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NCT Number: NCT06102070

Genetic Susceptibility to Severe Infections

Only a fraction of individuals infected with microbes develop clinical disease. This observation raises fundamental questions about the pathogenesis of infectious diseases. There is a complex interaction between environmental (microbial and non-microbial) and human (genetic and non-genetic) factors. This will determine the quality of the immune response against the infectious agent and the clinical manifestation. By definition, individuals who die from an infection have defective immunity to the pathogen in question (immune agent (immune deficiency).

The investigation of individual variability in the development of infectious diseases began in the early 20th. The first evidence to support the hypothesis that individual variability variability and immune deficiencies were hereditary came from observations of familial cases or genetic isolates genetic isolates (from a homogeneous population) of rare or common infectious diseases, which in some cases Mendelian heredity hat predisposition to infectious diseases runs in families even more so than diseases associated with less determined environmental factors, such as certain cancers. such as certain cancers. Finally, studies comparing the rate of concordance of infectious diseases between monozygotic and dizygotic twins also implicate genetic factors in disease susceptibility.

These observations were validated by the discovery of genetic defects associated with severe infectious diseases, leading to proof of concept. While a number of hereditary immune deficiencies associated with susceptibility to multiple pathogens or microorganisms, a growing number of new and rare new and rare immune deficiencies conferring restricted susceptibility to infections caused by a single caused by a single pathogen family, or even a single pathogen, in otherwise healthy children, have recently been identified (one gene, one pathogen). As a result, a dozen Mendelian clinical syndromes characterized by restricted susceptibility are now known. Over the last 20 years, it has been proven that these "idiopathic" infections were immune deficiencies.

The investigators now wish to study new severe infections, including but not limited to viral, fungal and bacterial infections. viral, fungal, bacterial and parasitic infections. This should lead to a better understanding of the pathophysiology of each disease, the development of new therapeutics and better patient care.

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Key information

Conditions

Infectious Disease Communicable Diseases Disease Attributes Infections Pathologic Processes Pathological Conditions, Signs and Symptoms

Sex eligibility

All sexes

Study type

Observational

Primary location

Centre d'Etudes des Déficits Immunitaires (CEDI), Hôpital Necker-Enfants

Paris, Île-de-France Region, 75015, France

Location status: Recruiting

Location contact

jacinta MD BUSTAMANTE, MD-PHD

CONTACT

[email protected]

0171196004

About this study

Justification of the number of subjects:

The prevalence of the various severe infections we wish to explore ranges from one case in 50,000 to one case in 1,000,000 individuals; consequently, we plan to recruit only a small cohort of patients per pathology. Due to the exploratory nature of this research, no sample size calculation is possible.

ELIGIBILITY CRITERIA

Inclusion criteria

  • Index cases (patients)
  • Informed consent signed by the patient. In the case of a minor patient, consent must be signed by the holders of parental authority. In the case of a protected adult patient, consent is signed by his or her signed by the patient's legal representative. In the case of an adult patient unable to consent at the time of consent is signed by a family member.
  • have a proven rare and severe infection defined by at least one of the following elements:
  • Acute, life-threatening infection requiring hospitalization, especially in an intensive particularly in intensive care.
  • Recurrent and/or chronic infections requiring frequent hospitalization or follow-up visits hospitalization or follow-up visits (dermatology, cardiology, neurology, infectious diseases, immunology, etc.), infectious diseases, immunology, etc.).
  • Acute and/or chronic infections leading to sequelae (motor or cognitive deficits, etc.).
  • Disseminated infection by an opportunistic microbe.
  • be hospitalized or followed in a specialized hospital ward, emergency room or intensive care unit
  • be affiliated to a Social Security scheme.
  • Related
  • have informed consent signed by the adult relative. In the case of a minor relative, the consent is consent is signed by the holders of parental authority. In the case of an adult relative the consent is signed by his or her legal representative
  • be related to the index case up to the 3rd degree: Parents, Children, Brother, Sister, Grandparents, Uncles, Aunts, Cousins, Nephews, Nieces
  • be affiliated to a Social Security system

Non-inclusion criteria :

  • Index case:4/4 C18-41 _Predisposition_Synopsis_V2.0_20220324
  • Acquired immunodeficiency (having received immunosuppressive treatment in the 3 months prior to the onset of the disease or HIV-positive)
  • Pregnant at the time of illness
  • Person under court protection
  • Related persons :
  • Pregnant or breast-feeding woman
  • Person under court protection

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • to sign the informed consent signed by the patient. In the case of a minor patient, consent is signed by the holders of parental authority. In the case of a protected adult patient, the consent is signed by their legal representative. In the case of an adult patient unable to consent at the time of inclusion, consent is signed by a family member.
  • to have a proven rare and severe infection
  • to be hospitalized or followed in a specialized hospital department, in the emergency room or in intensive care
  • to be affiliated to the French Social Security system
  • for relatives, to be related to the index case up to the 3rd degree: Parents, Children, Brother, Sister, Grandparents, Uncles, Aunts, Cousins, Nephews, Nieces

Exclusion criteria

  • to have an acquired immunodeficiency (having received immunosuppressive treatment in the 3 months preceding the onset of the disease or being HIV positive)
  • pregnant woman at the time of illness

Treatment and study plan

Blood samples drawing

Other

10 ml of periferal blood

Skin biopsy

Other

Skin biopsy only in some index cases depending of the pathology at the recruitment

Primary outcomes

  1. Identification of chromosomal regions associated with the disease through a "homozygosity mapping" study on multiplex and/or consanguineous families.

    Time frame: through study completion, an average of 10 years

    Whole genome genotyping using high density microarrays (Affymetrix 6.0 type or equivalent) on the gDNA of the index case and its relatives. Exome data will also be used for homozygosity calculation.

  2. Identification of candidate genes for genetic susceptibility to infectious diseases

    Time frame: through study completion, an average of 10 years

    • To sequence using the high-throughput sequencing technique (exome or genome).
    • To check the genetic segregation of mutations identified in relatives in each family.

  3. Validation of candidate genes as factor of susceptibility to infectious diseases

    Time frame: through study completion, an average of 10 years

    To validate the pathogenic effect of the mutation by functional and complementation tests on patient cells and control cells, and in an overexpression system

Study contacts

Contact information is provided by the study sponsor or research team.

Jacinta Md BUSTAMANTE, MD-PhD

CONTACT

[email protected]

01 71 19 60 04

Sponsors and collaborators

Lead sponsor

Institut National de la Santé Et de la Recherche Médicale, France

Other Gov

Registry information

Official study title

Genetic Susceptibility to Severe Infections Including in Particular But Not Exhaustively All Types of Viral, Bacterialn and Fungal Infections.

Acronym: PREDISPOSITI

Important dates

Study start
2022
Primary completion
2037
Study completion
2038
First posted
Oct 26, 2023
Registry last updated
Jul 7, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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