RecruitingNCT07395076

Study of the Immunological Pathophysiological Mechanisms Associated With Acute Respiratory Distress Syndrome

Sponsor

Assistance Publique - Hôpitaux de Paris

Enrollment

50 participants

Start Date

Mar 26, 2026

Study Type

OBSERVATIONAL

Conditions

Acute Respiratory Distress Syndrome (ARDS)

Summary

About 10% of patients admitted to the ICU suffer from ARDS, with a mortality rate of around 35-45%. The lack of therapeutic innovation in ARDS can be partly explained by the heterogeneity of patients included under this definition. A better understanding of the pathophysiological mechanisms underlying the different patient phenotypes is essential to develop new therapeutic strategies. Objectives: To characterize the inflammatory profile of patients with ARDS using circulating biomarkers and single-cell RNA sequencing of pulmonary immune cells. The investigators hypothesize that there is a correlation between the profile of serum biomarkers (inflammatory sub-phenotypes), the transcriptome of pulmonary immune cells. Briefly the experimental scheme is as follow: * Population: patients with ARDS under invasive mechanical ventilation in the ICU. * Intervention: 1. Determination of the inflammatory subphenotype on circulatory inflammatory biomarkers. 2. Characterization of inflammation by single cell RNA sequencing on lung immune cells collected on broncho-alveolar fluid.

Eligibility

Min Age: 18 Years

Inclusion Criteria5

ARDS risk factors: bacterial or viral pneumonia, extrapulmonary infection, major trauma, transfusion, inhalation injury, or shock.
Pulmonary edema not explained by a cardiogenic cause or volume overload.
Onset of respiratory symptoms within \<7 days.
Bilateral pulmonary involvement on chest X-ray, CT scan, or ultrasound.
PaO₂/FiO₂ ≤ 300 assessed with PEEP ≥ 5 cmH₂O.

Exclusion Criteria7

ARDS with intubation for more than 48 hours.
Contraindications to bronchoscopy: effective anticoagulation, dual antiplatelet therapy, thrombocytopenia \<50 G/L.
Pre-existing immunodeficiency: active solid tumor or remission \<5 years, active hematologic malignancy or remission \<5 years, systemic disease (even without specific treatment), solid organ or bone marrow transplant, HIV infection with CD4 \<200/mm³.
Patients \<18 year-old
Patients under legal guardianship, curatorship, or deprived of liberty.
Ongoing pregnancy.
Patients without social security coverage.

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