis, potentially even before clinical symptoms are present, eliminate the need for trained staff and enable early intervention. Such a test would not only conserve money and time but would also provide clues to ASD pathogenesis.

To date, no definitive treatment exists for ASD. Most therapies are symptom-focused, generally focusing on behavioral, social and communication skills. Recent works have reported on promising outcomes of mesenchymal stem cell (MSC) treatment of children with ASD. MSCs are multipotent, non-hematopoietic, easily isolatable and expandable stem cells involved in tissue repair, immunomodulatory responses and neuromodulation. MSC treatment of children with ASD has reportedly led to improvements in speech, sociability, eye coordination, balance, cognition and overall well-being. At the base of this approach lies the known plasticity of the human brain and immune system in the early childhood years and the ability of MSCs to modulate atypical inflammatory and immune activities. Assessment of ASD biomarker profiles in children with ASD who have undergone one or more SCT sessions may shed light on the mechanism of action, assist in better defining ASD-specific diagnostic markers and monitor treatment outcomes.

Read the detailed description

There is accumulating evidence that at least a subset of children diagnosed with ASD also have aberrant immune functions. This study will attempt to identify more specifically the nature of the potential immune abnormalities in children.

The study will follow a case-control design, involving the following cohorts:

  1. young children (2-12 years) diagnosed with ASD
  2. children (12-18 years) diagnosed with ASD
  3. age- and sex-matched typically developing children
  4. high-risk infants (10-19 months) with at least one sibling with diagnosed ASD
  5. mothers of these high-risk infants
  6. young children (2-12 years) diagnosed with ASD and scheduled to undergo stem cell transplantation therapy (SCT)

Parents will be asked to complete several questionnaires relating to demographic and anamnestic details and to the child's development.

  • A single blood draw from all participants will be performed in the clinic.
  • A stool sample will be collected from high-risk infants.
  • A stool and urine sample will be collected at home from children due to undergo SCT. For children scheduled to undergo SCT, the blood, stool and urine samples must be collected before therapy.
  • Parents of high-risk infants will be contacted by phone or email when the child reaches diagnosable age (3.5 years) and again at the age of 6 years, to obtain an update on the child's ASD status. If the child has been diagnosed with ASD, an additional blood and stool sample may be collected.
  • Children who underwent SCT will be contacted 2±1 months and 6±1 months after the first treatment session, for collection of additional blood samples. Stool and urine samples will be collected at the 6±1 month post-treatment visit as well. Should the child undergo additional SCT within two years of the first treatment, additional blood, stool and urine samples may be collected. At each subsequent visit, a parent/legal guardian will be asked to complete several short questionnaires.

Adverse events to blood drawing will be reported to the Data Coordinating Center using the appropriate Case Report Form (CRF).

In cases of adverse effects (AE) related to the drawing of blood or performance of examination of patients in the course of standard examination procedures, the investigating team will proceed in accordance with local guidelines (to be inserted by the PI), reporting the incidents which occurred during the course of a clinical trial.

Clinical data will be collected by the investigator, or a person appointed and appropriately trained by the investigator, and shall be entered into standardized CRFs and shared online with the sponsor. Source data will be retained for all data entered in the CRFs. Progress reports and the Final Report at the conclusion of the trial will be submitted to the regulatory authority and the Ethics Committee, as required.

Being tested
Blood draw, Stool Sample Collection, Urine Sample Collection
Keywords
Autoimmune Diseases, Child Development Disorders, Inflammation, Risk Factors, Pervasive, Autism, Autistic Disorder
Medical subject headings
Autistic Disorder, Autoimmune Diseases, Developmental Disabilities, Inflammation

What participants receive

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

  • Blood drawDiagnostic test

    Also called blood sample, venepuncture

    A blood sample (5 mL) will be collected.

  • Stool Sample CollectionDiagnostic test

    Also called Stool Analysis

    Subjects will be provided a dry, plastic, screw-top specimen container and will be asked to collect a stool sample at home.

  • Urine Sample CollectionDiagnostic test

    Also called Urinalysis

    Subjects will be provided a dry, plastic, screw-top specimen container and will be asked to collect a urine sample at home.

