Chronic Beryllium Disease (CBD)NCT02596347
The Role of JAK2 in Alveolar Macrophages (AM's) in Chronic Beryllium Disease (CBD)
An observational study of Chronic Beryllium Disease (CBD) and Beryllium Sensitization (BeS), run by National Jewish Health at 1 site in United States.
Trial summary
Current studies suggest that alveolar macrophages (AM) act as silencers of most immune responses in the lung. However, in pathological conditions, such as asthma, hypersensitivity pneumonitis, and sarcoidosis, AMs become involved in the maintenance and further expansion of the immune response in the target organ. Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Chronic Beryllium Disease (CBD), Beryllium Sensitization (BeS)
- What is being tested?
- Blood draw and bronchoscopy
- Type of treatment
- Surgery or procedure
- How many people
- 3 participants
- Where
- 1 siteUnited States
- Study dates
- Apr 2015to 6 Dec 2019
- Phase
- Observational
- 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 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Those diagnosed with Beryllium Sensitization. Those diagnosed with Chronic beryllium disease
Who may be able to join
- Chronic Beryllium Disease - These individuals will meet the following inclusion criteria:
- History of beryllium exposure;
- Positive blood and/or bronchoalveolar lavage (BAL) Beryllium Lymphocyte Proliferation Tests (BeLPT);
- Biopsy-proven pathologic changes consistent with CBD, specifically non-caseating granulomas and/or mononuclear cell interstitial infiltrates .
- Beryllium Sensitization - These individuals will meet the following inclusion criteria:
- History of beryllium exposure;
- Two or more positive blood beryllium lymphocyte proliferation tests (BeLPT) or positive bronchoalveolar lavage (BAL) BeLPT;
- Normal lung tissue (no histology suggestive of CBD).
Who cannot join
- -
Trial locations and contacts
1 site in 1 country.
About this study
Official title: The Role of JAK2 in Alveolar Macrophages in Chronic Beryllium Disease
Current studies suggest that alveolar macrophages (AM) act as silencers of most immune responses in the lung. However, in pathological conditions, such as asthma, hypersensitivity pneumonitis, and sarcoidosis, AMs become involved in the maintenance and further expansion of the immune response in the target organ. The Investigator has preliminary data demonstrating that CBD AMs at the site of disease involvement (bronchoalveolar lavage, BAL) display an activated cell surface phenotype compared to AMs from healthy controls. Furthermore, exciting data from our group demonstrates significant differences in gene expression profiles between CBD and Beryllium Sensitivity (BeS) bronchial alveolar lavage (BAL) cells, in pivotal immune response genes and networks. Specifically, the Investigator has found the JAK/STAT pathway and the JAK2 gene was dramatically overexpressed in CBD BAL cells. In addition, constitutively phosphorylated JAK2 (pJAK2) was found in AMs from Chronic Beryllium Disease (CBD) patients by Westernblot and was increased after beryllium (Be) stimulation for 30 min. Moreover, the JAK2 inhibitor TG101348 significantly inhibited Be-induced CBD AMs TNFa and IFNy production. Meanwhile, overexpression of the JAK2 inhibitor SOCS 1 (suppressors of cytokine signaling) protein decreased Be-induced TNFa production from AMs. Based on this information, the Investigator hypothesizes that CBD AMs overexpress JAK2, which augments the immune response to Be and development of CBD but not BeS.
The investigators believe that these studies are highly innovative since they will undoubtedly shed light on exposure-mediated immune dysregulation in Alveolar Macrophages (AMs) that lead to disease development and likely progression and with additional study of this pathway will reveal potential biomarkers for clinical prognosis and diagnosis. The results obtained from this study will improve the investigators understanding of factors involved in the development of Chronic Beryllium disease (CBD), as well as define targets for therapy, and will serve as a model of other exposure-related immune responses and environmentally-induced chronic diseases. Most importantly, these studies will provide the investigator with preliminary data to submit a high quality R01, allowing the Investigator to apply similar approaches to other genes, define a potential target for this and other similar immune-mediated diseases and continue research efforts at National Jewish Health (NJH.)
