NCT02361853

Brief Summary

Accumulating evidence suggest that the proliferative, invasive, and immune tolerance mechanisms that malignant tumors use to establish a nutrient supply and evade or edit the host immune response are similar to those used by the developing placenta during normal pregnancy. In addition to the shared capacity for invading through normal tissues, both cancer cells and cells of the developing placenta create a microenvironment supportive of both immunologic privilege and angiogenesis. CD11b+Gr1+ cells are a heterogeneous population of bone marrow-derived cells (BMDC) that consist of immature myeloid cells (IMCs), and were first described as myeloid-derived suppressor cells. In healthy individuals, IMCs that are generated in the bone marrow differentiate into mature granulocytes, macrophages, or dendritic cells (DCs). These cells have been shown to play an essential role in mediating immune suppression in animal models of human tumors. As a result of tumor-induced alterations in myelopoiesis, IMCs have been found in peripheral blood, lymphoid organs and the tumor tissue itself. An increased population of IMCs was identified in patients with several tumor types. Accordingly, IMCs detected in the peripheral blood of such patients bearing express the common myeloid marker CD33 but lack markers of mature myeloid cells such as the MHC class II molecule HLADR. IMCs have been shown to actively promote tumor growth and metastasis by modulating the cytokine environment, and through vascular remodeling by promoting angiogenesis. It has been demonstrated in our laboratory that IMCs infiltrate placentas of pregnant mice and actively promote angiogenesis. These cells show striking similarity to IMCs that populate malignant tumors. Accordingly, human placentas are also infiltrated by a significant population of IMCs. Immunostaining of human placentas showed that IMCs comprise around 25% ( range 10-40%) of total placental CD45+ bone marrow-derived hematopoietic cells and that this population is located close to blood capillaries. The investigators also demonstrated that immature DCs, cells originally described to regulate the adaptive immune response, also promote angiogenesis in models of choroidal neovascularization, endometriosis and tumors. Tho objective in this proposed study is to compare the abundance of IMC, DC, monocytes and neutrophils counts in blood samples of normal pregnancies: 1. in women in term active labor. 2. In women not in labor. 3. In pre term labor. According to our previous findings, the investigators hypothesize that IMC's, monocytes and in active delivery (both term and pre term) will be lower than women without signs for labor. The investigators also hypothesize that DC's and neutrophils will be more abundant in active delivery (in term and pre term) than women without signs for labor. Experimental plan: Blood count will be collected from pregnant women who agree to participate in the research: The samples will be sent for the routine complete blood count in Hillel Yaffe hematologic lab and also will be analyzed for IMC's and DC's population in our lab using fluorescent immunostaining with specific monoclonal antibodies and flow cytometry. IMC's per total CD45 positive hematopoietic cells from the placental tissue will be analyzed using fluorescent immunostaining with specific monoclonal antibodies and flow cytometry . The specific location of these cells in the placenta will be identified within the placental tissue using Immunohistochemistry (IHC). The expression of pro angiogenic genes will be analyzed by RT PCR and Western blotting.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
60

participants targeted

Target at P25-P50 for all trials

Timeline
Completed

Started Mar 2015

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 8, 2015

Completed
4 days until next milestone

First Posted

Study publicly available on registry

February 12, 2015

Completed
17 days until next milestone

Study Start

First participant enrolled

March 1, 2015

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2016

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2017

Completed
Last Updated

February 12, 2015

Status Verified

January 1, 2015

Enrollment Period

1 year

First QC Date

February 8, 2015

Last Update Submit

February 11, 2015

Conditions

Outcome Measures

Primary Outcomes (1)

  • Spontaneous labor

    maximum two weeks

Study Arms (3)

Active labor at term

Women in active labor normal pregnancy at term

Other: Exposure: abundance of Immature Myeloid Cells counts in blood samplesOther: Exposure: abundance of Immature Dentritic Cells counts in blood samplesOther: Exposure: abundance of Immature monocytes counts in blood samplesOther: Exposure: abundance of Immature neutrophils counts in blood samples

Non-active labor at term

Women, normal pregnancy at term who come for usual follow up without signs for labor ( contraction / "show" discharge/ rupture of membranes).

Other: Exposure: abundance of Immature Myeloid Cells counts in blood samplesOther: Exposure: abundance of Immature Dentritic Cells counts in blood samplesOther: Exposure: abundance of Immature monocytes counts in blood samplesOther: Exposure: abundance of Immature neutrophils counts in blood samples

Active labor, pre-term

Women in active pre term labor (34- 37w) normal pregnancy.

Other: Exposure: abundance of Immature Myeloid Cells counts in blood samplesOther: Exposure: abundance of Immature Dentritic Cells counts in blood samplesOther: Exposure: abundance of Immature monocytes counts in blood samplesOther: Exposure: abundance of Immature neutrophils counts in blood samples

Interventions

Active labor at termActive labor, pre-termNon-active labor at term
Active labor at termActive labor, pre-termNon-active labor at term
Active labor at termActive labor, pre-termNon-active labor at term
Active labor at termActive labor, pre-termNon-active labor at term

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Pregnant women from: 34 weeks to 42 weeks

You may qualify if:

  • Women in active labor normal pregnancy at term.
  • Women, normal pregnancy at term who come for usual follow up without signs for labor ( contraction / "show" discharge/ rupture of membranes).
  • Women in active pre term labor (34- 37w) normal pregnancy.

You may not qualify if:

  • Unwilling of the women to participate in the research
  • Signs for infection ( fever \>38)
  • Women in pre-term birth under 34 weeks.
  • Administration of Celeston in 2 weeks prior to enrollment.
  • Any complication to the women or fetus which require induction of labor ( Pre-eclampsia, Gestational Diabetes Mellitus A2, pre gestational diabetes, Intrauterine Growth Restriction).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Biospecimen

Retention: SAMPLES WITHOUT DNA

Blood sample.

MeSH Terms

Interventions

Blood Specimen Collection

Intervention Hierarchy (Ancestors)

Specimen HandlingClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisPuncturesSurgical Procedures, OperativeInvestigative Techniques

Central Study Contacts

Rivka Frankel, MD

CONTACT

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 8, 2015

First Posted

February 12, 2015

Study Start

March 1, 2015

Primary Completion

March 1, 2016

Study Completion

March 1, 2017

Last Updated

February 12, 2015

Record last verified: 2015-01