An Observational Study of the Immunopathogenesis of and Response to Step-Up Inflammatory Bowel Disease Therapy for Hermansky-Pudlak Syndrome-Associated Colitis
The primary purpose of this study is to detect patterns of immune abnormalities in the
colitis associated with Hermansky-Pudlak Syndrome (HPS). Additionally we aim to document the
clinical response to and tolerance of conventional inflammatory bowel disease (IBD) therapy
for HPS patients with active colitis associated with Hermansky-Pudlak Syndrome (HPS). HPS is
a rare autosomal recessive disorder causing dysfunctional lysosome-related organelle
formation and trafficking resulting in oculocutaneous albinism and a bleeding diathesis
secondary to platelet dysfunction. Associated conditions include pulmonary fibrosis, IBD,
and systemic ceroid deposition. The associated IBD has been reported to occur at a higher
frequency in the HPS-1 and HPS-4 subtypes compared to the prevalence of IBD in non-HPS
populations. HPS IBD has clinical features of both ulcerative colitis (UC) and Crohn's
disease, but histologically resembles Crohn's disease in that granulomas are commonly seen
in the mucosa of the intestine. The pathogenesis of HPS IBD is not fully understood and
little data beyond descriptions of the clinical and histologic manifestations have been
published. Furthermore reports on treatment of the colitis in HPS patients are largely
anecdotal, and our own experience suggests that many patients may be under-treated.
HPS patients with active colitis will be enrolled into this prospective treatment study.
Endpoints for the immunopathogenesis studies will include baseline measurements of and
changes in immune cell populations, cytokine, and chemokine expression. In the blood and gut
mucosa. Endpoints for the study of response to treatment will include changes in clinical,
endoscopic, and histologic scores as well as the rate and severity of adverse events.
Descriptive summary statistical analysis (n, mean, median, standard deviation, minimum and
maximum range) and simple correlations of clinical response variables with immune parameters
will be done.
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
To detect patterns of immune abnormalities in the colitis associated with Hermansky-Pudlak Syndrome (HPS).
United States: Federal Government
|National Institutes of Health Clinical Center, 9000 Rockville Pike||Bethesda, Maryland 20892|