Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Nutritional and Metabolic Diseases

Gland and Hormone Related Diseases

Nervous System Diseases

Symptoms and General Pathology

Infections

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Immune System Diseases

Breast Neoplasms

Diabetes Mellitus

Neuralgia

Acquired Immunodeficiency Syndrome

HIV Infections

Pain

Peripheral Nervous System Diseases

Neuromuscular Diseases

Neurologic Manifestations

Christoph Stein, Prof.

The purpose of this study is to analyze associations between symptoms and specific markers in the blood in patients suffering from neuropathic pain linked to diseases of different origin. Such markers could be utilized in the future for precise diagnosis of neuropathic pain and might lead to targeted pain treatment.

On average, 3-8% of the German population suffers from neuropathic pain, which can occur after damage of somatosensory nerves in the peripheral or central nervous system. In terms of a "personalized" medicine, only a strict separation of neuropathic and chronic pain allows an individualized therapy to reduce pain severity and to enhance patients' quality of life.

Currently, the diagnosis of neuropathic pain is based on the medical history, the subjective description of somatosensory symptoms and the application of (non-genetic) diagnostic tests. To improve diagnosis and therapy of complex disorders for individual patients, novel methods are introduced based on flow cytometric (FACS) analysis of human immune cells or analysis of the human genome (genomics). Those techniques can support the identification of characteristic features indicating ongoing individual pathophysiologic processes in the body (biomarkers).

Often diseases are based on a complex relationship between genetics, environmental factors and the manifestation of the disease. To capture this complexity via genomics, phenotypical and genotypical data of high quality and detailed information about the study population are required.

This observational study includes patients suffering from painful and non-painful neuropathies associated with HIV-infection, diabetes mellitus and breast cancer. With the targeted application of validated questionnaires (such as the Brief Pain Inventory, Pain Catastrophizing Scale, Hospital Anxiety and Depression Scale, Ten-Item Personality Inventory, 36-Item Short Form Health Survey, and the Insomnia Severity Index) and parallel usage of genomics or FACS analysis of selected biomarkers in the blood, this study will provide information about the manifestation of certain genes or immune markers which are directly correlated to the symptoms of the disease. Additional performance of neuropsychological/cognitive tests and quantitative sensory testing (QST) will enhance the phenotypic profile. Identification of potential indicators could be utilized prospectively to precisely diagnose and effectively treat neuropathic pain.

Analysis of Markers in the Blood Correlated With Neuropathic Pain

Neuropathic Pain: Association Between Phenotype and Biomarkers

Investigation of associations between phenotypic and genotypic data. Patients with chronic painful and non-painful neuropathy will be phenotyped in detail using validated questionnaires related to pain (Brief Pain Inventory and Numeric Rating Scale), mental health (Pain Catastrophizing Scale and Hospital Anxiety and Depression Rating Scale), personality (Ten-Item Personality Inventory) and quality of life (36-Item Short Form Health Survey and Insomnia Severity Index). Optional, a set of neuropsychological/cognitive tests and quantitative sensory testing (QST) will be performed. DNA will be isolated from patients' blood samples and analyzed for genetic variants which might have an effect on the development of neuropathic pain. Once, phenotypic and genotypic data are available they will be associated with each other with the goal to find genetic variants tied to pain phenotypes and which might serve as novel DNA biomarkers for neuropathic pain.

deCODE genetics

Christoph Stein, MD

Clinical director

Prostatic Neoplasms

Disease Progression

Neoplastic Cells, Circulating

Genital Neoplasms, Male

Urogenital Neoplasms

Genital Diseases

Genital Diseases, Male

Urogenital Diseases

Prostatic Diseases

Male Urogenital Diseases

Disease Attributes

All Drugs and Chemicals

Hormones

Phlebotomy collection of 2 tubes of blood then annual follow up for 5 years

epithelial-based marker approach for immunomagnetic enrichment, isolation, and quantitative immunofluorescence of CTCs

CellSearch CTC platform

Parsortix CTC platform

Alison Allan, PhD

The presence of circulating tumor cells (CTCs) in the blood of prostate cancer patients has been shown to be an important indicator of metastatic disease and poor prognosis. Additionally, changes in CTC number throughout treatment have been demonstrated to reflect therapy response. However, the CellSearch® (Menarini-Silicon Biosystems) is the only FDA- and Health Canada-cleared CTC platform available at the present time, and is thus considered the current "gold standard" for clinical CTC analysis.

