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Immunological Effects of Iron Supplementation in HHT Disease

RecruitingNAAges 18 Years - 99 YearsAllHospices Civils de Lyon
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In plain words

What the trial is, and whether it could suit you

Hereditary haemorrhagic telangiectasia (HHT), is a rare genetic vascular disorder with autosomal dominant inheritance. Its prevalence is estimated at approximately 1 in 6,000 individuals in France. Clinical manifestations include recurrent nosebleeds (epistaxis), cutaneous telangiectasias, and visceral arteriovenous malformations (AVMs) that may affect the lungs, gastrointestinal tract, liver, and brain. Beyond vascular abnormalities, patients often present with a decrease in circulating T lymphocytes (T-cell lymphopenia), which can be profound but remains unexplained. There is also a distinct infectious risk profile associated with the disease: brain abscesses in the presence of pulmonary AVMs (pAVMs), and osteoarticular infections in patients with the longest durations of epistaxis. However, no definitive correlation has been established between T-cell lymphopenia and infection risk.

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📋 Eligibility rules (as published)
Inclusion Criteria: * For all three groups: * Adult patient diagnosed with HHT (meeting 3 or 4 Curaçao criteria). * Documented pathogenic mutation in one of the following genes: ENG, ACVRL1, or MADH4. * Patient enrolled in the CIROCO cohort. * Written informed consent freely given and signed by the patient. * Patient covered by a social security scheme or equivalent. * Routine biological follow-up for HHT performed within the 15 days preceding the inclusion visit (complete blood count, reticulocytes, ferritin, CRP, calcium, phosphorus). * Specific to Group 1: * Ferritin \> 25 µg/L * No iron supplementation (oral or intravenous) in the past 3 months * No red blood cell transfusion in the past 3 months * Specific to Group 2: * Ferritin \> 25 µg/L * Ongoing oral iron therapy, or at least one intravenous iron infusion, or at least one red blood cell transfusion within the past 3 months * Specific to Group 3: * Ferritin \< 25 µg/L * No iron supplementation (oral or intravenous) in the past 3 months * No red blood cell transfusion in the past 3 months Exclusion Criteria: * Patients with hemoglobin levels \< 90 g/L. * Patients with active cancer or recent cancer remission (\< 3 months) that may alter the immune profile. * Patients with an active infection or recent infection recovery (\< 3 months) that may alter the immune profile. * Patients with an autoimmune or autoinflammatory disease, either active or recently treated (\< 3 months), requiring immunosuppressive therapy and potentially altering the immune profile. * Pregnant, postpartum, or breastfeeding women. * Minors. * Individuals deprived of liberty by judicial or administrative decision. * Individuals undergoing psychiatric care. * Individuals admitted to a healthcare or social institution for reasons other than research participation. * Adults under legal protection (guardianship, curatorship). * Individuals participating in another interventional clinical trial with an exclusion period still in effect at the time of pre-inclusion.
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What it tests

  • Blood test at D0
  • Blood test at D+3 months
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Where

1 site
Hôpital Femme-Mère-Enfant
Bron, France
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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