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| ID | Type | Description | Link |
|---|---|---|---|
| 2024-A01750-47 | Other Identifier | ANSM |
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Type I interferon (IFN-I) production is triggered by the detection of viral molecules, such as strands of viral RNA or DNA, by receptors known as PRRs (Pattern Recognition Receptors) present on many cell types. These interferons are secreted in minimal concentrations but can activate neighboring cells to secrete over 700 proteins with antiviral properties (inhibition of viral replication, destabilization of viral membranes, etc.). Thus, the IFN-I response serves as the immune system's first line of defense during a viral infection.
Very early in the COVID-19 pandemic, several research teams, including ours, identified a defect in the type I interferon response in about one in five subjects with severe COVID-19. In-depth studies have shown that 5 to 20% of these patients with severe COVID-19 disease have genetic mutations affecting genes involved in the activation cascade of the IFN-I pathway or produce autoantibodies that neutralize IFN-I, significantly impairing the effectiveness of their IFN-I response.
However, to date, not all causes of IFN-I response alteration are clearly identified, and 80% of patients suffering from severe COVID-19 do not appear to have evident genetic predispositions or anti-IFN-I autoantibodies, with the techniques currently available. This suggests the presence of other risk factors or causes that could potentially lead to alterations in the IFN-I response.
The gut microbiota is recognized for its influence on host health and immunity. SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2) infection has been associated with altered gut microbiota and correlated with inflammatory and immune responses. However, the association between dysbiosis and IFN-I response has yet to be studied in humans.
Therefore, to improve the management of individuals affected by viral respiratory infections, it seems essential to explore alterations in the IFN-I response to identify individuals potentially at risk of developing severe forms. It is known that a failure in the IFN-I response in the early stages of a viral infection leads to uncontrolled viral replication, which may result in a severe form of the disease. Since this IFN-I response is essential for controlling all viral infections, regardless of the virus involved, the investigators hypothesize that this IFN-I deficiency could be responsible for severe infections from various respiratory viruses that may lead to severe forms, even though a direct association between IFN-I deficiency and higher mortality risk has only been reported for a few viruses, such as SARS-CoV-2 and influenza.
Furthermore, the investigators consider the possibility of other underlying causes of IFN-I deficiencies, distinct from the already observed anti-IFN-I autoantibodies and genetic mutations. To achieve this, the investigators hypothesize that the use of functional immune tests could reveal these other alterations.
By identifying these alterations in individuals, the investigators hope to more accurately predict their propensity to develop severe forms of viral infections.
Patients who experienced :
Biological samples will be collected specifically for the study, outside of a healthcare procedure. No biological sample in biocollections coming from COVID-ser and NOSO-COR IMMUNO studies and the RNIPH study (Research Not Involving Human Persons) named MIR-COVID will be used for this new protocol.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mild patients | Other | Patients who experienced mild forms of COVID-19 during the first wave, without any prior vaccination, selected from the pre-existing COVID-Ser cohort (ClinicalTrial no. NCT04341142). |
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| Severe patients | Other | Patients who experienced severe forms of COVID-19 during the first wave, without any prior vaccination, selected from the pre-existing NOSO-COR IMMUNO cohort (ClinicalTrial no. NCT04637867) and the RNIPH study (Research Not Involving Human Persons) named MIR-COVID. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Biological Sampling | Other | The procedures specifically carried out for the study during a single visit are as follows:
o1 yellow tube (5mL) for anti-interferon antibody measurement o1 PAXgene tube (2.5mL) for the baseline IFN score without stimulation o3 green heparin tubes (12mL) for performing immune-functional tests o2 large purple tubes (20mL) for biological collection (if the patient provides specific consent) oA total of 39.5mL of venous blood will be collected for the study during a single visit.
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| Measure | Description | Time Frame |
|---|---|---|
| IFN-I score measured post-stimulation by Influenza A virus (IAV) in vitro | Comparison of the score IFN-I, measured by assessing the expression of a selection of IFN-I-stimulated genes, between the two groups of interest (mild or severe form). Given the limited advancement of studies on the interferon score following stimulation, no scoring scale is currently established. However, an increase in the score would be associated with a functional response to stimulation, indicating the absence of alterations in the targeted interferon induction pathway. | At inclusion visit (Day 0) |
| Measure | Description | Time Frame |
|---|---|---|
| IFN-I response induced post-stimulation in vitro by Poly I | Comparison of the score IFN-I, measured by assessing the expression of a selection of IFN-I-stimulated genes, between the two groups of interest (mild or severe form). Given the limited advancement of studies on the interferon score following stimulation, no scoring scale is currently established. However, an increase in the score would be associated with a functional response to stimulation, indicating the absence of alterations in the targeted interferon induction pathway. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jean-Christophe RICHARD, Pr | Contact | +33472011762 | j-christophe.richard@chu-lyon.fr | |
| Sophie TROUILLET-ASSANT, PhD | Contact | +33472678780 | sophie.trouillet-assant@chu-lyon.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospices Civils de Lyon - Hôpital de la Croix-Rousse | Recruiting | Lyon | 69004 | France |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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This is a single-center, comparative, prospective, interventional study with minimal risk and constraints, RIPH category 2 outside of healthcare product
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| At inclusion visit (Day 0) |
| Induction of immune pathways post-stimulation at a transcriptomic/proteomic level on a panel of genes and cytokines/chemokines specifically involved in key processes of the immune response | Comparison of gene expression levels, fold-changes expression, activation levels (Z-scores, p-value, FDR), and comparison of the concentrations of secreted cytokines/chemokines between the 2 groups of interest (mild or severe form) | At inclusion visit (Day 0) |
| Presence of anti-IFN-I autoantibodies | Comparison of the presence and levels of anti-IFN-I autoantibodies between the two groups | At inclusion visit (Day 0) |
| Presence of other serum anti-cytokine autoantibodies detected by multiplex ELISA (Infinity Biomarker) | Comparison of the presence and levels of other serum anti-cytokine antibodies between the two groups (mild or severe form) | At inclusion visit (Day 0) |
| Presence of genetic mutations affecting antiviral immune pathways | Comparison of the frequency of genetic mutations affecting genes involved in the IFN-I response detected by sequencing between the two groups (mild or severe form) | At inclusion visit (Day 0) |
| Comparison of the blood and nasal IFN score in vivo without stimulation to the blood IFN score post-stimulation in vitro by the live attenuated Influenza A virus (IAV). | Comparison of the blood and nasal IFN score in vivo without stimulation and the blood IFN score post-stimulation in vitro by the live attenuated Influenza A virus (IAV), Poly I:C, resiquimod (R848), diABZI, and IFNα | At inclusion visit (Day 0) |
| Propensity of individuals with a low IFN score post-stimulation by IAV to develop severe viral infections in the two winters following inclusion | Correlation of the IFN score post-stimulation by IAV with severe infectious episodes during the two winters following inclusion | After 2 winters (at last month 18) |
| Overall composition of the gut microbiota and possibly the metabolome, depending on the intensity of the functional immune response post-stimulation. | Correlation between the composition of the gut microbiota and possibly the metabolome and the immune response post-stimulation | At inclusion visit (Day 0) |
| IFN-I response induced post-stimulation in vitro by resiquimod (R848) | Comparison of the score IFN-I, measured by assessing the expression of a selection of IFN-I-stimulated genes, between the two groups of interest (mild or severe form) | At inclusion visit (Day 0) |
| IFN-I response induced post-stimulation in vitro by diABZI | Comparison of the score IFN-I, measured by assessing the expression of a selection of IFN-I-stimulated genes, between the two groups of interest (mild or severe form) | At inclusion visit (Day 0) |
| IFN-I response induced post-stimulation in vitro by IFNα | Comparison of the score IFN-I, measured by assessing the expression of a selection of IFN-I-stimulated genes, between the two groups of interest (mild or severe form) | At inclusion visit (Day 0) |
| Comparison of the blood and nasal IFN score in vivo without stimulation to the blood IFN score post-stimulation in vitro by Poly I:C | Comparison of the blood and nasal IFN score in vivo without stimulation and the blood IFN score post-stimulation in vitro by the live attenuated Influenza A virus (IAV), Poly I:C, resiquimod (R848), diABZI, and IFNα | At inclusion visit (Day 0) |
| Comparison of the blood and nasal IFN score in vivo without stimulation to the blood IFN score post-stimulation in vitro by resiquimod (R848) | Comparison of the blood and nasal IFN score in vivo without stimulation and the blood IFN score post-stimulation in vitro by the live attenuated Influenza A virus (IAV), Poly I:C, resiquimod (R848), diABZI, and IFNα | At inclusion visit (Day 0) |
| Comparison of the blood and nasal IFN score in vivo without stimulation to the blood IFN score post-stimulation in vitro by diABZI | Comparison of the blood and nasal IFN score in vivo without stimulation and the blood IFN score post-stimulation in vitro by the live attenuated Influenza A virus (IAV), Poly I:C, resiquimod (R848), diABZI, and IFNα | At inclusion visit (Day 0) |
| Comparison of the blood and nasal IFN score in vivo without stimulation to the blood IFN score post-stimulation in vitro by IFNα | Comparison of the blood and nasal IFN score in vivo without stimulation and the blood IFN score post-stimulation in vitro by the live attenuated Influenza A virus (IAV), Poly I:C, resiquimod (R848), diABZI, and IFNα | At inclusion visit (Day 0) |
| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |