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Sensorineural Hearing LossPERILOTONCT05670158

Immunity After Cochlear Implantation and Perilymph Molecular Profiles in Sensorineural Hearing Loss

A study testing Blood sampling and Perilymph sampling in people with Sensorineural Hearing Loss, run by University Hospital, Montpellier at 1 site in France.

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

Many patients receiving cochlear implant (CI) have some residual hearing prior to implantation surgery. However, approximately one third of them will lose it in next 6 months after cochlear implantation. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sensorineural Hearing Loss
What is being tested?
Blood sampling and Perilymph sampling
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteFrance
Study dates
7 Dec 2023to Mar 2027
Phase
Interventional
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients aged 18 years or more
  • Indication for the cochlear implantation surgery according to the criteria of French National Authority for Health (Severe to profound sensorineural deafness with indication for cochlear implant surgery: Intelligibility less than or equal to 50% when performing vocal audiometry tests with Fournier's list in free field with recent devices.)
  • Presence of "useful" residual hearing ≤ 80 dB on at least 2 consecutive frequencies (in air conduction) from the range 125, 250, 500, 1000 kHz on pure-tone audiometry
  • Patients given their free and informed written consent
  • Patients affiliated to a French social security system
  • Patients aged 18 years or more
Show all 10Show fewer
  • Indication for otological surgery of the middle ear (excluding active infectious or inflammatory pathology e.g. myringoplasty, ossiculoplasty, cure for otosclerosis)
  • Normal hearing (non affected inner ear): average hearing loss (mean threshold for the frequencies 500, 1000, 2000, 4000 Hz) ≤ 35 dB in bone conduction
  • Patients given their free and informed written consent
  • Patients affiliated to a French social security system

Who cannot join

  • Contraindication to surgery detected during the preoperative assessment
  • Pre-implantation cochlear assessment unfavorable to the implantation surgery
  • Absence of residual hearing shown by preoperative audiometry
  • History of bacterial labyrinthitis or bacterial meningitis
  • Cochlear ossification shown on preoperative imaging
  • Homozygous pathogenic mutations identified by molecular diagnosis of the SCL26A5 (prestin), TECTB (Beta-Tectorin) genes, and heterozygous of the COCH gene (Cochlin) prior to implantation (if available)
Show all 17Show fewer
  • Vulnerable subject: minors, protected adults as defined by the Public Health Code, pregnant or breastfeeding women, subject under guardianship or subject deprived of liberty
  • Participation in another pharmacological therapeutic interventional clinical research
  • Contraindication to surgery detected during the preoperative assessment
  • Fluctuating hearing = fluctuating hearing thresholds on at least one ear (shown by past bone conduction pure-tone audiometries)
  • History of bacterial labyrinthitis or bacterial meningitis
  • Middle ear infection or inflammation on the day of the surgery
  • Chronical immune or inflammatory disease
  • Active viral or bacterial infection on the day of inclusion visit or surgery
  • Fever on the day of the first blood sample
  • Vulnerable subject: minors, protected adults as defined by the Public Health Code, pregnant or breastfeeding women, subject under guardianship or subject deprived of liberty
  • Participation in another pharmacological therapeutic interventional clinical research

Trial locations and contacts

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

Frédéric Venail, PhD, MD contact

+33467336890

f-venail@chu-montpellier.fr

France1 site, 1 recruiting
  • UH Montpellier

    Montpellier, 34295

    Akil KARDEBAY, MD, +33467336890, a-kaderbay@chu-montpellier.fr

    Recruiting

Other trials in France

About this study

Official title: Study on the Inner Ear Immunisation Post-cohlear Implantation and Perilymph Molecular Profiling in Sensorineural Hearing Loss

Many patients receiving cochlear implant (CI) have some residual hearing prior to implantation surgery. However, approximately one third of them will lose it in next 6 months after cochlear implantation. Although the mechanisms involved in the residual audition loss remain unknown, animal experiments suggest the role of inflammatory or immune reaction in the cochlea. The goal of this project is to search in the perilymph (a fluid which fills the scala vestibuli and scala tympani of the cochlea) some predictive biomarkers of the residual hearing loss using modern proteomics and immunological techniques. A parallel search for blood biomarkers of post-implantation residual hearing loss and for molecular and cellular evidences of immune response to cochlear implantation will be performed.

The study will recruit 50 subjects-candidates for cochlear implantation surgery; 30 normally hearing individuals eligible for other types of otological interventions will form a control group. For all the participants blood samples will be collected and preserved. In addition, the perilymph sampling will be performed during cochlear implantation surgery.