Notably, CTCs are undetectable in \~35% of metastatic CRPC patients. This suggests that either CTCs are truly not present in \>1/3 of patients with advanced metastatic disease; and/or that CTCs are present but not detectable as they do not meet the standard CellSearch® definition of CTCs. Given the accumulating evidence that prostate cancer cells can lose epithelial characteristics as they evolve towards a more metastatic phenotype, the investigators believe the latter scenario is most likely.

The epithelial-to-mesenchymal transition (EMT) is a critical process during embryonic development and cancer metastasis.

Although the role of androgen receptor (AR) signaling in EMT is poorly understood, studies have also demonstrated that EMT may be facilitated by androgen deprivation, castration-resistance, and/or disruption of androgen signaling.

Importantly, several clinical studies have demonstrated that CTCs with a purely mesenchymal phenotype are undetectable by CellSearch®, but that the presence of mesenchymal marker expression on CTCs with a hybrid epithelial-mesenchymal phenotype is indicative of poor prognosis. In addition, previous pre-clinical data from the Allan laboratory has demonstrated that in animal models, prostate cancers with a mesenchymal phenotype shed greater numbers of CTCs more quickly and with greater metastatic capacity than those with an epithelial phenotype. Notably, the clinically-used CellSearch®-based assay captured the majority of CTCs shed during early-stage disease in vivo, and only after the establishment of metastases were a significant number of undetectable CTCs present. This suggests that current clinical assays may be limiting ability to capitalize on the full potential of CTCs, and that a greater understanding of CTC biology is necessary in order to guide future technology development and translation to the clinic.

The presence of circulating tumor cells (CTCs) in the blood of prostate cancer patients has been shown to be an important indicator of metastatic disease and poor prognosis. Additionally, changes in CTC number throughout treatment have been demonstrated to reflect therapy response. Although these cells are very rare (\~1 CTC per 105-107 leukocytes), recent technological advances have now facilitated sensitive enumeration and characterization of CTCs. Techniques to enrich and analyze CTCs include size- and/or density-based separation and antibody-based techniques with/without the aid of microfluidics, while detection techniques rely almost exclusively on protein- (immunofluorescence/flow cytometry) or nucleic acid-based (RT-PCR/qRT-PCR) assays. However, the CellSearch® (Menarini-Silicon Biosystems) is the only FDA- and Health Canada-cleared CTC platform available at the present time, and is thus considered the current "gold standard" for clinical CTC analysis.

CellSearch® uses an epithelial-based marker approach for immunomagnetic enrichment, isolation, and quantitative immunofluorescence of CTCs. Using this assay, it has been demonstrated that CTCs are readily detectable in \~65% of castrate-resistant prostate cancer (CRPC) patients and that the presence of ≥5 CTCs in 7.5ml of blood is indicative of progressive metastatic disease and reduced overall survival. Notably, CTCs are undetectable in \~35% of metastatic CRPC patients. This suggests that either CTCs are truly not present in \>1/3 of patients with advanced metastatic disease; and/or that CTCs are present but not detectable as they do not meet the standard CellSearch® definition of CTCs (EpCAM+/Cytokeratin 8/18/19 \[CK\]+/DAPI+/CD45-). Given the accumulating evidence that prostate cancer cells can lose epithelial characteristics as they evolve towards a more metastatic phenotype, the investigators believe the latter scenario is most likely.

