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Mast Cell Activation Test in Allergic Disease

NCT03406325 — Completed, 19 participants, Hong Kong Sanatorium & Hospital

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Assessment of Mast Cell Activation Diagnostic Test in Patients With Allergic Disease

RegistryNCT03406325
StatusCompleted
Study typeObservational
Enrollment19 (Actual)
SponsorHong Kong Sanatorium & Hospital (Industry); collaborators: Chinese University of Hong Kong, Stanford University
ConditionsAsthma, Mastocytosis, Mast Cell Activation Syndrome, Food Allergy, Chronic Idiopathic Urticaria, Anaphylaxis, Eczema
Datesstart 2018-02-01, primary completion 2019-12-01, completion 2019-12-01, first posted 2018-01-23, last updated 2020-04-09
Locations1 site in Hong Kong

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-Summary

Activation of mast cells in the immune system is known to cause allergic reactions sometimes with severe systemic symptoms. The investigators have recently developed a blood-based mast cell activation diagnostic test in which levels of functional activation in-vitro in primary cultured mast cells generated from the peripheral blood of single individuals can be assessed. It is the hypothesis that the test can be used to predict the potential state of in-vivo mast cell activation in any individual based on the functional activation profiles exhibited by their cultured mast cells. The investigators now wish to translate their in-vitro findings in a pilot study to disease groups where mast cell activation is expected to be high. These include highly allergic individuals; those with chronic idiopathic urticaria; those with mastocytosis; and those with the mast cell activation syndrome. Furthermore, they will use the functional genomics approach to identify gene expression biomarkers that are correlated with such diseases. The results will be compared with data that have been collected from a cohort of healthy control blood donors.

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+Detailed description

The objective of this study is to assess whether patients with severe allergic diseases exhibit high levels of mast cell activation as determined by the mast cell activation diagnostic test the investigators have developed. They anticipate that patients with history of severe allergic reactions will show up as high responders in the blood-based mast cell activation diagnostic test. Moreover, using microarray analysis as the approach for gene expression studies, they anticipate further that genomics biomarkers that are correlated with the high functional activation of the in-vitro mast cells derived from these patients can be readily identified.

About 100 ml of peripheral venous blood from individual patients will be drawn into heparinized syringes and collected in a blood-collecting bag/tube containing silica. The bag/tube will be promptly processed for the generation of primary human mast cell cultures using the protocol that has previously been developed \[Inflammation Research 66: 25 (2017). After culturing for 9 weeks, the resulting human mast cells will be analyzed for both their functional activity in terms of histamine release in response to the activation of high-affinity Immunoglobulin E (IgE) receptors in these cells and their gene expression profiles using microarray analysis. The in-vitro functional and genomics data will be correlated with specific diagnoses and measurements of blood prostaglandin D2 (PGD2), PGD2 metabolites, tryptase and histamine levels in blood. For mediator assays, plasma from each subject will be collected after the cluster of differentiation 34 positive (CD34+) isolation step and the samples will be aliquoted and frozen at -80 degrees centigrade for subsequent analysis.

+Arms and interventions

ArmTypeInterventionsDescription
urticariaPatients with this condition
asthmaPatients with this condition
eczemaPatients with this condition
food allergyPatients with this condition
anaphylaxisPatients with this condition
mastocytosisPatients with this condition
mast cell activating syndromePatients with this condition