Study groups in NCT02168868
Study groupRoleWhat they receive
Control Group of Young Children2-12 years old age \& sex-matched controls - typically developing (TD) children
Receives: Diagnostic Test: Blood draw
Young Children-Autism Spectrum Disorder2-12 years old children diagnosed with ASD according to DSM-IV (299.00) or DSM-V (299.00)
Receives: Diagnostic Test: Blood draw
Young Children-Autism Spectrum Disorder+SCT2-12 years old children diagnosed with ASD according to DSM-IV (299.00) or DSM-V (299.00) due to undergo stem cell transplantation therapy
Receives: Diagnostic Test: Blood draw; Diagnostic Test: Stool Sample Collection; Diagnostic Test: Urine Sample Collection
High-risk infantsInfants aged 10-19 months not diagnosed with ASD but with a sibling diagnosed with ASD
Receives: Diagnostic Test: Blood draw; Diagnostic Test: Stool Sample Collection
Mothers of high-risk infantsMothers of recruited infants aged 10-19 months not diagnosed with ASD but with a sibling diagnosed with ASD
Receives: Diagnostic Test: Blood draw
Adolescent-Autism Spectrum Disorder+SCT12-18 years old children diagnosed with ASD according to DSM-IV (299.00) or DSM-V (299.00) due to undergo stem cell transplantation therapy
Receives: Diagnostic Test: Blood draw; Diagnostic Test: Stool Sample Collection; Diagnostic Test: Urine Sample Collection

What is being measured

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

  1. Identification of discriminating proteomic biomarker profile in blood of children with ASD vs. matched TD children

    Finding a proteomic signature in children with ASD

    Measured: One day

  2. Identification of discriminating proteomic biomarker profiles in blood of high-risk infants, at recruitment vs. after diagnosis of ASD, if diagnosed

    Finding a proteomic signature in infants at high-risk of ASD

    Measured: Up to 5 years after initial blood draw

  3. Comparison of blood biomarker profiles in ASD children before versus after SCT

    Finding ASD-specific blood proteomic biomarkers that can be modified by SCT

    Measured: Through study completion, up to 6 months

Secondary outcomes (2)
  1. ASD severity vs. blood biomarker levels

    Correlative assessment of ASD severity vs. blood biomarker levels

    Measured: Through study, up to 5 years, depending on cohort

  2. Blood biomarker levels and SCT outcomes

    Correlative assessment of blood biomarker levels and SCT outcomes

    Measured: Through study completion, up to 6 months

Timeline

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

  1. First posted20 Jun 2014 (estimated)
  2. Study startMay 2013
  3. Primary completionDec 2030 (estimated)
  4. Study completionDec 2030 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
900 participants (estimated)
Target duration
1 Day
IDs, dates and publications
ClinicalTrials.gov ID
NCT02168868
Sponsor's protocol ID
CellEL-920130030
Status last verified
Feb 2023
First submitted
19 Jun 2014
Last updated
25 Nov 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Gesundheit B, Rosenzweig JP, Naor D, Lerer B, Zachor DA, Prochazka V, Melamed M, Kristt DA, Steinberg A, Shulman C, Hwang P, Koren G, Walfisch A, Passweg JR, Snowden JA, Tamouza R, Leboyer M, Farge-Bancel D, Ashwood P. Immunological and autoimmune considerations of Autism Spectrum Disorders. J Autoimmun. 2013 Aug;44:1-7. doi: 10.1016/j.jaut.2013.05.005. Epub 2013 Jul 15.

    PubMed 23867105
  • Gesundheit B, Zisman PD, Hochbaum L, Posen Y, Steinberg A, Friedman G, Ravkin HD, Rubin E, Faktor O, Ellis R. Autism spectrum disorder diagnosis using a new panel of immune- and inflammatory-related serum biomarkers: A case-control multicenter study. Front Pediatr. 2023 Feb 21;11:967954. doi: 10.3389/fped.2023.967954. eCollection 2023.

    PubMed 36896401

Questions about this trial

What is this clinical trial studying?

An observational study of Autistic Disorder, run by Benjamin Gesundheit at 1 site in Israel.

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 6 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: looking for participants now, as of the sponsor's last update on 25 Nov 2024. 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 Israel. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Benjamin Gesundheit, M.D. (gesundheitmd@cell-el.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Identification of discriminating proteomic biomarker profile in blood of children with ASD vs. matched TD children (time frame: One day). The study lists 3 primary outcomes in all. 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 NCT02168868, which also lists 2 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 25 Nov 2024.

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