The epithelial-to-mesenchymal transition (EMT) is a critical process during embryonic development and cancer metastasis. Activation of EMT leads to profound phenotypic changes resulting in loss of cell polarity, loss of cell-cell adhesion, resistance to apoptosis, and acquisition of migratory/invasive properties. It has also been proposed that tumor cells (via the mesenchymal-to-epithelial transition \[MET\]) may revert back to an epithelial phenotype in order to facilitate metastatic growth in secondary sites, suggesting a role for phenotypic plasticity during metastatic progression. At the molecular level, EMT is mediated by decreased expression of epithelial proteins (E-cadherin, CK, EpCAM); as well as corresponding increases in mesenchymal factors (N-cadherin, Vimentin, Twist, Zeb), with MET mediated by the opposite changes.

Clinically, Gleason grading can arguably be viewed as morphological evidence of EMT, since increasing Gleason score is associated with progressive loss of epithelial architecture, loss of defined basement membrane/cell polarity, and increased invasion. In support of this, studies have demonstrated that decreased expression of E-Cadherin or increased expression of mesenchymal markers (Vimentin, N-Cadherin, SNAIL) in primary prostate tumors is associated with advanced Gleason score, metastasis, and/or poor prognosis. Although the role of androgen receptor (AR) signaling in EMT is poorly understood, studies have also demonstrated that EMT may be facilitated by androgen deprivation, castration-resistance, and/or disruption of androgen signaling.

Importantly, several clinical studies have demonstrated that CTCs with a purely mesenchymal phenotype are undetectable by CellSearch®, but that the presence of mesenchymal marker expression on CTCs with a hybrid epithelial-mesenchymal phenotype is indicative of poor prognosis. In addition, previous pre-clinical data from the Allan laboratory has demonstrated that in animal models, prostate cancers with a mesenchymal phenotype shed greater numbers of CTCs more quickly and with greater metastatic capacity than those with an epithelial phenotype. Notably, the clinically-used CellSearch®-based assay captured the majority of CTCs shed during early-stage disease in vivo, and only after the establishment of metastases were a significant number of undetectable CTCs present. This suggests that current clinical assays may be limiting the ability to capitalize on the full potential of CTCs, and that a greater understanding of CTC biology is necessary in order to guide future technology development and translation to the clinic.

Influence of EMT on CTCs and Disease Progression in Prostate Cancer

Dynamic Influence of the Epithelial-to-mesenchymal Transition (EMT) on Circulating Tumor Cell (CTC) Generation, Phenotype, and Disease Progression in Prostate Cancer

Number of CTCs as assessed by the Parsortix system versus the clinical gold standard CellSearch platform

Number of CTCs that can be isolated from the Parsortix system

Level of RNA expression of AR and EMT markers (EpCAM, E-Cadherin, N-Cadherin, Zeb-1) as assessed by multiplex qRT-PCR of CTCs isolated from the Parsortix system

Differences in the number of CTCs between each of the 4 patient cohorts, and differences in the level of RNA expression of AR and EMT markers between each of the 4 patient cohorts

Correlation between number of CTCs and progression free survival and overall survival, and correlation between the level of RNA expression of AR/EMT markers and PFS and OS

Lawson Health Research Institute

Principal Investigator

Recurrence

determine the mutation profile of resected colorectal neoplasia

colonoscopy

Stepan Suchanek, assoc. prof.

Tomas Grega, MD, Ph.D.

Stepan Suchanek, MD., Ph.D.

Ondrej Ngo, Mgr.

Lucie Benesova, RNDr.

Ondrej Majek, RNDr.

Tereza Halkova, Mgr.

