About this trial
Viral pneumonia, including SARS-CoV-2 and influenza A virus (IAV), can culminate in acute respiratory distress syndrome (ARDS), a severe form of respiratory failure with high mortality. Uncontrolled local inflammatory response and impaired tissue repair are hallmarks of ARDS. However, lack of in-depth understanding of the immunopathology lead to limited identification of potential 'endotypes' who may benefit from individualized targeted therapies. Mucosal Associated Invariant T (MAIT) cells represent a peculiar lineage of T cells with a wide panel of effector functions. Thus, they emerge as potential key players and appealing targets in ARDS through their potent abilities to modulate immune response at barrier sites and promote tissue repair. Recent data from the investigators and others indicated that MAIT cells are highly activated in patients with Sars-Cov-2 and IAV ARDS, but the associated activation mechanisms and precise functions remain unknown.
In this context, the investigators aim at investigating the implication and potential harnessing of MAIT cells in severe viral pneumonias and associated ARDS by with a dedicated clinical study. First, the investigators will perform a comprehensive and longitudinal phenotyping of immune response during viral pneumonia-induced ARDS, including MAIT cells, in blood -and airway compartment for mechanically ventilated patients. To provide more insight into specificity of virally induced pneumonia and ARDS, longitudinal phenotyping of immune response of patients with bacterial pneumonia, and control patients with unrelated ARDS (severe trauma, pancreatitis or major surgery) will also be performed.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age ≥ 18 years
Patients admitted to critical care (Intensive Care Unit, Continuous Monitoring Unit, Intensive Care Unit) at the CHRU de Tours
Acute community-acquired pulmonary infection (pneumonia),
Severe acute pancreatitis, with onset of ARDS criteria less than 48 hours ago,
Disqualifiers
None
Trial population
Adult patients admitted to critical care units at the CHRU de Tours for different reasons
Trial design
Cohort
Prospective
Treatments tested in this trial
Not listed
Trial groups
Trial outcomes
Primary outcomes
MAIT cells frequency during pneumonia and ARDS
MAIT cell frequency will be determined as % of CD3+ cells using flow cytometry techniques on biological samples obtained from samples done during routine care of patients included in the study (blood samples, and tracheal aspiration and broncho alveolar lavage for mechanically ventilated patients).
Secondary outcomes
Activation of MAIT cells during severe pneumonia and ARDS
MAIT cell activation (expression of CD69, PD-1 and CD56), cytotoxicity markers (granzyme B, CD107a), and cytokine production (IL-17, IFNγ, IL-22) after PMA-ionmycin stimulation will be assessed using flow cytometry techniques on biological samples obtained from samples done during routine care of patients included in the study (blood samples, and tracheal aspiration and broncho alveolar lavage for mechanically ventilated patients) and ultimately expressed as % of activated MAIT cells.
Sponsors and contacts
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