Clinical Trial: Study of Cytokines in Children With Opsoclonus-Myoclonus Syndrome

Study Status: Completed
Recruit Status: Unknown status
Study Type: Observational

Official Title: Cytokines as Biomarkers and Therapeutic Targets in Paraneoplastic Opsoclonus-Myoclonus Syndrome (OMS)

Brief Summary: The purpose of this study is to determine if cytokines, inflammatory mediators, are increased in spinal fluid and blood, correlate with disease activity, and could serve as biomarkers or therapeutic targets in children with opsoclonus-myoclonus syndrome (OMS), an autoimmune complication of the tumor neuroblastoma.

Detailed Summary: In this translational research, immunological mechanisms that underlie the assault of the immune system on the brain in paraneoplastic opsoclonus-myoclonus syndrome (OMS) are under evaluation. To test our principal hypothesis that there is an imbalance of pro-inflammatory (Th1) and anti-inflammatory (Th2) cytokines in OMS, a comprehensive cytokine panel will be measured by enzyme-linked immunosorbent assay (ELISA) and multiplexed fluorescent bead-based immunoassay detection (LUMINEX 100 Lab MAP system)in blood and cerebrospinal fluid (CSF) of 400 children. To test the second hypothesis that cytokines could serve as biomarkers of disease activity in OMS, cytokine concentrations will be correlated with clinical variables, such as disease severity, OMS duration, prior relapses, and remissions, as well as immunological variables, such as lymphocyte subset analysis. The cytokine 'biomarker profile' could aid decision making for early intervention by identifying children at high risk for relapse and poor outcome and allow targeting of the most implicated inflammatory cytokines by cytokine therapies. To test our third hypothesis that lack of response to immunotherapy is due in part to failure to increase the expression of anti-inflammatory Th2 cytokines, we will make paired pre/post comparisons of the impact of immunotherapies given in the course of clinical care [steroids, adrenocorticotropin (ACTH), intravenous immunoglobulins (IVIg), rituximab, chemotherapy, other drugs, combinations] on the cytokine and clinical profile. This research could lead to the application of commercially-available cytokines and cytokine blockers or to the development of new ones for OMS.
Sponsor: National Pediatric Neuroinflammation Organization, Inc.

Current Primary Outcome: Reduction in inflammatory cytokines [ Time Frame: 6 and 12 months ]

Original Primary Outcome: Same as current

Current Secondary Outcome: Correlation of cytokine concentration and clinical severity score. [ Time Frame: 6 and 12 months ]

Original Secondary Outcome: Same as current

Information By: National Pediatric Neuroinflammation Organization, Inc.

Dates:
Date Received: December 8, 2008
Date Started: January 2008
Date Completion: December 2016
Last Updated: January 24, 2014
Last Verified: January 2014