It is known that the development of colorectal adenoma is dependent on the appearance of somatic mutations in protooncogenes and tumor suppressor genes. Based on our previous mutation analyses of 120 patients with high-risk adenoma removed by enbloc resection with subsequent colonoscopy after 1 year, there is a correlation between mutation in exon 7 of the TP53 gene and risk of early metachronous lesions development. The results also indicate that mutation phenotype (mutation profile and burden) of all lesions detected on index colonoscopy can determine risk of metachronous lesions. As not all synchronous lesions were analyzed and the surveillance colonoscopy interval was less than 3 years, this assumption could not be confirmed. In this study it is planned to perform mutation analysis of all synchronous lesions in 200 patients and correlate the data with appearance of metachronous lesions after 1, 3 and 5 years. Moreover, the mutation profile of all metachronous lesions developed during the 5 years of surveillance will be determinated and compared with mutation profile of index lesions from the same localization to verify their common biological origin. This all could help personalize the surveillance program in terms of reduction of the burden on the patient and endoscopic workplaces and risk of developing colorectal cancer in a particular patient.

The aim of this prospective study is to identify patients with recurrent colorectal lesions risk and try to design an optimal intervals of surveillance colonoscopies, especially in the high-risk group of patients, using mutation and clinical-pathologic phenotype. The partial goals are: 1. Determination of the mutation profile and mutation burden in 200 patients based on examination of all their index and synchronous lesions found during index colonoscopy using an established PCR/DCE-based heteroduplex method. 2. Clinical and histopathological evaluation and mutational profiling of all metachronous lesions found during five-year surveillance period. 3. Correlation of clinical and histopathological parameters with mutational phenotype of patient. 4. Correlation of patient's mutational phenotype with an occurrence of metachronous lesion/s during surveillance period. 5. Comparison of the mutation profile of lesions from the index period withthe mutation profile of metachronous lesions. 6. Analysis of the similarity of the mutation profile of lesions found in the same / close areas of the colorectum.

Innovative Approach to Detect Recurrent Colorectal Lesions With Surveillance Via Mutation Analysis & Clinical Phenotype

Development and Clinical Utility of a New Method to Identify Patients With Risk of Recurrent Colorectal Lesions and Personalization of Their Surveillance Based on Mutation Burden and Clinical-pathological Phenotype

Correlation of clinical and histopathological parameters with mutational phenotype of patient.

Correlation of patient's mutational phenotype with an occurrence of metachronous lesion/s during surveillance period.

Analysis of the similarity of the mutation profile of lesions found in the same / close areas of the colorectum.

To identify patients with high risk of metachronous colorectal lesions and try to design and optimal intervals of surveillance colonoscopies, especially in the high-risk group of patients, using mutation and clinical-pathologic phenotype.

Determination of the mutation profile and mutation burden in 200 patients based on examination of all their index and synchronous lesions found during index colonoscopy using an established PCR/DCE-based heteroduplex method.

Clinical and histopathological evaluation and mutational profiling of all metachronous lesions found during five-year surveillance period.

Military University Hospital, Prague

Syndrome

Polycystic Ovary Syndrome

Cysts

Ovarian Cysts

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Gonadal Disorders

Endocrine System Diseases

PHENOTYPE A: Hyperandrogenism + Ovulatory Dysfunction + PCOM

Each patient will receive a 3-month low-carbohydrate (40% CHO) diet from the same dietitian. Whether the patients adhere to the diet and which components the prescribed diet consists of is recorded in detail. After 3 months of standard application, the patient is examined again by the gynecologist and obstetrician at the PCOS clinic.

Low carbonhydrate diet

Mujde Can Ibanoglu

Yaprak Engin-Ustun

The aim of the study was to investigate the changes in the clinical and biochemical parameters of adolescents on a low-carbohydrate diet in relation to their PCOS phenotype in the 3rd trimester.

Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder characterized by menstrual irregularities, anovulation, clinical and/or biochemical symptoms of hyperandrogenism (hirsutism and/or acne), micropolycystic ovaries, and metabolic abnormalities. In addition, some clinical and laboratory phenotypic features have been defined that were not previously included in the PCOS definition criteria, but which complement the clinical picture and influence the severity and morbidity of the clinical picture. Phenotype A: HA + OD + PCOM; phenotype B: HA + OD; phenotype C: HA + PCOM and phenotype D: OD + PCOM.For adult patients, internationally recognized diagnostic criteria have been developed based on combinations of otherwise unexplained hyperandrogenism, anovulation and polycystic ovary and are covered by the Rotterdam Consensus Criteria. However, in the adolescent age group, the frequency of anovulatory cycles and associated menstrual irregularities, the frequent symptoms of hyperandrogenism and acne vulgaris in the developmental phase, the problems with testosterone measurement and the prevalence of polycystic ovarian morphology in normal adolescents complicate the diagnosis.