- Being tested
- Blood draw, bronchoscopy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Blood drawProcedure or surgery
We will draw 4 heparin tubes for peripheral blood mononuclear cells (PBMC)
bronchoscopyProcedure or surgery
Also called BAL
CBD subjects will undergo a bronchoscopy with lavage. This is the passage of a think flexible tube through the nose into the windpipe then into the bronchial tubes. Sterile saltwater solution is through the flexible tube then immediately removed.
| Study group | Role | What they receive |
|---|---|---|
| Beryllium Sensitization (BeS) | Blood draw Receives: Procedure: Blood draw | |
| Chronic Beryllium Disease(CBD) | blood draw BAL Receives: Procedure: Blood draw; Procedure: bronchoscopy |
What is being measured
The primary outcome is the main question the study is designed to answer.
The primary outcome for the aims is the downregulation of Th1 cytokine TNFalpha with the inhibition of the JAK2 using siRNA and the inhibitor INCB018424, CEP-701 and TG101348 in CBD or overexpression of the JAK2 gene.
As the primary outcome is the downregulation of TNFalpha level with the inhibition of the JAK2 using the inhibitor TG101348 in CBD, we expect a 50% reduction with a standard deviation of 0.2 based on our preliminary data. We will have more than 95% power with n=6 CBD patients for these aims.
Measured: year 1
The secondary outcomes for the aims are the changes in BeLPT and AMs phenotype from BeS, CBD and Healthy controls (HC).
The investigator will use repeated measure Welch's ANOVA in SAS 9.4, which correctly accounts for the correlation between measurements and allows for comparisons within and between groups. Normalizing transformations will be performed when necessary to conform to model assumptions and Mauchly's sphericity test will be assessed and adjustments will be added to the analysis as necessary. Estimate and contrast statements will be developed to test hypotheses of interest.
Measured: year 2
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Nov 2015 (estimated)
- Study startApr 2015
- Primary completion6 Dec 2019
- Study completion6 Dec 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Chronic Beryllium Disease (CBD)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 only
- Time perspective
- Cross-sectional
- Enrolment
- 3 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Jewish Health
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Li Li, National Jewish Health
- Investigators
- Li Li, MD, Principal investigator, National Jewish Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02596347
- Sponsor's protocol ID
- 2877
- Status last verified
- Oct 2020
- First submitted
- 29 Oct 2015
- Last updated
- 19 Oct 2020
- Results posted
- No
- Data monitoring committee
- No
Publications
Li L, Schmitt A, Reinhardt P, Greiner J, Ringhoffer M, Vaida B, Bommer M, Vollmer M, Wiesneth M, Dohner H, Schmitt M. Reconstitution of CD40 and CD80 in dendritic cells generated from blasts of patients with acute myeloid leukemia. Cancer Immun. 2003 Jul 16;3:8.
PubMed 12862419Greiner J, Ringhoffer M, Taniguchi M, Li L, Schmitt A, Shiku H, Dohner H, Schmitt M. mRNA expression of leukemia-associated antigens in patients with acute myeloid leukemia for the development of specific immunotherapies. Int J Cancer. 2004 Feb 20;108(5):704-11. doi: 10.1002/ijc.11623.
PubMed 14696097Li L, Reinhardt P, Schmitt A, Barth TF, Greiner J, Ringhoffer M, Dohner H, Wiesneth M, Schmitt M. Dendritic cells generated from acute myeloid leukemia (AML) blasts maintain the expression of immunogenic leukemia associated antigens. Cancer Immunol Immunother. 2005 Jul;54(7):685-93. doi: 10.1007/s00262-004-0631-8. Epub 2004 Dec 31.
PubMed 15627212Greiner J, Li L, Ringhoffer M, Barth TF, Giannopoulos K, Guillaume P, Ritter G, Wiesneth M, Dohner H, Schmitt M. Identification and characterization of epitopes of the receptor for hyaluronic acid-mediated motility (RHAMM/CD168) recognized by CD8+ T cells of HLA-A2-positive patients with acute myeloid leukemia. Blood. 2005 Aug 1;106(3):938-45. doi: 10.1182/blood-2004-12-4787. Epub 2005 Apr 12.
