NCT05083520

Brief Summary

Classical immunomodulatory drugs (IMiDs) like thalidomide and its second- and third-generation analogues lenalidomide, pomalidomide, avadomide (CC-122), and iberdomide (CC-220) have constantly emerged to new therapeutic areas. Originally developed as a sedative and banned in 1961 for its teratogenic effects when used during pregnancy, thalidomide and a number of newly developed analogues are approved for the treatment of multiple myeloma (MM),4 erythema nodosum5 and myelodysplastic syndrome (MDS) Thalidomide was used as a treatment for morning sickness from 1957 until 1961 but was withdrawn from the market after it was discovered that it caused birth defects. Because of their pleiotropic and especially anti-angiogenic properties, IMiDs have further been reported effective in many off-label indications as for Hodgkin's lymphoma, light chain-associated (AL) amyloidosis, and acute myeloid leukemia (AML). The drug thalidomide binds to cereblon and changes which substrates can be degraded by it, which leads to an antiproliferative effect on myeloma cells and possibly the teratogenic effect on fetal development. The idea that cereblon modulation is responsible for the teratogenic activity of thalidomide in the chick and zebrafish was cast into doubt due to a 2013 report that pomalidomide (a more potent thalidomide analog) does not cause teratogenic effects in these same model systems even though it binds with cereblon more strongly than thalidomide. Cereblon (CRBN) is a substrate receptor of the E3 ubiquitin ligase complex. Several key findings suggest diverse roles of CRBN, including its regulation of the large-conductance calcium- and voltage-activated potassium (BKCa) channels, regulation of thalidomide-binding proteins, and mediation of lenalidomide treatment in multiple myeloma. Recent studies also indicate that CRBN is involved in energy metabolism and negatively regulates AMP-activated protein kinase signaling. Recent studies also indicate that CRBN is involved in energy metabolism and negatively regulates AMP-activated protein kinase signaling. Mice with genetic depletion of CRBN are resistant to various stress conditions including a high-fat diet, endoplasmic reticulum stress, ischemia/reperfusion injury, and alcohol-related liver damage. There are different drugs that have an immunomodulating effect, such as thalidomide analogs, and are used in various situations. Some of the diseases in which the immune system plays a role in its etiology are Acute Respiratory Distress Syndrome (ARDS), Acute Lung Injury (ALI), septic shock, and sepsis. In cases of lung injury such as sepsis, septic shock, ARDS, ALI, the immune system is over-activated and as a result, the immune system cells damage the own tissue of the lung. To break this mechanism, immunomodulatory drugs are used in intensive care in the treatment of these diseases. There is no publication regarding the role of Cereblon in the mechanism of action of these immunomodulatory drugs used in intensive care. In these intensive care diagnoses (sepsis, ARDS, ALI), there is no publication showing the correlation between the severity of the disease and Cereblon protein. Other laboratory parameters are used to estimate the effects (mortality and morbidity) of these diseases on the patient. At the end of the investigators study, the investigators think that the Cereblon gene can be used in this estimation of mortality or morbidity.

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
30

participants targeted

Target at below P25 for all trials

Timeline
Completed

Started Dec 2021

Shorter than P25 for all trials

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

September 24, 2021

Completed
25 days until next milestone

First Posted

Study publicly available on registry

October 19, 2021

Completed
1 month until next milestone

Study Start

First participant enrolled

December 1, 2021

Completed
2 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2022

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2022

Completed
Last Updated

October 19, 2021

Status Verified

October 1, 2021

Enrollment Period

2 months

First QC Date

September 24, 2021

Last Update Submit

October 6, 2021

Conditions

Keywords

Critical careCereblon

Outcome Measures

Primary Outcomes (1)

  • The presence of Cereblon protein

    To demonstrate the presence of Cereblon protein in tracheal aspiration fluid from intensive care patients.

    until 31 December 2021

Secondary Outcomes (1)

  • The relationship between Cereblon and intensive care length of stay

    until 31 December 2021

Study Arms (1)

critical care patients

Eligibility Criteria

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

critical care patient

You may qualify if:

  • Being over 18 years old,
  • Having (-) Covid PCR test,
  • Being intubated,
  • Getting permission from the patient's relatives to be included in the study

You may not qualify if:

  • Being under the age of 18,
  • Having (+) Covid PCR test,
  • Not be able to get consent from the relatives of the patient

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (2)

  • Yang H, Song Z, Hong D. CRBN knockdown mitigates lipopolysaccharide-induced acute lung injury by suppression of oxidative stress and endoplasmic reticulum (ER) stress associated NF-kappaB signaling. Biomed Pharmacother. 2020 Mar;123:109761. doi: 10.1016/j.biopha.2019.109761. Epub 2019 Dec 19.

    PMID: 31865141BACKGROUND
  • Gil M, Kim YK, Kim HY, Pak HK, Park CS, Lee KJ. Cereblon deficiency confers resistance against polymicrobial sepsis by the activation of AMP activated protein kinase and heme-oxygenase-1. Biochem Biophys Res Commun. 2018 Jan 1;495(1):976-981. doi: 10.1016/j.bbrc.2017.11.098. Epub 2017 Nov 21.

    PMID: 29170136BACKGROUND

MeSH Terms

Conditions

Critical IllnessSepsis

Condition Hierarchy (Ancestors)

Disease AttributesPathologic ProcessesPathological Conditions, Signs and SymptomsInfectionsSystemic Inflammatory Response SyndromeInflammation

Study Officials

  • Pınar Ayvat, ass. prof.

    Izmir Democracy University

    STUDY CHAIR

Central Study Contacts

Pınar Ayvat, ass. prof.

CONTACT

Ali Galip Ayvat, dr.

CONTACT

Study Design

Study Type
observational
Observational Model
OTHER
Time Perspective
CROSS SECTIONAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Head of Anesthesia and Reanimation Department

Study Record Dates

First Submitted

September 24, 2021

First Posted

October 19, 2021

Study Start

December 1, 2021

Primary Completion

February 1, 2022

Study Completion

April 1, 2022

Last Updated

October 19, 2021

Record last verified: 2021-10