Defining the Basis of Fibromuscular Dysplasia (FMD)

Study Overview
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Brief Summary
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The purpose of this study has evolved and expanded since its inception. Originally the intent was to establish the functional, molecular and genetic profile of fibroblasts from Fibromuscular Dysplasia (FMD) patients as compared to carefully matched control subjects. While this remains among the objectives, the study has been expanded to undertake a fully powered cross-tissue systems genetics analysis of FMD, and now also the related arteriopathies spontaneous coronary artery dissection (SCAD) and cervical artery dissection (CvAD). The overall objective is to disclose the core biologic mechanisms of these disorders.

Detailed Description
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Specific aims Specific aim 1: To establish a library of fibroblasts, DNA, plasma and serum from patients with FMD, SCAD and CvAD and unaffected healthy control subjects. Specific aim 2: To perform a fully powered cross-tissue systems analysis of the key regulatory gene networks and disease drivers underlying FMD, SCAD and CvAD. Specific aim 3: To cross-compare the molecular and genomic profiles of FMD, SCAD and CvAD to establish the degree of biologic similarity among these disorders.

Official Title
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Defining the Basis of Fibromuscular Dysplasia: The Define-FMD Study

Conditions
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Fibromuscular Dysplasia, Spontaneous Coronary Artery Dissection, Cervical Artery Dissection

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients of any age and freely willing to participate. For patients < 18 years of age consent will be via parents. Fluency in either English or Spanish. Signed, informed consent For FMD, SCAD or CvAD subjects - a clinical diagnosis of FMD, SCAD or CvAD with fulfillment of standard diagnostic criteria. For healthy controls - no clinical features of FMD, SCAD or CvAD and absence of any major ongoing systemic disease including any condition requiring hospitalization, immune suppression, intravenous or injected medications or that result in functional impairment in the performance of activities of daily living. Healthy controls will be matched to enrolled FMD patients on the basis of gender and approximate age (within a 5 year window of another FMD subject). Exclusion Criteria: Patients who have co-morbidities which reduces life expectancy to one year. Patients with any solid organ or hematological transplantation, or those in whom transplantation is considered. Active autoimmune disease. Illicit drug use. HIV positive. Prior malignancy. Any other form of vascular disease, including other arteriopathy coronary artery disease or peripheral vascular disease Family history of arteriopathy other than FMD, SCAD or CvAD (e.g. Ehlers-Danlos syndrome)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| FMD subjects<br>patients who fulfill standard diagnostic criteria for FMD | |
| SCAD subjects<br>patients who fulfill standard diagnostic criteria for SCAD | |
| CvAD subjects<br>patients who fulfill standard diagnostic criteria for CvAD | |
| Healthy control subjects<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Identification of regulatory gene networks | The identification of regulatory gene networks, and their key drivers, underlying FMD, SCAD and CvAD | single time point at study enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Identification of molecular features | To cross-compare the molecular features of FMD, SCAD and CvAD | single time point at study enrollment | 
| Identification of genomic features | To cross-compare the genomic features of FMD, SCAD and CvAD | single time point at study enrollment | 
| RNA sequencing | To define and compare the genomic (RNA sequencing) profile of fibroblasts from FMD, SCAD and CvAD subjects versus healthy control subjects | single time point at study enrollment | 
| Circulating cytokine | To define and compare the circulating cytokine profile of FMD versus healthy control subjects. | single time point at study enrollment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cross-sectional study, Fibromuscular dysplasia, Fibroblast, Spontaneous Coronary Artery Dissection, Cervical Artery Dissection