Non-invasive assessment of graft vs host disease using optoacoustic imaging

使用光声成像对移植物抗宿主疾病进行无创评估

• 批准号: 10578012
• 负责人: Jennifer Lin Holter Chakrabarty
• 金额: $ 16.95万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10578012
• 关键词: Abdomen; Adverse event; Alloantigen; Allogenic; Anesthesia procedures; Autoimmune Responses; Biological Markers; Biopsy; Body Weight decreased; Caring; Categories; Clinical; Clinical Research; Clinical Trials; Colitis; Collagen; Colonoscopy; Complication; Contrast Media; Crohn' s disease; Data; Deposition; Diagnosis; Diagnostic tests; Disease; Dose; Endoscopy; Feces; Genetic Diseases; Goals; Hematologic Neoplasms; Hematopoietic Stem Cell Transplantation; Hemoglobin; Human; Image; Immune; Immune system; Immunocompromised Host; Immunologic Deficiency Syndromes; Infectious colitis; Intervention; Intestines; Liver; Methods; Modality; Molecular; Mus; Muscular Dystrophies; Non-Neoplastic Hematologic and Lymphocytic Disorder; Output; Oxyhemoglobin; Pathologic; Patient risk; Patients; Pharmaceutical Preparations; Phase; Physicians; Pilot Projects; Refractory; Risk; Schedule; Skin; Skin Temperature; Solid Neoplasm; Steroids; Symptoms; T-Lymphocyte; Testing; Therapeutic; Time; Transplant Recipients; Weight Gain; chemotherapy; clinical diagnosis; clinical efficacy; deoxyhemoglobin; diagnostic accuracy; experience; gastrointestinal; graft vs host disease; high risk; histological stains; improved; individual patient; mortality; optoacoustic tomography; patient stratification; personalized medicine; photoacoustic imaging; safe patient; safety assessment; safety testing

Allogeneic hematopoietic stem cell transplant (HSCT) remains the only curative modality for patients with aggressive hematologic malignancies and many nonmalignant hematologic disorders (genetic disorders and immunodeficiency disorders). Graft vs host disease (GVHD) is the major complication and cause of non-relapse mortality in allogeneic HSCT. GVHD is attributable to donor T cell recognition of recipient alloantigen, presenting commonly in skin, liver and gastrointestinal (GI-GVHD). Initial clinical suspicion of GI-GVHD is made by symptoms of severe weight loss and increased stool output >500cc (500->1500)per day, without other cause identified. Clinical diagnosis of GI-GVHD separately from chemotherapy/infectious colitis (CI- Colitis) requires colonoscopy/endoscopy followed by biopsy, but has < 60% intra-expert variability of pathological diagnosis. To overcome these limitations in diagnosis of GI-GVHD, we propose to: 1) test the safety of Clinical MSOT detecting oxy-/deoxy-hemoglobin, total hemoglobin, and collagen contrast in patients with GI-GVHD and to 2) evaluate the potential of clinical MSOT to differentiate GI-GVHD from chemotherapy/infectious colitis (CI-Colitis) to ultimately increase diagnostic accuracy, decrease patient risk, and decrease time to therapy. Building upon our experience in HSCT and autoimmune responses in patients, as well as experience with multispectral optoacoustic tomography, these proposed studies aim to assess the potential of MSOT imaging to differentiate GVHD from CI-Colitis with the ultimate goal to provide patients a transabdominal non-invasive, accurate and objective method to identify disease for individual patients in support of personalized medicine. We hypothesize that clinical MSOT imaging is safe for patients with compromised immune systems and that clinical MSOT can distinguish GVHD from CI-Colitis based upon a combination of oxy- and deoxy-hemoglobin and collagen. We will test this hypothesis by the following Aims: 1) Assess safety of clinical features of MSOT in patients with GI-GVHD or CI-Colitis; and 2) Evaluate potential of clinical MSOT to identify and stratify GI-GVHD in HSCT patients. Our study will be the first to test clinical MSOT in HSCT patients and the first proposed study to use MSOT differentiate diseases of similar clinical presentation but radically different therapies.

同种异体造血干细胞移植（HSCT）仍然是唯一的治愈方式 具有攻击性血液系统恶性肿瘤和许多非恶性血液学的患者 疾病（遗传疾病和免疫缺陷障碍）。移植与宿主病（GVHD）是 同种异体HSCT中非释放死亡率的主要并发症和原因。 GVHD是 归因于供体T细胞识别的受体同种剂，通常呈现在皮肤，肝脏 和胃肠道（GI-GVHD）。 GI-GVHD的最初临床怀疑是由 严重的体重减轻和粪便增加> 500cc（500-> 1500），而没有其他原因 确定。 GI-GVHD的临床诊断是从化学疗法/传染性结肠炎中分别诊断 结肠炎）需要结肠镜检查/内窥镜检查，然后进行活检，但<60％的专家 病理诊断的变异性。为了克服GI-GVHD诊断的这些局限性，我们 建议：1）测试临床MSOT检测氧气/脱氧 - 血红蛋白的安全性， GI-GVHD患者的总血红蛋白和胶原蛋白对比，至2）评估 临床MSOT将GI-GVHD与化学疗法/传染性结肠炎区分开的潜力 （CI-Colitis）最终提高诊断准确性，降低患者风险并减少时间 接受治疗。 基于我们在HSCT和患者自身免疫反应方面的经验以及 具有多光谱光声断层扫描的经验，这些拟议的研究旨在评估 MSOT成像将GVHD与CI-肺炎区分开的潜力与最终目标 为患者提供腹部非侵入性，准确和客观的方法 确定支持个性化医学的个别患者的疾病。我们 假设临床MSOT成像对免疫受损患者是安全的 系统和临床MSOT可以根据A的 氧和脱氧血红蛋白和胶原蛋白的组合。我们将通过 以下目的：1）评估GI-GVHD患者MSOT临床特征的安全性 或CI肺炎； 2）评估临床MSOT的潜力以识别和分层GI-GVHD HSCT患者。我们的研究将是第一个在HSCT患者中测试临床MSOT的研究，第一个 拟议的研究使用MSOT分化了相似临床表现的疾病，但 根本不同的疗法。