IDentification of EGPA Autoantigens (IDEA)
Research type
Research Study
Full title
Identification of autoantigens and their potential post-translational modification in EGPA and Severe Asthma.
IRAS ID
274097
Contact name
Myles Lewis
Contact email
Sponsor organisation
Queen Mary University of London
Duration of Study in the UK
1 years, 5 months, 30 days
Research summary
Summary of Research
Immune responses within the body of healthy individuals are carefully regulated to ensure health and prevent damaging infections. However in many diseases, immune responses themselves cause the damage. The ongoing trigger to the immune system in diseases such as severe asthma and eosinophilic granulomatous polyangiitis (EGPA) is unknown but there is some evidence the body may be producing damaging antibodies that attack benign structures within the body itself, and potentially target a different type of immune cell called an eosinophil. This research study will look for evidence of these auto-antibodies and characterise whether they may be a useful diagnostic marker in such diseases.
In the study we will collect samples of blood and sputum (phlegm) from healthy individuals, and patients with lung and rheumatological diseases such as EGPA. From these samples we will isolate antibodies and immune cells that we will further study and compare to clinical measures of disease.
This research is being conducted in research laboratories at Queen Mary University of London (QMUL) with samples donated by patients from Barts Health NHS Trust and healthy individuals. For participants there is a single short study visit in which the samples and basic clinical information are collected.
Summary of Results
Immune responses within the body of healthy individuals are carefully regulated to ensure health and prevent damaging infections. However in many diseases, immune responses themselves cause the damage. The ongoing trigger to the immune system in diseases such as severe asthma and eosinophilic granulomatous polyangiitis (EGPA) is unknown but there is some evidence the body may be producing damaging antibodies that attack benign structures within the body itself, and potentially target a different type of immune cell called an eosinophil. This research study investigated evidence for these auto-antibodies and whether they may be a useful diagnostic marker in such diseases.
Patients with severe asthma, EGPA, and other similar diseases, as well as healthy volunteers, were recruited from Barts Health NHS Trust, Royal Free London NHS Trust and Queen Mary University of London. 122 people consented to participate in the study with 120 participants providing blood samples that were analysed at Queen Mary University of London.
Two research methods were used to look for disease-related auto-antibodies – immunofluorescent microscopy of white blood cells known as neutrophils and eosinophils, and ELISA studies to look for auto-antibodies to protein structures suspected to be the target of auto-antibody responses.
Immunofluorescence studies showed a high proportion of patients with asthma to have antibodies to neutrophils. ELISA studies showed a significantly greater proportion of patients than healthy volunteers to have auto-antibodies to a panel of possible protein targets, though no single auto-antibody test could distinguish patients from healthy volunteers.
Further research has examined whether there are differences in the spectrum of antibodies produced by white blood cells in patients compared to healthy volunteers.
In summary our research shows that there is potential for a blood test testing a panel of auto-antibodies to aid diagnosis of severe asthma and associated diseases such as EGPA. This would accelerate identification of patients with these diseases that can often be difficult to diagnose. However, further research is still needed to identify the targets of auto-antibodies.REC name
London - Central Research Ethics Committee
REC reference
20/PR/0004
Date of REC Opinion
13 Aug 2020
REC opinion
Further Information Favourable Opinion