PCOS is a serious clinical and psychological problem for adolescent girls. Key interventions include lifestyle modification, including diet, physical activity and weight loss. These measures have been shown to alter the course of the disease in overweight and obese girls. In particular, it is known that high glycemic index carbohydrate intake and glycemic load lead to a rapid rise in blood glucose levels and increased insulin production.

It is therefore thought that reducing the amount of insulin could have a more positive effect on PCOS than the usual carbohydrates. A low-carbohydrate diet is an effective, weight-independent approach in the treatment of metabolic disorders in PCOS patients. With this in mind, this study aimed to evaluate the clinical and biochemical outcomes at month 3 after application of the low-carbohydrate diet in adolescents according to their PCOS phenotype.

Adolescent Polycystic Ovary Syndrome on a Low-carbohydrate Diet

Effect of a Low-carbohydrate Diet on Outcomes According to Phenotype in Juvenile Polycystic Ovary Syndrome

Age, smoking, physical activity status, weight, height, body mass index (weight (kilogram)/height\*2 (meter2)), waist circumference(centimeters), degree of hirsutism (Ferriman-Gallwey Hirsutism Scoring Scale; lowest 8 highest: 24) were obtained from hospital records. Calculation of BMI: Height and body weight of the patients were measured using professionally calibrated devices. BMI was calculated using the formula BMI = weight (kg)/height (m)2.

Collection of serum samples: C-reactive protein (CRP) (mg/dL), complete blood analysis, sex hormone-binding globulin (SHBG), free and total testosterone (ng/mL), 17-OH progesterone (mIU/mL), prolactin (ng/mL), thyroid stimulating hormone (TSH) (mIU/mL), androstenedione (mosm/kg), dehydroepiandrosterone sulfate (DHEA-S) (μg/dL), Total cholesterol (mg/dL), high-density lipoprotein (HDL) cholesterol (mg/dL), low-density lipoprotein (LDL) cholesterol (mg/dL), triglycerides (mg/dL), fasting blood glucose, 50 g screening test values were analyzed in the biochemistry laboratory. Serum levels of DHEA-S, 17-OH-progesterone and testosterone were measured using the radiometric method. The blood count was measured using the Sysmex/XN-1000 (2016) blood analyzer. Serum levels of DHEA-S, 17-OH-progesterone and free testosterone were measured using a radiomonassay. Serum lipid and glucose levels were analyzed using the AU680 Chemistry System (Beckman Coulter, Fullerton, CA, USA).

Calculation of insulin resistance: A fasting blood glucose level between 100-125 mg/dl was considered as 'impaired fasting glucose'. A Homeostatic Model Assessment Insulin Resistance (HOMA-IR) value of ≥2.5 was defined as insulin resistance. Insulin resistance was calculated using the formula of the homeostatic model. \[HOMA-IR= fasting glucose (mg/dl)xfasting insulin (mIU/mL)/405\].

Etlik Zubeyde Hanım Women's Health Care, Training and Research Hospital

Assoc. Prof

Digestive System Diseases

Carcinoma

Carcinoma, Hepatocellular

Liver Neoplasms

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Adenocarcinoma

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Liver Diseases

Anti-Infective Agents

Hematinics

Metronidazole

Liver Extracts

Phenotype signature database building Image features extraction and clustering

The image processing operations required for local content-based image feature extraction consist of two main tasks: 1) tiling the images in smaller VOIs, typically a small cube, whose size depends on the modality, on the image resolution and on the purpose of the content-based query, and 2) performing feature extraction operations on the VOIs.