PubMed 15827130Li L, Giannopoulos K, Reinhardt P, Tabarkiewicz J, Schmitt A, Greiner J, Rolinski J, Hus I, Dmoszynska A, Wiesneth M, Schmitt M. Immunotherapy for patients with acute myeloid leukemia using autologous dendritic cells generated from leukemic blasts. Int J Oncol. 2006 Apr;28(4):855-61.
PubMed 16525634Li Q, Li L, Shi W, Jiang X, Xu Y, Gong F, Zhou M, Edwards CK 3rd, Li Z. Mechanism of action differences in the antitumor effects of transmembrane and secretory tumor necrosis factor-alpha in vitro and in vivo. Cancer Immunol Immunother. 2006 Dec;55(12):1470-9. doi: 10.1007/s00262-006-0150-x. Epub 2006 Mar 23.
PubMed 16555058Giannopoulos K, Li L, Bojarska-Junak A, Rolinski J, Dmoszynska A, Hus I, Greiner J, Renner C, Dohner H, Schmitt M. Expression of RHAMM/CD168 and other tumor-associated antigens in patients with B-cell chronic lymphocytic leukemia. Int J Oncol. 2006 Jul;29(1):95-103.
PubMed 16773189Greiner J, Schmitt M, Li L, Giannopoulos K, Bosch K, Schmitt A, Dohner K, Schlenk RF, Pollack JR, Dohner H, Bullinger L. Expression of tumor-associated antigens in acute myeloid leukemia: Implications for specific immunotherapeutic approaches. Blood. 2006 Dec 15;108(13):4109-17. doi: 10.1182/blood-2006-01-023127. Epub 2006 Aug 24.
PubMed 16931630Schmitt M, Li L, Giannopoulos K, Chen J, Brunner C, Barth T, Schmitt A, Wiesneth M, Dohner K, Dohner H, Greiner J. Chronic myeloid leukemia cells express tumor-associated antigens eliciting specific CD8+ T-cell responses and are lacking costimulatory molecules. Exp Hematol. 2006 Dec;34(12):1709-19. doi: 10.1016/j.exphem.2006.07.009.
PubMed 17157168
Study at a glance
From the registry record, last updated by the sponsor on 19 Oct 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Role of JAK2 in Alveolar Macrophages in Chronic Beryllium Disease
- ClinicalTrials.gov ID
- NCT02596347
- Acronym / sponsor ID
- 2877
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 3 participants (actual)
- Lead sponsor
- National Jewish HealthUniversity, hospital or other
- Study start
- Apr 2015
- Primary completion
- 6 Dec 2019 (actual)
- Study completion
- 6 Dec 2019 (actual)
- First posted
- 4 Nov 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Current studies suggest that alveolar macrophages (AM) act as silencers of most immune responses in the lung. However, in pathological conditions, such as asthma, hypersensitivity pneumonitis, and sarcoidosis, AMs become involved in the maintenance and further expansion of the immune response in the target organ. The Investigator has preliminary data demonstrating that CBD AMs at the site of disease involvement (bronchoalveolar lavage, BAL) display an activated cell surface phenotype compared to AMs from healthy controls. Furthermore, exciting data from our group demonstrates significant differences in gene expression profiles between CBD and Beryllium Sensitivity (BeS) bronchial alveolar lavage (BAL) cells, in pivotal immune response genes and networks. Specifically, the Investigator has found the JAK/STAT pathway and the JAK2 gene was dramatically overexpressed in CBD BAL cells. In addition, constitutively phosphorylated JAK2 (pJAK2) was found in AMs from Chronic Beryllium Disease (CBD) patients by Westernblot and was increased after beryllium (Be) stimulation for 30 min. Moreover, the JAK2 inhibitor TG101348 significantly inhibited Be-induced CBD AMs TNFa and IFNy production. Meanwhile, overexpression of the JAK2 inhibitor SOCS 1 (suppressors of cytokine signaling) protein decreased Be-induced TNFa production from AMs. Based on this information, the Investigator hypothesizes that CBD AMs overexpress JAK2, which augments the immune response to Be and development of CBD but not BeS.
