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Community-acquired PneumoniaImPACTNCT03379207

Innate Immune Response During Community Acquired Pneumonia

An observational study of Community-acquired Pneumonia and Acute Respiratory Distress Syndrome, run by University Hospital, Tours at 3 sites in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Community acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. Despite recent improvement in acute management (specifically for administration of antibiotics) many severe presentations of pneumonia worsen, progressing to Acute Respiratory Distress Syndrome (ARDS), a clinical entity with 40%… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Blood samples, Tracheal Aspirates and Surplus of Broncho-alveolar lavage fluid
How many people
258 participants
Where
3 sitesFrance
Study dates
10 Jan 2018to 4 Jun 2025
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Participants admitted to the Intensive Care Unit of the University Hospital of Tours or University Hospital of Limoges (France) with an initial diagnosis of Community Acquired Pneumonia, or participants admitted without diagnosis of pneumonia or shock and for whom invasive mechanical ventilation is required.

Who may be able to join

  • "Pneumonia" group:
  • Admission to the Intensive Care Units or Pneumonia service of Tours University Hospital or Intensive Care Unit or Limoges University Hospital
  • Initial diagnosis of acute community-acquired pneumonia suggested by the presence of a cough, dirty sputum, chest pain and / or dyspnea (at least two criteria required), associated with the presence of a radiological or CT infiltrate initially
  • Patient for whom it is not envisaged, a priori, to limit treatment within 5 days following inclusion, for ethical reasons, due to age and advanced comorbidities, and / or a level of severity beyond all therapeutic possibilities.
  • Diagnosis of pneumonia done within 48 hours after admission to the hospital
  • Participant admitted to the hospital for less than 8 days
Show all 14Show fewer
  • "Control" group:
  • Admission to the Intensive Care Units of the University Hospital of Tours or Limoges University Hospital
  • Use of invasive mechanical ventilation for less than 48 hours
  • Predictable duration of invasive mechanical ventilation> 48h
  • Participant admitted to the hospital for less than 8 days
  • Absence of pneumonia criteria (according to the criteria defined for the "Pneumonia" participant group)
  • Absence shock (defined by the need for vasopressor despite volume expansion ≥30mL/kg, associated with a blood lactate level ≥ 2mmol / L
  • Patient for whom it is not envisaged, a priori, to limit treatment within 5 days following inclusion, for ethical reasons, due to age and advanced comorbidities, and / or a level of severity beyond all therapeutic possibilities.

Who cannot join

  • Participant under protection
  • Pregnant or lactating women

Trial locations and contacts

3 sites in 1 country.

France3 sites
  • University Hospitakl of TOURS Département of Pneumonia

    Tours, 37044

  • University Hospital -Bretonneau - Intensive Care

    Tours, 37044

  • University Hospital of Tours; INSERM CIC 1415

    Tours, 37044

Other trials in France

About this study

Official title: Innate Immunity During Community Acquired Pneumonia: A Translational Approach

Community acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. Despite recent improvement in acute management (specifically for administration of antibiotics) many severe presentations of pneumonia worsen, progressing to Acute Respiratory Distress Syndrome (ARDS), a clinical entity with 40% hospital mortality.

Dysregulation of immune response is thought to be largely implicated in severe pneumonia progressing to ARDS. Notably, experimental studies have recently suggested the implication of non-conventional T lymphocytes and innate cells in this immunopathology. However, no data are available in Humans in clinical settings.

Read more

This study aims to explore the role of non-conventional T cells in pneumonia and ARDS, in participants. For this purpose, 100 participants admitted to Intensive Care Unit (ICU) with a diagnosis of CAP will be included, and 50 "control" participants with no pneumonia nor shock. Presence and functionality of non-conventional T cells and innate cells will be explored using flow-cytometry and ex-vivo stimulation, alongside with cytokines productions. These analyses are conducted in the blood, and, for invasively ventilated participants, in tracheal aspirates or broncho-alveolar fluids if available. For each participants included, the analyses are conducted at different time-points during ICU stay: inclusion, day 3, day 8 and day 15. Moreover, participants with ARDS, for whom a post-ICU follow-up program is normally established after discharge, will have blood analysis from blood samples taken during the follow-up visit up to 8 months after inclusion.

