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 volunteersQualifiers
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
Single group
Treatments tested in this trial
No intervention: no treatment
Other interventiontranslationnal study: Only blood sampling and imaging will be performed on two groups of ILD patients.
Treatment groups
Trial outcomes
Primary outcomes
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.
Secondary outcomes
To define whether blood eosinophilia is analogous to bronchial eosinophilia in ILDs patients
T2 immunity caractirization
To determine whether bronchial eosinophilia is a characteristic that can be targeted by anti-T2 biotherapy
T2 immunity caractirization
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
Sponsors and contacts
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