The investigators believe that these studies are highly innovative since they will undoubtedly shed light on exposure-mediated immune dysregulation in Alveolar Macrophages (AMs) that lead to disease development and likely progression and with additional study of this pathway will reveal potential biomarkers for clinical prognosis and diagnosis. The results obtained from this study will improve the investigators understanding of factors involved in the development of Chronic Beryllium disease (CBD), as well as define targets for therapy, and will serve as a model of other exposure-related immune responses and environmentally-induced chronic diseases. Most importantly, these studies will provide the investigator with preliminary data to submit a high quality R01, allowing the Investigator to apply similar approaches to other genes, define a potential target for this and other similar immune-mediated diseases and continue research efforts at National Jewish Health (NJH.)
Study design
- Observational model
- Case only
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Beryllium Sensitization (BeS) | – | Procedure: Blood drawBlood draw |
| Chronic Beryllium Disease(CBD) | – | Procedure: Blood draw, Procedure: bronchoscopyblood draw BAL |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Those diagnosed with Beryllium Sensitization. Those diagnosed with Chronic beryllium disease
Key inclusion criteria (8 listed)
- Chronic Beryllium Disease - These individuals will meet the following inclusion criteria:
- History of beryllium exposure;
- Positive blood and/or bronchoalveolar lavage (BAL) Beryllium Lymphocyte Proliferation Tests (BeLPT);
- Biopsy-proven pathologic changes consistent with CBD, specifically non-caseating granulomas and/or mononuclear cell interstitial infiltrates .
- History of beryllium exposure;
Key exclusion criteria (1 listed)
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Blood drawWe will draw 4 heparin tubes for peripheral blood mononuclear cells (PBMC) | Procedure or surgery | Beryllium Sensitization (BeS), Chronic Beryllium Disease(CBD) |
| bronchoscopyAlso: BALCBD subjects will undergo a bronchoscopy with lavage. This is the passage of a think flexible tube through the nose into the windpipe then into the bronchial tubes. Sterile saltwater solution is through the flexible tube then immediately removed. | Procedure or surgery | Chronic Beryllium Disease(CBD) |
Primary outcome
The primary outcome for the aims is the downregulation of Th1 cytokine TNFalpha with the inhibition of the JAK2 using siRNA and the inhibitor INCB018424, CEP-701 and TG101348 in CBD or overexpression of the JAK2 gene.
Time frame: year 1
As the primary outcome is the downregulation of TNFalpha level with the inhibition of the JAK2 using the inhibitor TG101348 in CBD, we expect a 50% reduction with a standard deviation of 0.2 based on our preliminary data. We will have more than 95% power with n=6 CBD patients for these aims.
The secondary outcomes for the aims are the changes in BeLPT and AMs phenotype from BeS, CBD and Healthy controls (HC).
Time frame: year 2
The investigator will use repeated measure Welch's ANOVA in SAS 9.4, which correctly accounts for the correlation between measurements and allows for comparisons within and between groups. Normalizing transformations will be performed when necessary to conform to model assumptions and Mauchly's sphericity test will be assessed and adjustments will be added to the analysis as necessary. Estimate and contrast statements will be developed to test hypotheses of interest.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Oct 2020.
- Background: PubMed 12862419Li L, Schmitt A, Reinhardt P, Greiner J, Ringhoffer M, Vaida B, Bommer M, Vollmer M, Wiesneth M, Dohner H, Schmitt M. Reconstitution of CD40 and CD80 in dendritic cells generated from blasts of patients with acute myeloid leukemia. Cancer Immun. 2003 Jul 16;3:8.
