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Imaging Immune Activation in COVID-19

Primary Purpose

Covid19, SARS-CoV Infection

Status
Recruiting
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
[18F]F-AraG (2'-deoxy-2'-fluoro-9-β-D-arabinofuranosylguanine)
Sponsored by
CellSight Technologies, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Covid19 focused on measuring PET-CT Imaging, [18F]F-AraG

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age >18 years
  • Ability to read and understand written informed consent document
  • Have a recent diagnosis of SARS-CoV-2 infection as defined by a prior positive SARS-CoV-2 nucleic acid-based diagnostic test performed in a clinical laboratory on one or more nasopharyngeal or respiratory secretion samples.
  • > 14 days since onset of COVID-19 symptoms (or if no symptoms, from time of initial nucleic acid based diagnostic test).
  • Laboratory evaluations obtained within 60 days prior to entry.

    • Platelet count ≥75,000/mm3
    • ANC >1000/mm3
    • Aspartate aminotransferase (AST) <3 x ULN
    • Alanine aminotransferase (ALT) <3 x ULN
    • Calculated creatinine clearance (CrCl) ≥60 mL/min as estimated by the Cockcroft-
    • Gault equation

Exclusion Criteria:

  • Any medical condition that would compromise the imaging acquisition, in the opinion of the investigator
  • Participants who are pregnant (female participants of childbearing age will be tested prior to injection of imaging agent at entry visit/initial visit - positive test will exclude from further participation in the study)
  • Participants who are breastfeeding
  • Female participants of reproductive potential (defined as women who have not been post-menopausal for at least 24 consecutive months (i.e., who have had menses within the preceding 24 months), or women who have not undergone surgical sterilization, specifically hysterectomy and/or bilateral oophorectomy or bilateral salpingectomy) must have a negative urine or serum pregnancy test with a sensitivity of at least 25 mIU/mL performed within 24 hours prior to PET imaging. Females of reproductive potential will need to be on 2 forms of birth control (excluding withdrawal or timing methods).
  • Participants who have had prior allogeneic stem cell or solid organ transplant.
  • Screening absolute neutrophil count <1,000 cells/mm3, platelet count <75,000 cells/mm3, hemoglobin < 8 mg/dL, estimated creatinine clearance <60 mL/minute, aspartate aminotransferase >3 x ULN, alanine aminotransferase >3 x ULN.
  • Known SARS-CoV-2 shedding within 5 days of PET imaging.
  • Previously diagnosed myelodysplasia syndrome or history of lymphoproliferative disease prior to study entry
  • Active systemic autoimmune diseases not related to COVID-19.
  • COVID-19 vaccine prior to the first PET imaging session. Participants may receive COVID-19 vaccination after the first PET imaging session and the optional second PET scan, with the scan being performed at least 2 weeks following the most recent vaccine dose.
  • Prior PET scan or therapeutic radiation within 1 year of study enrollment.

Sites / Locations

  • University of California, San FranciscoRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

[18F]F-AraG

Arm Description

Radiofluorinated imaging agent, [18F]F-AraG (2'-deoxy-2'-fluoro-9-β-D-arabinofuranosylguanine) Trade name: VisAcT

Outcomes

Primary Outcome Measures

[18F]F-AraG uptake in participants with convalescent COVID-19
To determine regional uptake of [18F]F-AraG in participants with convalescent COVID-19.

Secondary Outcome Measures

[18F]F-AraG uptake in participants with convalescent COVID-19 over time
To determine the anatomical distribution of [18F]F-AraG in participant with convalescent COVID-19 approximately 4 weeks and 5 months (optional) over time.
[18F]F-AraG uptake in participants with mild to severe COVID-19 symptoms
To compare maximum SUV (SUVmax) and the mean SUV (SUVmean) from regions of interest (ROI; e.g. lungs, lymph node chains,) between convalescent COVID-19 individuals with mild (N=10) to those with moderate to severe initial disease (N=10) at each imaging timepoint
[18F]F-AraG uptake in female versus male participants
To compare maximum SUV (SUVmax) and the mean SUV (SUVmean) from regions of interest (ROI; e.g. lungs, lymph node chains,) between male and female participants with convalescent COVID-19 at each imaging time point.

Full Information

First Posted
March 23, 2021
Last Updated
September 27, 2023
Sponsor
CellSight Technologies, Inc.
Collaborators
University of California, San Francisco
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1. Study Identification

Unique Protocol Identification Number
NCT04815096
Brief Title
Imaging Immune Activation in COVID-19
Official Title
Imaging Immune Activation in COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 15, 2021 (Actual)
Primary Completion Date
October 1, 2024 (Anticipated)
Study Completion Date
October 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CellSight Technologies, Inc.
Collaborators
University of California, San Francisco

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a single center, single arm exploratory imaging study involving up to two intravenous microdoses of [18F]F-AraG (the second tracer dose is optional) followed by whole-body PET-CT imaging in participants with convalescent COVID-19. Up to 20 participants will be enrolled over an accrual period of approximately 24 months. Each participant will undergo one PET-CT scan following 50 +/- 10 minutes uptake following a single bolus injection of [18F]F-AraG in order to determine the tissue distribution of tracer in pariticpants with recent SARS-CoV-2 infection. A second optional [18F]F-AraG dose and PET-CT will be offered approximately 4 months following the initial imaging time point.
Detailed Description
This is a single center exploratory imaging study involving up to two intravenous microdoses of [18F]F-AraG (the second tracer dose is optional) followed by whole-body PET-CT imaging in participants 18 years of age and older with recent SARS-CoV-2 diagnosis and COVID-19 at least 14 days following onset of symptoms. The primary objective is to determine the anatomical distribution of [18F]F-AraG in participant with convalescent COVID-19 approximately 4 weeks and 5 months (optional, 4 months following first PET imaging visit) following onset of symptoms (N = 20). Tracer activity will also be compared with sex and age-matched uninfected historical control participants enrolled in prior studies. Up to 20 participants will be enrolled in this study who will be identified in the UCSF LIINC longitudinal COVID-19 cohort study. Each participant will undergo one PET-CT scan following 50 +/- 10 minutes uptake following a single bolus injection of [18F]F-AraG. A second optional [18F]F-AraG dose and PET-CT will be offered approximately 4 months following the initial imaging time point.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid19, SARS-CoV Infection
Keywords
PET-CT Imaging, [18F]F-AraG

