In Vivo Alzheimer Proteomics (PROMARA)

University Hospital Center (CHU)

Status: Terminated

Conditions: Probable Alzheimer Disease; Acute Hydrocephaly; Parkinson Disease; Neurological Disease Without Cognitive Degradation; Brain Trauma

Treatments: Biological: administration of stable isotope-labelled leucine-; Other: collection of CSF, blood, urine, saliva

Study type: Interventional

Funder types: Other

Identifiers

NCT02263235

8652

Details and patient eligibility

About

In France, an estimated 860 000 patients are affected by Alzheimer Disease (AD) which represents, as in other developed countries, a major public health issue. In many cases, AD diagnosis is uncertain and its clinical evolution unpredictable. The exactitude of the diagnosis is however particularly important in the perspective of the validation and use of new therapeutic strategies in AD. Detection of cerebrospinal fluid (CSF) diagnosis biomarkers fell short in the detection, of atypical/mixed cases, of some differential diagnosis, and in differentiating rapid or slow clinical evolutions. Hence, CSF analysis gives a unique opportunity to detect and validate biomarkers in many neurological disorders. Nevertheless, in medical practice, CSF biological analysis is currently limited to a small number of analytes.Quantitative and targeted mass spectrometry, especially operated in the Multiple reaction monitoring mode (MRM), represents an alternative to immunodetection and could be used to detect specific biomarkers in complex matrices such as plasma by specifically discriminating the proteotypic peptides corresponding to each proteins. Mass spectrometry has also the ability to distinguish and quantify isotopically labelled and unlabeled selected targets. This ability was used in a publication by the group of R. Bateman (Washington University, St Louis, USA) who could, after administering stable isotope-labelled leucine, evaluate Ab synthesis and clearance in humans. This approach has an enormous potential to study the metabolism of proteins within the human CNS and consequently help in the understanding and diagnosis of neurological disorders.The main objective of this program is set up a targeted quantitative mass spectrometry method for existing and stable isotope-labelled CSF biomarkers in the neurological field; exploit this approach for diagnostic purpurses and to gain knowledge in the pathophysiology of diseases.

Enrollment: 89 patients

Sex: All

Ages: 55 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Reports written consent, informed and signed by the patient and a trusted person
• Subject member or beneficiary of a social security system

Specific criteria for group 1 and 2B :

• Age between 55 and 85 years old for patients
• Subject with AD or other neurodegenerative disease (frontotemporal dementia, dementia with Lewy bodies, Parkinson disease)
• Subjects with chronic adult hydrocephalus (HCA) requiring depletion lumbar puncture (PL)

Specific criteria for group 2A :

• Adult patient requiring neurosurgery with CSF shunt (subject with brain trauma, acute hydrocephaly) and favorable evolution that allows removal of the shunt

Exclusion criteria

• Patient deprived of liberty by judicial or administrative decision
• Major protected by law
• Pregnancy, women of childbearing age with risk of pregnancy, or breast-feeding
• Presence of a transmissible viral disease (HlV, hepatitis B and C)
• Patient included in a clinical trial
• lnadequate cardiac, hepatic or severe renal disfunction
• Disease amino acid metabolism (Leucinose..)

Exclusion Criteria:

• Information clinical and para-clinical insufficient or unavailable
• Patient deprived of liberty by judicial or administrative decision
• Major protected by law
• Pregnancy, women of childbearing age with risk of pregnancy, or breast
• feeding
• Presence of a transmissible viral disease (HIV, hepatitis B and C)
• Patient included in a clinical trial
• Patient exclusion period relative to another protocol or for which the maximum annual compensation of 4500€ has been reached
• Inadequate cardiac, hepatic or severe renal
• Disease amino acid metabolism (Leucinose..)

Trial design

Primary purpose: Diagnostic

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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89 participants in 3 patient groups

Group 1

Experimental group

Description:

60 patients (20 probable AD, 20 Parkinson Disease (PK), 20 neurological disease without cognitive degradation)

Treatment:

Other: collection of CSF, blood, urine, saliva

Group 2A

Experimental group

Description:

20 patients (patients with brain trauma, acute hydrocephaly), with temporary derivation of the CSF

Treatment:

Biological: administration of stable isotope-labelled leucine-

Group 2B

Experimental group

Description:

30 patients (15 probable AD, 15 neurological disease without cognitive degradation)

Treatment:

Biological: administration of stable isotope-labelled leucine-