The Feature Extraction Engine performs totally unsupervised, automatic and asynchronous extractions of features from the images, organizes and indexes them in a no-SQL database based on unique similarity metric. The results of this phase are a series of clusters of phenotype signatures.

Image features extraction and clustering

Since the clusters are self-organizing their pathophysiological meaning is not readily apparent and requires further analysis. The characterization of each cluster is performed by analyzing representative samples and their respective correlation with histopathology results. After a series of iterations, the clusters are organized to correlate with distinct tissue subtypes identified by their signature similarity. The final number of clusters is not known a priori and depends on the heterogeneity of the underlying imaging phenotypes.

Phenotype signature database building

Olivier Lucidarme, MD

The purpose of this study is the development of a content-based image retrieval (CBIR) platform, where validation studies will be conducted for liver disease subtyping and hepatocellular carcinoma (HCC) phenotyping on images for use as diagnostic and prognostic markers of outcome in conjunction with large scale data registries and advanced predictive machine learning methodologies. The proposed objectives will deliver one or more fit-for-purpose non-invasive imaging-based methodologies to evaluate the presence, activity and type of HCC in clinical practice.

The study will advance through two distinct phases.

* Phase 1 has two main stages: The first stage will identify unique tumor phenotypes based on the iBiopsy phenotyping platform which extracts image-based signatures corresponding to each individual phenotype and will assess the analytic/technical performance of the iBiopsy platform. Gaps in characterization of the analytic readout under varying conditions of image acquisition and the repeat variability under identical analytic conditions will be filled by the proposed design. Once a set of suitable tumor phenotypes have been identified they will advance to the characterization phase. This will be done by the evaluation of an initial representative specific dataset (e.g. hundreds of patients) for training (to discover) and validation (to test robustness). The second stage will complete a preliminary biological/clinical validation of the above phenotypes for diagnosis and disease subtyping. This includes the investigation of a large dataset (e.g. thousands of patients) CDR for training and validation, using histopathology data as the reference standard and the optimization of the imaging signatures using AI based learning methodologies.
* Phase 2 also has two stages. The first stage of Phase 2 is to rigorously validate the candidate phenotypes emerging from Phase 1 for the diagnosis of subjects with HCC. The second stage of Phase 2 is to validate these select candidate phenotypes for prediction of outcome. These rigorous validations include using large CDR of patients with HCC (late stage biological/clinical validation).

Traditional medical image retrieval systems such as Picture Archival Systems (PACS) use structured data (metadata) or unstructured text annotations (physician reports) to retrieve the images. However, the content of the images cannot be completely described by words, and the understanding of images is different from person to person, therefore text-based image retrieval system cannot meet the requirements for massive images retrieval. In response to these limitations, CBIR systems using visual features extracted from the images in lieu of keywords have been developed. An important and useful outcome of these CBIR is the possibility to bridge the semantic gap, allowing users to search an image repository for high-level image features allowing the matching of image-based phenotype signatures extracted directly from the query medical image with phenotype signatures indexed in a registry.

The Median Technologies CBIR system uses patented algorithms and processes to decode the images by automatically extracting hundreds of imaging features as well as highly compact signatures from tens of thousands of 3D image patches computed across the entire image without the need for any prior segmentation. In addition to detailed phenotypic profiles which can be correlated with histopathology and genomic and plasmatic profiles, the system generates a unique signature for each tile providing a fingerprint of the "image-based phenotype" of the corresponding tissue. Using massively parallel computing methods, imaging biomarkers and phenotype signatures are extracted from a target image are then organized into clusters of similar signatures and indexed for real-time search and retrieval into schema-less (NoSQL) databases.