7. Study Design

Primary Purpose
Basic Science
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Model Description
This is a single center exploratory imaging study involving up to two intravenous microdoses of [18F]F-AraG (the second tracer dose is optional) followed by whole-body PET-CT imaging in participants 18 years of age and older with recent SARS-CoV-2 diagnosis and COVID-19 at least 14 days following onset of symptoms.
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
[18F]F-AraG
Arm Type
Experimental
Arm Description
Radiofluorinated imaging agent, [18F]F-AraG (2'-deoxy-2'-fluoro-9-β-D-arabinofuranosylguanine) Trade name: VisAcT
Intervention Type
Drug
Intervention Name(s)
[18F]F-AraG (2'-deoxy-2'-fluoro-9-β-D-arabinofuranosylguanine)
Other Intervention Name(s)
VisAcT
Intervention Description
[18F]F-AraG is a radiolabeled high affinity substrate for deoxyguanosine kinase (dGK) and a low affinity substrate for deoxycytidine kinase (dCK), which are over-expressed in activated T cells.
Primary Outcome Measure Information:
Title
[18F]F-AraG uptake in participants with convalescent COVID-19
Description
To determine regional uptake of [18F]F-AraG in participants with convalescent COVID-19.
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
[18F]F-AraG uptake in participants with convalescent COVID-19 over time
Description
To determine the anatomical distribution of [18F]F-AraG in participant with convalescent COVID-19 approximately 4 weeks and 5 months (optional) over time.
Time Frame
5 months
Title
[18F]F-AraG uptake in participants with mild to severe COVID-19 symptoms
Description
To compare maximum SUV (SUVmax) and the mean SUV (SUVmean) from regions of interest (ROI; e.g. lungs, lymph node chains,) between convalescent COVID-19 individuals with mild (N=10) to those with moderate to severe initial disease (N=10) at each imaging timepoint
Time Frame
1 year
Title
[18F]F-AraG uptake in female versus male participants
Description
To compare maximum SUV (SUVmax) and the mean SUV (SUVmean) from regions of interest (ROI; e.g. lungs, lymph node chains,) between male and female participants with convalescent COVID-19 at each imaging time point.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age >18 years Ability to read and understand written informed consent document Have a recent diagnosis of SARS-CoV-2 infection as defined by a prior positive SARS-CoV-2 nucleic acid-based diagnostic test performed in a clinical laboratory on one or more nasopharyngeal or respiratory secretion samples. > 14 days since onset of COVID-19 symptoms (or if no symptoms, from time of initial nucleic acid based diagnostic test). Laboratory evaluations obtained within 60 days prior to entry. Platelet count ≥75,000/mm3 ANC >1000/mm3 Aspartate aminotransferase (AST) <3 x ULN Alanine aminotransferase (ALT) <3 x ULN Calculated creatinine clearance (CrCl) ≥60 mL/min as estimated by the Cockcroft- Gault equation Exclusion Criteria: Any medical condition that would compromise the imaging acquisition, in the opinion of the investigator Participants who are pregnant (female participants of childbearing age will be tested prior to injection of imaging agent at entry visit/initial visit - positive test will exclude from further participation in the study) Participants who are breastfeeding Female participants of reproductive potential (defined as women who have not been post-menopausal for at least 24 consecutive months (i.e., who have had menses within the preceding 24 months), or women who have not undergone surgical sterilization, specifically hysterectomy and/or bilateral oophorectomy or bilateral salpingectomy) must have a negative urine or serum pregnancy test with a sensitivity of at least 25 mIU/mL performed within 24 hours prior to PET imaging. Females of reproductive potential will need to be on 2 forms of birth control (excluding withdrawal or timing methods). Participants who have had prior allogeneic stem cell or solid organ transplant. Screening absolute neutrophil count <1,000 cells/mm3, platelet count <75,000 cells/mm3, hemoglobin < 8 mg/dL, estimated creatinine clearance <60 mL/minute, aspartate aminotransferase >3 x ULN, alanine aminotransferase >3 x ULN. Known SARS-CoV-2 shedding within 5 days of PET imaging. Previously diagnosed myelodysplasia syndrome or history of lymphoproliferative disease prior to study entry Active systemic autoimmune diseases not related to COVID-19. COVID-19 vaccine prior to the first PET imaging session. Participants may receive COVID-19 vaccination after the first PET imaging session and the optional second PET scan, with the scan being performed at least 2 weeks following the most recent vaccine dose. Prior PET scan or therapeutic radiation within 1 year of study enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Timothy Henrich, MD
Phone
6282065518
Email
timothy.henrich@ucsf.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Leo Torres
Email
Leonel.torres@ucsf.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Timothy Henrich, MD
Organizational Affiliation
University of California, San Francisco
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94110
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Timothy J Henrich, MD
Phone
415-206-5518
Email
timothy.henrich@ucsf.edu
First Name & Middle Initial & Last Name & Degree
Timothy J Henrich, MD
First Name & Middle Initial & Last Name & Degree
Henry F Vanbrocklin, PhD
First Name & Middle Initial & Last Name & Degree
Robert Flavel, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Imaging Immune Activation in COVID-19

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