Read more

This project relies on the calculation that from 50 patients post-cochlear implantation, 15 patients will form a group with maintained residual hearing and 15 will display delayed hearing loss. For these 30 subjects together with the control group the blood biomarkers search will be performed.

For the group of implanted patients, the follow-up will last for 12 months with 6 visits in total :

  • the inclusion visit V0 during which the study will be presented and the consent form will be signed
  • the surgery visit V1 with blood sample and perilymph collection
  • the activation visit V2, 1 month ± 1 week after V1, visit V3 3 months ± 7 days after V1, V4 6 months ± 7 days after V1, V5 12 months ± 1 month after V1. During each of this visit blood sampling will be performed.

For the control group, the follow up will be 6 months long with 4 visits in total arranged during the routine follow-up appointments:

  • the inclusion visit V0 during which the study will be presented and the consent form will be signed
  • the surgery visit V1, the 1 month visit V2 and the 6 months visit V3 during which the blood sampling will be performed.
Read the detailed description

With the progress of technologies and surgical methods, cochlear implantation, initially proposed only to patients with completely non-functional inner ear, can be now performed on individuals with still some measurable hearing left in some frequencies. Such patients can additionally benefit from a special treatment by electric-acoustic stimulation (EAS). Combining the electric stimulation with cochlear implant (CI) and acoustic amplification of residual hearing using a conventional hearing aid (HA) can drastically improve one's quality of life and ameliorate the performance in noisy environment as well as music perception.

Since the main condition for EAS is the residual hearing preservation, it is important to understand the reasons of its loss post-cochlear implantation. This loss can occur in 2 periods:

  • Early after surgery (˂ 1 month): mainly due to the trauma from electrode insertion. This risk decreases with the development of surgical techniques. Another possible reason is early inflammation processes in the cochleae.
  • Later after surgery (˃ 1 month): occurs mainly about 3 months post-implantation in 30-40 % of patients. This loss is the main reason for dropping out the EAS leaving the patient to rely on CI only.

Animal studies suggest that the delayed residual hearing loss might happen as consequence of cochlear fibrosis development, supposedly due to the inflammation and foreign body response to the CI materials within the cochlea. In its natural state, the cochlea does not contain any immune cells and is well protected from immune stimulation by infectious agents. Cochlear implantation, however, provides a single clinical cause for infectious or autoimmune fibrosis. Such immune response might be provoked by autoantigens against cochlear proteins like Cochline or TectB. This study aims to search blood markers of immunisation against inner ear proteins after cochlear implantation. Another goal is to seek potential biomarkers of delayed residual hearing loss directly in perilymph. Proteomic analysis will be performed using Liquid Chromatography - High Resolution Mass Spectroscopy (HRMS) technique.

The main objective of this study is

  • to identify, in the perilymph of implanted patients, biomarkers predictive of the delayed residual hearing loss
  • to identify blood biomarkers predictive of delayed residual hearing loss in implanted patients

The secondary objectives are

  • to describe qualitatively and quantitatively the time evolution for blood biomarkers of interest after cochlear implantation
  • to correlate quantitative values of identified biomarkers with clinical data of implanted patients
  • to identify perilymph and blood biomarkers of early residual hearing loss post-cochlear implantation
  • depending on molecular profiles identified, to study metabolic pathways and mechanisms involved in delayed residual hearing loss post-cochlear implantation
  • to seek for blood indicators in favour of anti-cochlear immunisation through screening for peripheral blood mononuclear cells (PBMC)
  • to create a bio collection of human perilymph and blood serum biobank of cochlear implants users for future proteomics/molecular studies
Being tested
Blood sampling, Perilymph sampling
Keywords
Perilymph, Proteomics, Metabolomics, Sensorineural hearing loss, Residual hearing, Cochlear implantation
Medical subject headings
Hearing Loss, Sensorineural

What participants receive

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

  • Blood samplingBiological

    Blood will be collected into 2 EDTA and 1 heparin tube. The 2 EDTA tubes (4ml of blood in each) will be transported on ice to the proteomics platform in the next three hours, centrifuged and stored on -80 degrees Celcius in low-binding tubes for further molecular analysis. 1 heparin tube (5mL) will be sent to the Bacteriology-Virology Department for the active PBMC counting.

