Genetic and Immunologic Characterization of IEI

Study Overview
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Brief Summary
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Inborn Errors of Immunity (IEI) include clinically heterogeneous rare genetic diseases depending on mutations in about 300 different genes. Clinically, this group of diseases is characterized by the presence of infectious, inflammatory, autoimmune, and lymphoproliferative symptoms. Understanding the pathogenesis of these diseases can guide the implementation of targeted therapies and improve prognosis. In recent years, IEI have been described that do not necessarily present with repeated infectious symptoms but rather with autoimmune, lymphoproliferative, and autoinflammatory manifestations, or with forms of immunodeficiency with a spectrum of susceptibility to one or few infectious agents. In this case, simple laboratory tests are not sufficient to characterize the disease since no particular immunophenotypic changes are evident. To correct classify the patients and to improve knowledge on the pathogenesis of the diseases, complex immunologic-functional studies are required. These studies should be started prior to genetic analysis, with the aim of targeting and narrowing it down. Although the ever-decreasing costs of Next Generation Sequencing (NGS) methods make it convenient to analyse many genes or even the entire exome simultaneously, the analysis of the data resulting from NGS can be complex and provide results of uncertain interpretation. In these cases, immunologic-functional studies can clarify the real causal role of the identified genetic variants. The identification of genotype-phenotype correlation is crucial to establish new therapeutic targets for diseases orphan of specific etiological treatments. In vitro and in vivo disease models are key tools to test drugs repositioning, as was the case for Lapaquistat in the treatment of periodic fevers caused by de-regulation of the cholesterol metabolic pathway.

Official Title
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Genetic and Immunologic Characterization of Inborn Errors of Immunity

Conditions
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Immunity Disorders, Inborn Errors of Immunity

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects with suspected IEI Exclusion Criteria: No consent from the patients' guardians Subjects undergoing hematopoietic stem cell transplantation.

Ages Eligible for Study
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Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To identify immunologic-functional characteristics of IEI subjects | Several test will be carried out on peripheral blood samples (i.e.,evaluation of lymphocyte subpopulations, natural killer cell degranulation assay, intracellular protein expression analysis, interferon signature in real time PCR). | Within 30 days of enrollment | 
| To identify genetic characteristics of IEI subjects | Using NGS and exome analysis | Within 30 days of enrollment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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inborn errors of immunity, genotype-phenotype correlation, drugs repositioning, genetics