Changes in the immune system of patients with HLH after anakinra
Research type
Research Study
Full title
Characterising the Dynamic Changes in Immune Cell Subsets and Activation profiles in Adult patients with Haemophagocytic Lymphohistiocytosis treated with the interleukin 1 receptor antagonist Anakinra
IRAS ID
310559
Contact name
Mark Bishton
Contact email
Sponsor organisation
R&I, Nottingham University Hospitals NHS Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Haemophagocytic Lymphohistiocytosis (HLH) is a rare inflammatory syndrome characterised by fevers, organ dysfunction and low blood counts, which may rapidly develop into multi-organ failure. HLH can be caused by several different problems. Infants tend to have inherited problems with their T-cells, while younger adults have acute viral infections and autoimmunity while older adults are those most likely to suffer from underlying cancer.
Until recently, treatments for adults with HLH were based on chemotherapy protocols for children from the 1990s regardless of the underlying cause of the HLH. Recently NHS England approved the use of Anakinra, (an IL1-antagonist) for HLH in all ages presenting with primary or secondary HLH regardless of trigger condition. Anakinra and high dose steroids help to control the inflammation, allowing time to diagnose the underlying causes of HLH and treat with targeted (chemo) therapies.
Information on how all the major immune cell subsets cause HLH in adults is very limited and there is no data on how these cells alter following Anakinra.
This study will use full spectrum Flow Cytometry and cyto/chemokine quantification to characterise in detail how the immune cells subsets and their activation cause HLH.
Our focus will be on finding immune cells or cytokines unaffected by Anakinra and therefore looking at what other anti-inflammatory treatments can be used in addition to Anakinra which can control inflammation better.
REC name
London - City & East Research Ethics Committee
REC reference
22/PR/0379
Date of REC Opinion
19 Apr 2022
REC opinion
Favourable Opinion