  • Perilymph samplingProcedure or surgery

    The perilymph collection will be performed during the cochlear implantation surgery at the same time as the round window opening. 5 to 15 microliters will be aspirated using an atraumatic spinal needle mounted onto 1 ml insulin syringe.

Study groups in NCT05670158
Study groupRoleWhat they receive
"Cochlear Implantation" groupExperimental50 patients with sensorineural hearing loss eligible for cochlear implantation surgery. The blood and perilymph sampling will be performed during surgery (visit V1). The blood sampling will be additionally done during the visits V2, V3 and V4. After the visit V4, this arm will be subdivided into 2 groups: group 1, 15 patients with the delayed residual hearing loss, and group 2,15 patients with preserved residual hearing. For these 30 patients, blood sampling will be also performed during the visit V5.
Receives: Biological: Blood sampling; Procedure: Perilymph sampling
Control groupOther30 normally hearing patients who will undergo through an otological surgery other than cochlear implantation. A blood sampling will be performed during surgery (visit V1) as well as during the visits V2 and V3.
Receives: Biological: Blood sampling

What is being measured

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

  1. Expression levels of proteins and metabolites in the perilymph before surgery in the 2 groups of implanted patients

    Expression levels of proteins and metabolites identified by high-resolution mass spectrometry (Lc-HRMS) in the perilymph of group 1, "delayed residual hearing loss" and group 2, "maintained residual hearing" patients, collected before cochlear implantation surgery

    Measured: Before cochlear implantation surgery (V1)

  2. Expression levels of proteins and metabolites in the blood before surgery in the 2 groups of implanted patients

    Expression levels of proteins and metabolites identified by high-resolution mass spectrometry (Lc-HRMS) in the blood of group 1 "delayed residual hearing loss" and group 2 "maintained residual hearing" patients, collected before cochlear implantation surgery

    Measured: Before cochlear implantation surgery (V1)

Secondary outcomes (9)
  1. PBMC cell counting

    Counting of activated blood immune cells, using FACS technique after the PBMC cells culture is performed

    Measured: Before cochlear implantation surgery (V1)

  2. PBMC cell counting

    Counting of activated blood immune cells, using FACS technique after the PBMC cells culture is performed

    Measured: At 1 month post-implantation (V2)

  3. PBMC cell counting

    Counting of activated blood immune cells, using FACS technique after the PBMC cells culture is performed

    Measured: At 3 months post-implantation (V3)

  4. PBMC cell counting

    Counting of activated blood immune cells, using FACS technique after the PBMC cells culture is performed

    Measured: At 6 months post-implantation (V4)

  5. PBMC cell counting

    Counting of activated blood immune cells, using FACS technique after the PBMC cells culture is performed

    Measured: At 12 months post-implantation (V5)

  6. Expression levels of identified molecules in the 2 groups of implanted patients after the surgery

    Expression levels of identified molecules for each group over time

    Measured: At 1 month post-implantation (V2)

  7. Expression levels of identified molecules in the 2 groups of implanted patients after the surgery

    Expression levels of identified molecules for each group over time

    Measured: At 3 months post-implantation (V3)

  8. Expression levels of identified molecules in the 2 groups of implanted patients after the surgery

    Expression levels of identified molecules for each group over time

    Measured: At 6 months post-implantation (V4)

  9. Expression levels of identified molecules in the 2 groups of implanted patients after the surgery

    Expression levels of identified molecules for each group over time

    Measured: At 12 months post-implantation (V5)

Timeline

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

  1. First posted4 Jan 2023
  2. Study start7 Dec 2023
  3. Primary completionMar 2026 (estimated)
  4. Study completionMar 2027 (estimated)

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 N/A
Primary purpose
Other
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
The study will recruit individuals eligible for cochlear implantation surgery. In parallel, the control group will be formed from normal hearing patients - candidates for other otological interventions. The two groups will be matched by age and gender of participants.
Masking
None (open label)
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05670158
Sponsor's protocol ID
RECHMPL21_0380
Acronym
PERILOTO
Status last verified
Jan 2024
First submitted
12 Dec 2022
Last updated
18 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Blood sampling and Perilymph sampling in people with Sensorineural Hearing Loss, run by University Hospital, Montpellier at 1 site in France.

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 10 inclusion and 17 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 18 Jan 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 France. 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 Akil Kaderbay, MD (+33467336890, a-kaderbay@chu-montpellier.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Expression levels of proteins and metabolites in the perilymph before surgery in the 2 groups of implanted patients (time frame: Before cochlear implantation surgery (V1)). 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?
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 18 Jan 2024.

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