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Report for Clinical Trial NCT02400853

Developed by Shray Alag, 2020.
SNP Clinical Trial Gene

Research a New Predictive Marker of Intraventricular Hemorrhage in Very Preterm Infants: HEMO PREMA Study

The most frequent complications in premature infants are neurological complications: intracranial hemorrhages and white matter lesions. In Epipage 2 study the incidence of severe intraventricular hemorrhages remains stable. Severe hemorrhages are associated with neurological sequelae. A recent study in humans and in animals shows the role of the complex formed by plasminogen activator (t-PA) and its inhibitor (PAI-1) in the induction of vascular fragility via stromelysin (MMP-3). FIBRINAT study in Rouen University Hospital showed a rate of complex t-PA-PAI1 probably very high in preterm infants. An other factor maturation PDGF-C induced by t-PA is associated with the vascular embrittlement. Among the few genetic factors associated with cerebral palsy include 2 SNP of PAI-1 gene and one SNP in the gene of endothelial NO synthase. The hypothesis is that a high rate of the complex t-PA-PAI-1 in cord blood could be a high risk of intracranial hemorrhage in preterm infants and provide predictive of their occurrence. The rates of MMP-3, PDGF-C and PAI-1 free in cord blood, and the polymorphism of PAI-1 gene and eNOS could separately or associated with the main criterion to identify predictive of hemorrhages. The main objective is to search a rate difference of the complex t-PA-PAI-1 in cord blood of preterm infants (before 30 weeks of gestation) that would predict intracranial hemorrhage coming in the first days of life. The secondary objectives are - Evaluate potential marker risk of high levels of MMP-3, PAI-1 free, and PDGF-CC - Search in both groups the presence of alleles -675G4 / G5 and 11053 (G / T) of the PAI-1 gene and -922 (A / G) of the eNOS gene. 120 preterm infants will be included before 30 weeks of gestation with precise inclusion and exclusion criteria during a period of 3 years. Patients will be divided into two groups according to whether they will or not showed intracranial hemorrhage (detected by ultrasound J5-J7). The complex rate tPA-PAI-1, PAI-1 free, MMP-3 and PDGF-C will be measured. The comparison between the two groups will be carried out using statistical tests. Comparison of the presence of the alleles -675 4G and 11053T the PAI-1 gene or -922G eNOS gene between the two groups will be performed. The demonstration of this hypothesis would permit to identify children from birth in whom the immediate implementation of preventive treatment of bleeding is desirable.

NCT02400853 Intraventricular Hemorrhage
MeSH:Cerebral Hemorrhage Hemorrhage
HPO:Cerebral hemorrhage

2 Interventions

Name: Standard cranial echography

Description: Standard cranial echography will be done at day 5 day 7 post-birth looking for radiological finding of intraventricular hemorrhage
Type: Device
Group Labels: 2

preterm infants with intracranial hemorrhage preterm infants without intracranial hemorrhage

Name: Cord blood analysis

Description: Cord blood will be collected during deliverance and analysed
Type: Procedure
Group Labels: 2

preterm infants with intracranial hemorrhage preterm infants without intracranial hemorrhage


Primary Outcomes

Description: tPA-PAI-1 Complex rate in cord blood will be analysed in the 2 groups of infants

Measure: tPA-PAI-1 Complex rate in cord blood

Time: day 1

Secondary Outcomes

Description: MMP-3 rate in cord blood will be analysed in the 2 groups of infants

Measure: MMP-3 rate in cord blood

Time: day 1

Description: PAI-1 rate in cord blood will be analysed in the 2 groups of infants

Measure: PAI-1 rate in cord blood

Time: day 1

Description: PDGF-CC rate in cord blood will be analysed in the 2 groups of infants

Measure: PDGF-CC rate in cord blood

Time: day 1

Description: Polymorphism of specified sequence will be performed in the 2 groups of infants

Measure: 675G4 / G5 G11053T PAI-1 Genetic variations sequencing

Time: day 1

Description: Polymorphism of specified sequence will be performed in the 2 groups of infants

Measure: A-922g eNOS Genetic variations sequencing

Time: day 1

Purpose: Prevention

Allocation: Non-Randomized

Single Group Assignment


There is one SNP

SNPs


1 G11053T

675G4 / G5 G11053T PAI-1 Genetic variations sequencing. --- G11053T ---



HPO Nodes


HPO: