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Chronic Mucocutaneous CandidiasisNCT01386437

Natural History of Individuals With Immune System Problems That Lead to Fungal Infections

An observational study of Chronic Mucocutaneous Candidiasis and Invasive Aspergillosis, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Background: The immune system is made up of special cells, tissues, and organs that fight infections. Problems with this system may lead to frequent, severe, or unusual fungal infections. These infections are often difficult to treat. Read more about this study

Who is it for?
Ages 1 day to 99 yearsHealthy volunteers can take part
How many people
1,200 participants
Where
1 siteUnited States
Study dates
5 Nov 2012to not given
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 day to 99 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: The study population will be drawn from referrals from the NIH Clinical Center staff, physicians at outside medical facilities, the Clinical Center Volunteer Program, and self-referrals. Patients may be evaluated as inpatients, or at the NIAID outpatient clinic depending on the severity of the clinical manifestations of their infection. The patients genetic relatives will be evaluated at the NIAID outpatient clinic. Patients or relatives who meet the inclusion and/or exclusion criteria, but who are not able to travel to the NIH Clinical Center may be enrolled in the study and evaluated for immune and genetic defects using send-in blood samples or clinical specimens (e.g., previously obtained biopsy specimens or saliva). Healthy volunteers must be seen at NIH and will not have the option to mail in samples.

Who may be able to join

  • Patients:
  • Patients with or without inherited or acquired abnormalities of immune function manifesting mucocutaneous and/or invasive fungal infections are eligible for screening and assessment under this protocol. Specifically, patients must meet all the following inclusion criteria in order to participate in this study:
  • Adults or children (regardless of age, sex, or ethnicity/race) with a known or yet uncharacterized inherited immunodeficiency and a definitively diagnosed mucocutaneous or invasive fungal infection.
  • OR
  • Adults or children (regardless of age, sex, or ethnicity/race) with acquired immunodeficiency and a severe, unusual, persistent or treatment-refractory chronic mucocutaneous fungal infection.
  • OR
Show all 30Show fewer
  • Adults or children (regardless of age, sex, or ethnicity/race) with acquired immunodeficiency and a possible, probable or proven invasive fungal infection (European Organization for Research and Treatment of Cancer / Mycoses Study Group criteria).
  • OR
  • Adults or children (regardless of age, sex, or ethnicity/race) with a well-documented prior, unusual, severe, persistent, or treatment-refractory mucocutaneous or invasive fungal infection(s), who have clinically recovered from the fungal infection.
  • OR
  • Adults or children (regardless of age, sex, or ethnicity/race) with confirmed or suspected autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) who have not yet developed CMC.
  • Ongoing care by a referring/primary care physician (inside or outside NIH).
  • Willing to allow storage of blood and tissue samples for future analyses.
  • Willing to allow genetic testing from blood, body fluids or tissue specimens.
  • Willing to have HIV testing
  • Able to provide informed consent or be accompanied by a parent(s)/legal guardian(s) or legally authorized representative (LAR) who is able to provide informed consent.
  • No children under the age of 2 years will be seen at the Clinical Center, however they will be able to participate via mail-in specimens
  • Patient Relatives:
  • Individuals (regardless of age, sex, or ethnicity/race) who are genetically related to the patient (e.g., mother, father, siblings, children) may be recruited to establish the genetic origin of immune defects that may be identified in the study patients at the discretion of the PI. Relatives must meet all the following inclusion criteria in order to participate in this study:
  • Willing to allow storage of blood and tissue samples for future analyses.
  • Willing to allow genetic testing from blood, body fluids or tissue specimens.
  • Willing to have HIV testing
  • Able to provide informed consent or, if younger than 18, be accompanied by a parent(s)/legal guardian(s) who is able to provide informed consent.
  • Healthy Volunteers:
  • Healthy adults regardless of sex, and ethnicity/race between the ages of 18 and 85 years old may be eligible to participate in this study. Healthy volunteers must meet all the following inclusion criteria in order to participate in this study:
  • Willing to allow storage of blood and tissue samples for future analyses.
  • Willing to allow genetic testing from blood, body fluids or tissue specimens.
  • Willing to have HIV testing
  • Able to provide informed consent
  • NIH employees are eligible

Who cannot join

  • Patients:
  • A patient will not be eligible if he/she has any of the following:
  • Any condition which, in the investigator's opinion, may interfere with the evaluation of a co-existing abnormality of immunity that is the subject of study under this protocol.
  • Any condition which, in the investigator's opinion, places the patient at undue risk by participating in the study.
  • Unwillingness to undergo testing or procedures associated with this protocol.
  • Hemoglobin of < 7 gm/dL. If a patient is enrolled solely to obtain left-over pathology specimens, saliva, a buccal sample, skin swab, vaginal swab, or a stool sample, this exclusion criteria will not apply as there will be no blood withdrawal.
Show all 17Show fewer
  • Patient Relatives:
  • A genetically related relative will not be eligible for this study if he/she has any condition which, in the investigator's opinion, may interfere with the evaluation of an immune system abnormality that is the subject of study under this protocol.
  • Healthy Volunteers:
  • A healthy volunteer will not be eligible if he/she has any of the following:
  • HIV infection.
  • History of recurrent or severe infections.
  • History of an underlying malignancy or receipt of cancer chemotherapy within the past 5 years
  • Receipt of systemic corticosteroids or other systemic immunosuppressants or immunomodulators within the past 30 days
  • Pregnancy or lactating
  • History of heart, lung, kidney disease, or bleeding disorders.
  • Any condition which, in the investigator's opinion, may interfere with the comparison of clinical specimens against those obtained from affected subjects.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Michail S Lionakis, M.D. contact

(301) 443-5089

lionakism@mail.nih.gov

United States1 site, 1 recruiting
  • National Institutes of Health Clinical Center

    Bethesda, Maryland, 20892

    For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR), 800-411-1222 ext. TTY dial 711, ccopr@nih.gov

    Recruiting

Other trials in United States

About this study

Official title: The Natural History and Pathogenesis of Human Fungal Infections

Background:

  • The immune system is made up of special cells, tissues, and organs that fight infections. Problems with this system may lead to frequent, severe, or unusual fungal infections. These infections are often difficult to treat. Researchers want to collect blood and tissue samples from people who have unusual, persistent or severe fungal infections or immune problems that increase the risk of these infections.
Read more

Objectives:

  • To collect medical information and samples for a long-term study of people with immune system problems that lead to fungal infections.

Eligibility:

  • People with a history of fungal infections caused by immune system problems.
  • Parents, children, and siblings of this group.
  • Healthy volunteers not related to the first two groups.

Design:

  • This long-term study may last for up to 25 years. Those in the study may need to provide new information about every 6 months. The procedures for each person may vary with the particular diagnosis and the extent of fungal infection. Healthy volunteers may have only one or two visits.
  • At the first visit, those in the study will have a full medical history and physical exam. They will also provide blood.
  • Research procedures may include the following:
  • Saliva, urine or stool testing
  • Mouthwash collection for DNA testing
  • Collection of cheek cells, nail clippings, or vaginal fluid
  • Tests of leftover tissue or body fluid from previous medical procedures
  • Skin or oral mucous membrane biopsy
  • Collection of white blood cells
  • Followup visits will involve a physical exam and updated medical history. Blood, saliva, urine, or nail clipping samples may be taken for ongoing studies. Any additional tests or exams required by the study doctors may also be done.
  • Participants may withdraw from the study pool at any time.
Read the detailed description

This protocol is a natural history study designed to investigate the clinical, microbiologic, genetic and immunologic correlates of primary immune deficiencies and other conditions associated with mucocutaneous and invasive fungal infections (IFIs). The hypothesis is that chronic mucocutaneous mycoses and IFIs are caused by abnormalities in immune function in these patients that can be identified using modern methods in molecular and cell biology and immunology. For inclusion, patients must have a history of or an active mucocutaneous or invasive fungal infection, but may or may not have a defined primary or acquired immunodeficiency state. Patients will undergo evaluations that include history/physical examination and blood, saliva, and possible tissue sampling for genetic and immunological testing. Patient relatives may also be screened for clinical, microbiological, genetic and/or immunological correlates of host defense abnormalities. Healthy volunteers will be enrolled as a source of control blood, saliva, and possible tissue sampling, and for genetic testing.

The aim of this protocol is to use modern methods in molecular and cell biology and immunology to elucidate the immunopathogenesis of fungal disease in humans. A better understanding of primary immunodeficiency and identification of fungal and host risk factors for fungal infection may provide new insights into pathogenesis and identify targets for development of novel therapies. Enrolled subjects may be followed for up to 25 years to undergo additional clinical evaluation and sampling. Follow-up may occur every 6 months or more frequently depending on clinical course, the underlying risk factor(s), and the type of fungal infection. Under some circumstances, standard medical treatment will be provided for a fungal infection or immune deficiency.

