Innate Immune Response of Blood Cells in Patients With Pneumonia (ASTRAL)
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| ClinicalTrials.gov Identifier: NCT03231670 |
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Recruitment Status : Unknown
Verified August 2018 by Lille Catholic University.
Recruitment status was: Recruiting
First Posted : July 27, 2017
Last Update Posted : August 21, 2018
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Pulmonary bacterial infections such as exacerbations of chronic bronchitis, nosocomial and community-acquired pneumonia represent a major public health issue. Antibiotics have shown their efficacy by direct antimicrobial activity and their limit particularly in case of multidrug-resistant microorganisms or in treating patients with aggravating pathologies. Innate immunity could be an alternative or complementary therapeutic pathway. Innate immunity receptors bind universal and invariant microbial molecular patterns present in bacteria, virus, fungus or parasite. Toll-like Receptors (TLR) activation by microbial agonist stimulates the innate immunity response which results in the production of chemokines, cytokines, antimicrobial molecules and the recruitment of innate cells.
The " Pulmonary Infection and Innate Immunity " team of the Immunity and Infection Center in Lille (Group of Dr. Sirard and Carnoy) has a long expertise in the study of TLR5 and its agonist, the flagellin, a structural protein of bacterial flagella. TLR5 is expressed on the cell surface of macrophages, monocytes, dendritic and epithelial cells. Several studies in mice have shown the flagellin prophylactic potential during bacterial infections through a TLR5 dependent stimulation of innate immunity. Recently, the group of Dr. Sirard and Carnoy has shown that flagellin can be used in association with antibiotics to treat Streptococcus pneumoniae respiratory infections in mice. The results demonstrate that an agonist of TLR can increase the therapeutic index of an antibiotic and improve the pulmonary anti-infectious reaction. This innovative approach allows us to consider new antibacterial strategies where antibiotics have reached their limit (nosocomial infection, multidrug-resistant bacteria…). TLR agonists can activate multiple human cell type. Indeed, blood cells activation by TLR agonists have been recently characterized in healthy volunteers.
However, there is no available data on the ability of TLR agonists to activate cells from patients with infectious pneumopathies. A study in these patients is inevitable if one is to consider the therapeutic use of agonists in respiratory pathologies.
| Condition or disease | Intervention/treatment |
|---|---|
| Lobar Pneumonia | Procedure: Blood sampling |
| Study Type : | Observational |
| Estimated Enrollment : | 38 participants |
| Observational Model: | Case-Only |
| Time Perspective: | Prospective |
| Official Title: | Analysis of Blood Cells Innate Immune Response in Patients With Lobar Pneumonia |
| Actual Study Start Date : | October 13, 2017 |
| Estimated Primary Completion Date : | October 2020 |
| Estimated Study Completion Date : | September 2021 |
| Group/Cohort | Intervention/treatment |
|---|---|
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lobar pneumonia
Inpatient with lobar pneumonia will undergo a blood sampling during their hospitalization and after resolution of the infection (2 Months)
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Procedure: Blood sampling
5ml blood will be taken in addition to standard sampling |
- Change in IL-6 specific transcripts [ Time Frame: Baseline and 2 months ]IL-6 specific transcripts will be measured in blood mononuclear cells after stimulation with a TLR5 agonist.
- Change in expression of innate immunity genes after stimulation by TLR2 agonist [ Time Frame: Baseline and 2 months ]
- Change in expression of innate immunity genes after stimulation by TLR4 agonist [ Time Frame: Baseline and 2 months ]
- Change in expression of innate immunity genes after stimulation by TLR5 agonist [ Time Frame: Baseline and 2 months ]
- Change in expression of innate immunity genes after stimulation by TLR9 agonist [ Time Frame: Baseline and 2 months ]
- Change in ELISA assay on mediators of inflammation with stimulation by TRL2 agonist [ Time Frame: Baseline and 2 months ]ELISA assay on mediators of inflammation in the supernatant of blood mononuclear cells stimulated by TRL2 agonist
- Change in ELISA assay on mediators of inflammation with stimulation by TRL4 agonist [ Time Frame: Baseline and 2 months ]ELISA assay on mediators of inflammation in the supernatant of blood mononuclear cells stimulated by TRL4 agonist
- Change in ELISA assay on mediators of inflammation with stimulation by TRL5 agonist [ Time Frame: Baseline and 2 months ]ELISA assay on mediators of inflammation in the supernatant of blood mononuclear cells stimulated by TRL5 agonist
- Change in ELISA assay on mediators of inflammation with stimulation by TRL9 agonist [ Time Frame: Baseline and 2 months ]ELISA assay on mediators of inflammation in the supernatant of blood mononuclear cells stimulated by TRL9 agonist
- Genotyping of TLR 2 gene [ Time Frame: Baseline ]
- Genotyping of TLR 4 gene [ Time Frame: Baseline ]
- Genotyping of TLR 5 gene [ Time Frame: Baseline ]
- Genotyping of TLR 9 gene [ Time Frame: Baseline ]
Biospecimen Retention: Samples With DNA
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
- Adult patient hospitalized in the department of pneumology for whom clinical, radiological and biological criteria confirm the diagnosis of lobar pneumonia
- Beneficiary of the French National Health Insurance Fund
- Signed informed consent form
Exclusion Criteria:
- Patient under guardianship
- Patient with acute respiratory distress syndrome or septic shock
- Pregnant women
- Patient with HIV, HCV or Mycobacterium tuberculosis
- Transplanted patient receiving immunosuppressive therapy
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03231670
| Contact: Amélie Lansiaux, MD, PhD | 03 20 22 52 69 ext +33 | lansiaux.amelie@ghicl.net | |
| Contact: Jean-Jacques Vitagliano, PhD | 03 20 22 57 51 | vitagliano.jean-jacques@ghicl.net |
| France | |
| Hôpital Saint-Philibert | Recruiting |
| Lomme, Hauts De France, France, 59000 | |
| Contact: Anne-France Georgel | |
| Principal Investigator: Philippe Delecluse, MD | |
| Sub-Investigator: Nicolas Masson, MD | |
| Study Director: | Christophe Carnoy, PhD | Institut Pasteur de Lille | |
| Study Director: | Jean-Claude Sirard, PhD | Institut Pasteur de Lille |
| Responsible Party: | Lille Catholic University |
| ClinicalTrials.gov Identifier: | NCT03231670 |
| Other Study ID Numbers: |
RT-12 |
| First Posted: | July 27, 2017 Key Record Dates |
| Last Update Posted: | August 21, 2018 |
| Last Verified: | August 2018 |
| Studies a U.S. FDA-regulated Drug Product: | No |
| Studies a U.S. FDA-regulated Device Product: | No |
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Pneumonia Respiratory Tract Infections Infections Lung Diseases Respiratory Tract Diseases |