+Outcome measures

Primary outcomes

  • Mast Cell Activation Test Results for Validation Group [Mast cells studied after 9 weeks in culture]: Mast Cell Activation Test results of high/low level of house dust mite sensitivity by using normal donor cultured mast cells for validation.
  • Evaluation of Patient's Serum for Autoreactivity on Normal Average Responder Mast Cell Activation [Mast cells studied after 9 weeks in culture]: Patient's serum was incubated with mast cells derived from normal donors for detection of mast cell activation as evidenced by histamine release.
  • Percentage Histamine Release by Normal Average Responder Mast Cells + Patient's Serum to Assess Autoreactivity [Mast cells studied after 9 weeks in culture]: percentage of total histamine release by normal average responder mast cells that had been activated with patient's serum
  • Percentage Histamine Release by Patient's Mast Cells + Immunoglobulin E (IgE)/Anti-IgE [Mast cells studied after 9 weeks in culture]: percentage of total histamine release by patient's mast cells that had been activated with anti-IgE
  • Percentage of Histamine Release by Patient's Mast Cells + Patient's Serum + Allergen [Mast cells studied after 9 weeks in culture]: Percentage of total histamine release when patient's mast cells were activated with patient's own serum and Der p2. Each patient's results are reported individually.
  • Cell Yield Per 100ml Blood [Mast cells studied after 9 weeks in culture]: Cell yield of patient's mast cell culture after 9 weeks in culture as an index of cell growth and differentiation.

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

Any patients with the above diagnoses -

Exclusion Criteria:

Children < 18 years old; those who are unwilling or unable to donate blood; pregnant mothers.

\-

+Posted results

Participant flow

MilestoneValidation GroupSH#1SH#2SH#3SH#4SH#5SH#6SH#7
Started121111111
Completed121111111
Not completed00000000

Outcome results

  • Mast Cell Activation Test Results for Validation Group (Primary), Count of participants, Participants: Validation Group 6
  • Evaluation of Patient's Serum for Autoreactivity on Normal Average Responder Mast Cell Activation (Primary), Count of participants, Participants: Validation Group 0; SH#1 1; SH#2 0; SH#3 0; SH#4 0; SH#5 0; SH#6 0; SH#7 0
  • Percentage Histamine Release by Normal Average Responder Mast Cells + Patient's Serum to Assess Autoreactivity (Primary), Mean, percentage of histamine released: Validation Group 2.15 +/- 0.71; SH#1 32.1; SH#2 3.3; SH#3 2.8; SH#4 3.4; SH#5 5.1; SH#6 3.2; SH#7 3.8
  • Percentage Histamine Release by Patient's Mast Cells + Immunoglobulin E (IgE)/Anti-IgE (Primary), Number, percentage of histamine release: SH#1 11.5; SH#2 38.3; SH#3 69.6; SH#4 47.9; SH#5 36.3; SH#6 45.5; SH#7 41.6
  • Percentage of Histamine Release by Patient's Mast Cells + Patient's Serum + Allergen (Primary), Number, percentage of histamine release: SH#1 24.5; SH#2 54.7; SH#3 79; SH#4 8.4; SH#5 0.2; SH#6 0.2; SH#7 0
  • Cell Yield Per 100ml Blood (Primary), Number, Cell yield per 100ml blood: SH#1 14045000; SH#2 2895522; SH#3 115294; SH#4 625263; SH#5 4867778; SH#6 352000; SH#7 1400000

Adverse events

Time frame: 18 months

ArmDeathsSerious adverse eventsOther adverse events
Validation Group0/12 (0.0%)0/12 (0.0%)0/12 (0.0%)
SH#10/1 (0.0%)0/1 (0.0%)0/1 (0.0%)
SH#20/1 (0.0%)0/1 (0.0%)0/1 (0.0%)
SH#30/1 (0.0%)0/1 (0.0%)0/1 (0.0%)
SH#40/1 (0.0%)0/1 (0.0%)0/1 (0.0%)
SH#50/1 (0.0%)0/1 (0.0%)0/1 (0.0%)
SH#60/1 (0.0%)0/1 (0.0%)0/1 (0.0%)
SH#70/1 (0.0%)0/1 (0.0%)0/1 (0.0%)

+Locations (1)

FacilityCityCountryStatus
Hong Kong Sanatorium & HospitalHong KongHong Kong

+Publications

  • Tam IYS, Ng CW, Tam SY, Lau HYA. Novel six-week protocol for generating functional human connective tissue-type (MCTC) mast cells from buffy coats. Inflamm Res. 2017 Jan;66(1):25-37. doi: 10.1007/s00011-016-0989-z. Epub 2016 Sep 15. PMID 27628164

+Study documents

+Investigators

  • Tak H Lee, Principal investigator, Hong Kong Sanatorium and Hospital

My Notes