Keywords
Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy (APECED), Fungal Infections, Molds, Autoimmune Polyendocrinpathy Syndrome (APS) Type 1, Natural History, Mucocutaneous Fungal Infection, Invasive Fungal Infection
Medical subject headings
Candidiasis, Chronic Mucocutaneous, Polyendocrinopathies, Autoimmune, Mycoses, Invasive Fungal Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT01386437
Study groupRoleWhat they receive
Fungal infectionsPatients with or without inherited or acquired abnormalities of immune function manifesting mucocutaneous and/or invasive fungal infections

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Immunological mechanisms of fungal susceptibility

    Characterize and understand the immunological mechanism(s) by which inherited immunodeficiencies or acquired conditions increase susceptibility to mucocutaneous and invasive fungal infections.

    Measured: 25 years

Secondary outcomes (2)
  1. Determine microbiologic test usefullness

    Determine the usefulness of various microbiologic tests (e.g., cultures, serology, molecular assays) for diagnosis and follow-up of the course of fungal infections.

    Measured: 25 years

  2. Determine immunological profile of mucosal fungal infections

    Define the transcriptional profiles and perform proteomic and microbiome analyses of skin, oral and/or vaginal mucosa, and/or other tissues, and body fluids of patients with inherited or acquired conditions predisposing them to fungal infections.

    Measured: 25 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Jul 2011 (estimated)
  2. Study start5 Nov 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
1,200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01386437
Sponsor's protocol ID
110187
Other IDs
11-I-0187
Status last verified
28 Oct 2026
First submitted
30 Jun 2011
Last updated
5 Nov 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Ahonen P, Myllarniemi S, Sipila I, Perheentupa J. Clinical variation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in a series of 68 patients. N Engl J Med. 1990 Jun 28;322(26):1829-36. doi: 10.1056/NEJM199006283222601.

    PubMed 2348835
  • Atkinson TP, Schaffer AA, Grimbacher B, Schroeder HW Jr, Woellner C, Zerbe CS, Puck JM. An immune defect causing dominant chronic mucocutaneous candidiasis and thyroid disease maps to chromosome 2p in a single family. Am J Hum Genet. 2001 Oct;69(4):791-803. doi: 10.1086/323611. Epub 2001 Aug 21.

    PubMed 11517424
  • Holland SM, DeLeo FR, Elloumi HZ, Hsu AP, Uzel G, Brodsky N, Freeman AF, Demidowich A, Davis J, Turner ML, Anderson VL, Darnell DN, Welch PA, Kuhns DB, Frucht DM, Malech HL, Gallin JI, Kobayashi SD, Whitney AR, Voyich JM, Musser JM, Woellner C, Schaffer AA, Puck JM, Grimbacher B. STAT3 mutations in the hyper-IgE syndrome. N Engl J Med. 2007 Oct 18;357(16):1608-19. doi: 10.1056/NEJMoa073687. Epub 2007 Sep 19.

    PubMed 17881745
  • Ferre EMN, Yu Y, Oikonomou V, Hilfanova A, Lee CR, Rosen LB, Burbelo PD, Vazquez SE, Anderson MS, Barocha A, Heller T, Soldatos A, Holland SM, Walkiewicz MA, Lionakis MS. Case report: Discovery of a de novo FAM111B pathogenic variant in a patient with an APECED-like clinical phenotype. Front Immunol. 2023 Feb 17;14:1133387. doi: 10.3389/fimmu.2023.1133387. eCollection 2023.

    PubMed 36875114
  • Chascsa DM, Ferre EMN, Hadjiyannis Y, Alao H, Natarajan M, Quinones M, Kleiner DE, Simcox TL, Chitsaz E, Rose SR, Hallgren A, Kampe O, Marko J, Ali RO, Auh S, Koh C, Belkaid Y, Lionakis MS, Heller T. APECED-Associated Hepatitis: Clinical, Biochemical, Histological and Treatment Data From a Large, Predominantly American Cohort. Hepatology. 2021 Mar;73(3):1088-1104. doi: 10.1002/hep.31421.

    PubMed 32557834
  • Burbelo PD, Ferre EMN, Chaturvedi A, Chiorini JA, Alevizos I, Lionakis MS, Warner BM. Profiling Autoantibodies against Salivary Proteins in Sicca Conditions. J Dent Res. 2019 Jul;98(7):772-778. doi: 10.1177/0022034519850564. Epub 2019 May 16.

    PubMed 31095438

Questions about this trial

What is this clinical trial studying?

An observational study of Chronic Mucocutaneous Candidiasis and Invasive Aspergillosis, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 30 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 5 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Michail S Lionakis, M.D. ((301) 443-5089, lionakism@mail.nih.gov), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Immunological mechanisms of fungal susceptibility (time frame: 25 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01386437, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Nov 2026.

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