- Background: PubMed 14696097Greiner J, Ringhoffer M, Taniguchi M, Li L, Schmitt A, Shiku H, Dohner H, Schmitt M. mRNA expression of leukemia-associated antigens in patients with acute myeloid leukemia for the development of specific immunotherapies. Int J Cancer. 2004 Feb 20;108(5):704-11. doi: 10.1002/ijc.11623.
- Background: PubMed 15627212Li L, Reinhardt P, Schmitt A, Barth TF, Greiner J, Ringhoffer M, Dohner H, Wiesneth M, Schmitt M. Dendritic cells generated from acute myeloid leukemia (AML) blasts maintain the expression of immunogenic leukemia associated antigens. Cancer Immunol Immunother. 2005 Jul;54(7):685-93. doi: 10.1007/s00262-004-0631-8. Epub 2004 Dec 31.
- Background: PubMed 15827130Greiner J, Li L, Ringhoffer M, Barth TF, Giannopoulos K, Guillaume P, Ritter G, Wiesneth M, Dohner H, Schmitt M. Identification and characterization of epitopes of the receptor for hyaluronic acid-mediated motility (RHAMM/CD168) recognized by CD8+ T cells of HLA-A2-positive patients with acute myeloid leukemia. Blood. 2005 Aug 1;106(3):938-45. doi: 10.1182/blood-2004-12-4787. Epub 2005 Apr 12.
- Background: PubMed 16525634Li L, Giannopoulos K, Reinhardt P, Tabarkiewicz J, Schmitt A, Greiner J, Rolinski J, Hus I, Dmoszynska A, Wiesneth M, Schmitt M. Immunotherapy for patients with acute myeloid leukemia using autologous dendritic cells generated from leukemic blasts. Int J Oncol. 2006 Apr;28(4):855-61.
- Background: PubMed 16555058Li Q, Li L, Shi W, Jiang X, Xu Y, Gong F, Zhou M, Edwards CK 3rd, Li Z. Mechanism of action differences in the antitumor effects of transmembrane and secretory tumor necrosis factor-alpha in vitro and in vivo. Cancer Immunol Immunother. 2006 Dec;55(12):1470-9. doi: 10.1007/s00262-006-0150-x. Epub 2006 Mar 23.
- Background: PubMed 16773189Giannopoulos K, Li L, Bojarska-Junak A, Rolinski J, Dmoszynska A, Hus I, Greiner J, Renner C, Dohner H, Schmitt M. Expression of RHAMM/CD168 and other tumor-associated antigens in patients with B-cell chronic lymphocytic leukemia. Int J Oncol. 2006 Jul;29(1):95-103.
- Background: PubMed 16931630Greiner J, Schmitt M, Li L, Giannopoulos K, Bosch K, Schmitt A, Dohner K, Schlenk RF, Pollack JR, Dohner H, Bullinger L. Expression of tumor-associated antigens in acute myeloid leukemia: Implications for specific immunotherapeutic approaches. Blood. 2006 Dec 15;108(13):4109-17. doi: 10.1182/blood-2006-01-023127. Epub 2006 Aug 24.
- Background: PubMed 17157168Schmitt M, Li L, Giannopoulos K, Chen J, Brunner C, Barth T, Schmitt A, Wiesneth M, Dohner K, Dohner H, Greiner J. Chronic myeloid leukemia cells express tumor-associated antigens eliciting specific CD8+ T-cell responses and are lacking costimulatory molecules. Exp Hematol. 2006 Dec;34(12):1709-19. doi: 10.1016/j.exphem.2006.07.009.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Li Li, MD principal investigator
National Jewish Health
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Chronic Beryllium Disease (CBD) and Beryllium Sensitization (BeS), run by National Jewish Health at 1 site in United States.
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 8 inclusion and 1 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 19 Oct 2020. 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 United States. 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?
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?
The primary outcome for the aims is the downregulation of Th1 cytokine TNFalpha with the inhibition of the JAK2 using siRNA and the inhibitor INCB018424, CEP-701 and TG101348 in CBD or overexpression of the JAK2 gene. (time frame: year 1). The study lists 2 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 NCT02596347, which also lists 9 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 19 Oct 2020.