Interpretation of the Role of Eosinophils in Diffuse Interstitial Pneumopathies

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-75
SponsorHopital Foch

About this trial

Diffuse interstitial lung diseases (ILDs) represent a group of rare, heterogeneous disorders of various etiologies, all sharing a common histopathological feature: fibrotic remodeling of the pulmonary parenchyma induced by a chronic inflammatory process. Although the prevalence of ILDs in France has recently been estimated at 19.4 per 100,000 inhabitants per year, they are frequently encountered in clinical practice due to their need for specialized hospital care. ILDs are associated with significant morbidity and a poor prognosis, despite the heavy burden of current therapeutic strategies. This highlights the urgent need to identify new therapeutic targets for these diseases.

Eosinophilic polymorphonuclear cell could represent one such target. As a source of pro-fibrotic mediators such as TGF-β, they may contribute to pulmonary fibrosis from a clinical standpoint. Our hypothesis is that a component of bronchial exacerbation in ILD patients may involve a type 2 immune response through the recruitment and activation of eosinophilic polymorphonuclear cell.

Given their role in pro-fibrotic signaling, our objective is to characterize type 2 immunity parameters-focusing in particular on eosinophilic polymorphonuclear cell-using a multi-source approach in a cohort of ILD patients. If type 2 immunity is significantly present in this population (referred to as ILD-eosinophilic polymorphonuclear cell), the investigators will investigate the role of eosinophilic polymorphonuclear cell in vitro using a co-culture model involving eosinophilic polymorphonuclear cell and respiratory epithelial cells (both bronchial and alveolar). Based on the results obtained, future prospects include evaluating the effects of biotherapy within this model as a preliminary step toward a subsequent clinical study.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

PID-PNE interest group (n= 30 patients): Adult subjects followed for chronic interstitial lung disease with a follow-up duration > 1 year with at least one biological sample showing a circulating PNE level > 300/mm3 during their follow-up, without any prescription of systemic corticosteroid therapy and antifibrotic agents (PIRFENIDONE and NINTENADIB) responsible for modulation of the eosinophil count.

PNE ILD control group (n= 30 patients): Adult subjects with ILD with a PNE level < 150/mm3 during their follow-up, without any prescription of systemic corticosteroid therapy and antifibrotic agents (PIRFENIDONE and NINTENADIB). - Have signed a consent form.

Be affiliated with a health insurance plan.

Disqualifiers

Patients under 18 years of age

Patients over 75 years of age

Pregnant patients

Subjects with eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

Trial design

Design model

Single group

Treatments tested in this trial

  • No intervention: no treatment

    Other intervention

    translationnal study: Only blood sampling and imaging will be performed on two groups of ILD patients.

Treatment groups

60 Participants
are divided into 2 treatment groups
Group A: ILDs eosinophilic polymorphonuclear cellOther 1 intervention
Group B: ILDs NO eosinophilic polymorphonuclear cellOther 1 intervention

Trial outcomes

Primary outcomes

1

The highlighting of significant differences in parameters related to T2 immunity (notably eosinophilic polymorphonuclear cell) in diffuse interstitial lung disease-EPN cells patients compared to no eosinophilic polymorphonuclear cell in ILDs patients.

T2 immunity caractirization. A description of the variables will be provided, by median and interquartile for quantitative variables, taking into account the numbers in each group, and by number and percentages for qualitative variables. Differences in variables between the two groups will be tested using the Chi-square test or Fisher's exact test for qualitative variables and the Mann-Whitney test for quantitative variables. To address the primary objective, variables with a p-value \<0.20 will be included in the multivariate model. A forward-backward multiple logistic regression will be performed to identify predictive factors for differentiation in epithelial damage and fibrotic phenomena between the two population groups.

Time frame
Two years

Secondary outcomes

1

To define whether blood eosinophilia is analogous to bronchial eosinophilia in ILDs patients

T2 immunity caractirization

Time frame
Two years
2

To determine whether bronchial eosinophilia is a characteristic that can be targeted by anti-T2 biotherapy

T2 immunity caractirization

Time frame
two years
3

validate these observations from an experimental point of view on an in vitro model of healthy epithelium in coculture with PNE from the blood of PID patients presenting with eosinophilia.

T2 immunity caractirization

Time frame
two years

Other outcomes

Sponsors and contacts

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