Cellular Stress Reactions During Graft-versus-host Disease

Study Overview
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Brief Summary
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This study has the aim to analyze intestinal expression of cellular stress molecules in patients with intestinal GVHD. Patients with colitis and patients without intestinal inflammation will serve as controls.

Detailed Description
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Acute graft-versus-host disease (GVHD) is a major cause of morbidity and mortality in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). Acute GVHD results from a complex multi-step crosstalk between extensive epithelial tissue damage in the patient and activation of the allo-reactive immune system transferred with the donor graft. The conditioning treatment prior to allo-HCT creates an inflamed microenvironment with high concentrations of pathogen-associated and danger-associated molecular patterns (PAMPs and DAMPs) as well as pro-inflammatory cytokines. This inflammation is perpetuated by activation of myeloid immune cells and recruitment of allo-reactive T cells to the intestine. Enterocytes are subjected to cellular stress and undergo apoptosis. As a result, patients can develop high-voluminous diarrhea, dehydration, intestinal bleeding, hypalbuminemia, and generalized infections. In this study, the investigators aim to analyze the expression of molecules related to different types of cellular stress in the intestine of patients with acute GVHD. The hypothesis is that some stress-related markers would be upregulated during GVHD. The results will be valuable to study the role of cellular stress reactions during acute GVHD pathogenesis or as potential biomarkers for disease activity.

Official Title
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Analysis of Cellular Stress Markers in the Intestine of Patients With Graft-versus-host Disease

Conditions
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Graft Vs Host Disease, Graft Versus Host Disease

Intervention / Treatment
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* Diagnostic Test: Immunohistochemistry on intestinal biopsies


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >18 years intestinal biopsy depending on cohort: healthy intestinal tissue, colitis or GVHD

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 |
| --- | --- |
| Uninflamed intestine<br>Patients who underwent diagnostic endoscopy and received a diagnosis of no intestinal inflammation | Diagnostic Test: Immunohistochemistry on intestinal biopsies<br>* Immunohistochemistry will be performed on human intestinal biopsies<br>|
| Colitis<br>Patients with active colitis | Diagnostic Test: Immunohistochemistry on intestinal biopsies<br>* Immunohistochemistry will be performed on human intestinal biopsies<br>|
| Acute GVHD<br>Patients with acute gastrointestinal (GI) GVHD | Diagnostic Test: Immunohistochemistry on intestinal biopsies<br>* Immunohistochemistry will be performed on human intestinal biopsies<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Immunohistochemical staining | Immunohistochemical staining | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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GVHD