Loeys-Dietz syndrome (LDS) is a rare vascular genetic disorder (estimated prevalence 1/25,000-1/100,000) due primarily to mutations in the Transforming growth factor beta (TGF-β) cytokine receptor 1 and 2 genes. In addition to a common vascular phenotype with Marfan syndrome (dilatation of the ascending aorta, arachnodactyly, lens dislocation), patients present specific malformations (bifid uvula, hypertelorism, tortuous arteries) and immuno-allergic manifestations (asthma, eczema, food allergy, eosinophilic esophagitis, chronic inflammatory bowel disease). Pathophysiologically, LDS appears to be associated with hyperactivation of the intracellular TGF-β signaling pathway in a manner similar to Marfan syndrome, as evidenced by increased intracellular phosphorylated Smad2/3 (pSmad2/3) in lymphocytes. The immuno-allergic complications appear paradoxical because of the major immunosuppressive role of this cytokine on lymphoid and myeloid immune lineages. The biological description of immunological abnormalities associated with LDS is based on a single 2013 study that found increased regulatory T (Treg) and Th2 lymphocyte polarizations, as well as increased circulating eosinophil and total IgE levels. In order to better understand the underlying mechanisms, the investigators propose to perform a descriptive clinical-biological study to identify and study the immune subpopulations most impacted by the causative mutations of LDS.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
60
Only one visit for each participant: A large majority of visits will be part of patients' usual care. * Medical examination : weight, gender, blood pressure, medical history * Blood samples : 1 EDTA tube (3 mL) for CBC, 3 heparin tubes (3 × 7 mL) for frozen PBMC, 1 EDTA tube (3 mL) for frozen plasma
Only one visit for each participant: * Medical examination : weight, gender, blood pressure, medical history * Blood samples : 1 EDTA tube (3 mL) for CBC, 3 heparin tubes (3 × 7 mL) for frozen PBMC, 1 EDTA tube (3 mL) for frozen plasma
Hôpital Femme-Mère-Enfant / Centre de Compétences pour le syndrome de Marfan et apparentés
Bron, France
Percentage of circulating TFH lymphocyte subpopulation.
Measured from the Blood samples of each patients / volunteers.
Time frame: Day 1
Intracellular pSmad2/3 labeling level of circulating TFH lymphocytes.
Measured from the Blood samples of each patients / volunteers.
Time frame: Day 1
Identification of Immuno-allergic pathologies
Identification of Immuno-allergic, serious infectious pathologies (diagnostic criteria, severity criteria, treatment, current activity) in LDS patients.
Time frame: Day 1
Identification of serious infectious pathologies
Identification of serious infectious pathologies (diagnostic criteria, severity criteria, treatment, current activity) in LDS patients.
Time frame: Day 1
Identification of Vascular complications
Identification of Vascular, morpho-skeletal complications (diagnostic criteria, severity criteria, treatment, current activity) current course) in patients with LDS.
Time frame: Day 1
Identification morpho-skeletal complications
Identification of morpho-skeletal complications (diagnostic criteria, severity criteria, treatment, current activity) current course) in patients with LDS.
Time frame: Day 1
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