Phenotyping Liver Cancer Registry

Large Scale Clinical Data Registry (CDR) to Accurately Identify the Specific Tumor Phenotypes to Better Diagnose and Predict Patient Outcome in HCC

accurately identify the specific tumor phenotypes to better diagnose and predict patient outcome in hepatocellular carcinoma

deliver one or more fit-for-purpose non-invasive imaging-based methodologies to evaluate the presence, activity and type of hepatocellular carcinoma in clinical practice

Testing of phenotypes robustness by repeatability and reproducibility studies

: qualification of the imaging phenotypes against underlying pathophysiology and clinical outcome

Description: deliver one or more fit-for-purpose non-invasive imaging-based methodologies to detect and characterize small lesions (\< 2cm) (AUC 0.8)

Assistance Publique - Hôpitaux de Paris

Diseases and Abnormalities at or Before Birth

Rare Diseases

Neurofibromatoses

Neurofibromatosis 1

Neurofibroma

Nerve Sheath Neoplasms

Neoplasms, Nerve Tissue

Neoplastic Syndromes, Hereditary

Neurocutaneous Syndromes

Heredodegenerative Disorders, Nervous System

Neurodegenerative Diseases

Genetic Diseases, Inborn

Nervous System Neoplasms

Peripheral Nervous System Neoplasms

Neurofibromatosis

Neurofibromatosis Type 1

Legius Syndrome

Affected participants, must have a correct clinical diagnosis of NF1.

Unaffected individuals greater than 2 years of age who are relatives of participants.

Douglas R Stewart, M.D.

This study may identify genes that predict the seriousness of neurofibromatosis type 1 (NF1). Finding these genes may explain why some people with NF1 have more medical problems than others. The study will also examine medical problems in NF1 that are rarely seen and are not well understood.

Male and female patients with NF1 who have gone through puberty may be eligible for this study, as well as patients of any age who have unique or under-recognized disease features. Affected and unaffected family members, including parents, siblings, and more distant relatives, may also be enrolled. Candidates are screened with a discussion of medical history or review of medical records, or both. Participants undergo the following procedures:

Patients with NF1

* Physical examination and family history
* Photographs of the iris of each eye
* Photographs of the back, abdomen and thigh to count skin tumors
* Photographs of the face and body (with underwear on) to help track growth and appearance
* Magnetic resonance imaging (MRI) of the spine (This test uses a magnetic field and radio waves to look for tumors and curvature of the spine. The patient lies still in the scanner, a narrow cylindrical device, wearing earplugs to muffle loud knocking sounds that occur during the scan. A contrast material called gadolinium is injected into a vein through a catheter to enhance the images.)
* Blood draw for genetic studies
* Possibly a skin biopsy (with the use of numbing medicine, removal of a small sample of skin tissue) to grow cells in the laboratory

Patients with NF1 who have unique or under-recognized disease features

* Physical examination and family history
* Blood draw for genetic studies
* Possibly a skin biopsy
* Possibly additional tests, such as blood work, x-rays, photographs, MRIs, ultrasounds, or other tests

Unaffected family members

* Blood draw for genetic studies
* Brief skin and eye examinations
* Possibly a skin biopsy for cell culture

Families are asked to give permission for researchers to recontact them for follow-up information, additional blood samples, or follow-up visit.

We hypothesize that normal germline variation in gene expression accounts, in part, for variation in the clinical severity and phenotype of the monogenic disorder neurofibromatosis type 1 (NF1). The phenotype of NF1 is constituted by a variety of quantifiable features; we term these features sub-phenotypes . Our main focus is on sub-phenotypes with published evidence of variation in expression from an inherited component. These include our primary sub-phenotype of spinal neurofibroma burden (quantified by MRI of spinal neurofibromas) and the secondary sub-phenotypes of dermal neurofibroma burden, head circumference, number of Lisch nodules, scoliosis, history of plexiform neurofibromas, and height. Other sub-phenotypes, as collected by a routine history and physical, will also be evaluated.

According to our hypothesis, the severity of a sub-phenotype will correlate with heritable differences in the germline expression of certain genes. As an example, consider a spectrum of individuals affected with the primary sub-phenotype of spinal neurofibroma burden. For most genes, there will be no relationship of expression level to the number of spinal neurofibromas. However, some genes will have a direct (or inverse, or other) correlation of their level of expression and the number of neurofibromas. Such genes would be considered as candidate modifier genes. The secondary sub-phenotypes will also be analyzed in a similar way. To limit false positives, candidate genes will then be tested for association (using the transmission/disequilibrium test, TDT) with the appropriate sub-phenotype.

Recruitment will be focused on identifying individuals with a range of severity of the primary sub-phenotype, spinal neurofibroma burden. We will primarily recruit post-pubertal individuals who meet the 1988 NIH criteria for neurofibromatosis type 1 (NIH Consensus Development Conference 1988). We will exclude those with recognized segmental or mosaic NF1. The rate of cutaneous neurofibroma growth and number is known to vary widely; these tumors typically appear in adolescence. For this reason we will ascertain patients after puberty. We expect most individuals to be 18 years or older, but will also accept post-pubertal pediatric patients (and use a hand film to demonstrate bone age). Parents (whether affected or not) are critical when using family-based tests of association (like the TDT) and tests of linkage and will also be recruited.

Tests of association with the TDT require trios (mother, father, proband). Multiple trios can be derived from a single family, if there are multiple affected individuals within the family. We set a recruitment goal of 100 trios and a ceiling of 1500 individuals (500 affected individuals, plus 1000 parents or additional sibs in about 400 families).

In the interest of improving care for people living with NF1, this protocol also seeks to characterize, at the PI s discretion, individuals with unique or under-recognized features of NF1 as well as individuals with NF1-like phenotypes, including those patients with a known or suspected RAS pathway disorder.

Study of Disease Severity in Adults With Neurofibromatosis Type 1 (NF1)

Variation in Gene Expression in Neurofibromatosis Type 1

.De-identified clinical data will be shared with collaborators under appropriate agreements.

Phenotype severityPhenotype individuals and family members affected with NF1 by routine history and physical. The primary (spinal neurofibroma burden) and secondary (dermal neurofibroma burden, head circumference, number of Lisch nodules, scoliosis, history of plexiform neurofibromas, height) sub- phenotypes will be quantified with as appropriate technology (MRI, iris exam and photography, physical exam, medical history).

Identify candidate modifier genes by determining the correlation coefficient of the level of gene expression and the severity of each sub- phenotype (as phenotyped in Aim 1).

Characterize individuals with 1) unique or under-recognized features of NFl, and 2) individuals with NFl-like phenotypes, including those patients with a known or suspected RAS pathway disorder.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Analysis of Markers in the Blood Correlated With Neuropathic Pain	NCT02208206	Neuropathy		18 Years -	Charite University, Berlin, Germany
Influence of EMT on CTCs and Disease Progression in Prostate Cancer	NCT04021394	Prostate Cancer	CellSearch CTC ... Parsortix CTC p...	18 Years -	Lawson Health Research Institute
Innovative Approach to Detect Recurrent Colorectal Lesions With Surveillance Via Mutation Analysis & Clinical Phenotype	NCT05929365	Predictive Canc...	colonoscopy	18 Years - 75 Years	Military University Hospital, Prague
Adolescent Polycystic Ovary Syndrome on a Low-carbohydrate Diet	NCT06429618	Polycystic Ovar... Adolescent Beha... Diet Habit	Low carbonhydra...	12 Years - 24 Years	Etlik Zubeyde Hanım Women's Health Care, Training and Research Hospital
Phenotyping Liver Cancer Registry	NCT04681274	Hepatocellular ...	Image features ... Phenotype signa...	18 Years - 100 Years	Assistance Publique - Hôpitaux de Paris
Study of Disease Severity in Adults With Neurofibromatosis Type 1 (NF1)	NCT00111384	Neurofibromatos... Legius Syndrome		2 Years - 100 Years	National Institutes of Health Clinical Center (CC)
Analysis of Markers in the Blood Correlated With Neuropathic Pain	NCT02208206	Neuropathy		18 Years -	Charite University, Berlin, Germany

Spots Global Cancer Trial Database for phenotype

Every month we try and update this database with for phenotype cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for phenotype

Every month we try and update this database with for phenotype cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for phenotype cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.