Immunophenotypage and functionality of non-conventional T cells and innate cells will be compared to clinical parameters and their evolution, between "CAP" participants and "Control" participants", and for each participants, according to the different time-point of analysis, in order to better understand dynamic of innate immunity during pneumonia and ARDS.

Read the detailed description
  • Clinical and scientific background:

Community acquired pneumonia is a major cause of morbidity and mortality worldwide. Despite recent improvement in acute management (specifically for administration of antibiotics), severe pneumonia can worsen and ultimately progressing to Acute Respiratory Distress Syndrome (ARDS), a clinical entity with an inacceptable 40% hospital mortality. From a pathophysiological point of view, ARDS is characterized by a deregulation of pulmonary inflammation initially triggered by the local aggression, which is, in two-third of the cases, a pneumonia. Alteration of tissue repair is another major characteristic of this entity. So far, the scientific knowledge on this pathophysiology did not translate into specific therapy that could modulate efficiently the inflammatory response and to control the progression from pneumonia to ARDS, and/or to improve tissue repair. Thus, a complete reconsideration of the pathophysiological mechanisms is mandatory. Recent progresses in mucosal biology and innate immunity give interesting new opportunities. Specifically, recently discovered unconventional T cells have shown to be major actors in shaping and modulating early immune responses in the lung mucosa during microbial aggressions and for secondary tissue repair. However, these evidences are limited to pre-clinical models. In many other human diseases (oncology, immune diseases), these sub-populations are already being explored as potential targets for immune therapies.

  • Objective of the study:

The aim of this study is to explore potential implications of unconventional T cells during human severe pneumonia and ARDS.

This translational study will complement experimental approaches currently undertaken in the laboratory exploring the role of unconventional T cells in murine models of severe pneumonia and ARDS.

  • Design:

This is a prospective single-center study including participants admitted in Intensive Care Department of the university hospital of Tours for community-acquired pneumonia. Given the exploratory nature of the study, we designed a "control" group of participants admitted to ICU without evident signs of pneumonia and shock.

Number of participants: 300 for "pneumonia" group, and 50 for "control" group

  • Interventions and analysis:

Blood samples will be collected at inclusion, day 3, 8 and 15 during patient's stay in ICU. For mechanically ventilated participants, tracheal aspirates will be also collected at the same timing. If available, broncho-alveolar lavages will be also collected. If ARDS or Ventilator Associated Pneumonia (VAP) are subsequently diagnosed, supplemental blood and tracheal aspirates samples will be collected.

Blood samples and airway fluid samples will be treated to perform flow cytometry analysis for immunophenotypage (cellular content). In some cases, intra-cellular staining will be performed to assess cytokine production and/or transcription factor expression. Functions of unconventional T cells will also be performed after ex vivo stimulation on purified population (cell sorting). Cytokine level sand transcriptomic analyses will also be performed on blood samples.

Clinical characteristics (including respiratory parameters, blood gas, organ dysfunctions, survival at day 28 and day 90) will also be collected. Thus, frequency, activation status and functions of unconventional T cells will be dynamically analyzed in regard of clinical evolution within-individuals and across pneumonia vs control groups. A particular focus will be made on respiratory parameters (ventilation mode, and for participants with ARDS, P/F ratio, driving pressure), organ dysfunctions (as measured by SOFA score), and microbial documentation of the pneumonia.

Moreover, participants treated for ARDS are usually followed in a post-ICU follow-up clinic program in the ICU where the research is conducted. Thus, investigators will perform analysis of the unconventional T cell compartment (blood samples) in the participants firstly enrolled in the study. This will allow exploration of long-term imprinting on the innate immune response after the initial trigger.

Being tested
Blood samples, Tracheal Aspirates, Surplus of Broncho-alveolar lavage fluid
Keywords
Community-acquired Pneumonia, Acute Respiratory Distress Syndrome, Innate Immunity, Non Conventional T Lymphocytes
Medical subject headings
Community-Acquired Pneumonia, Respiratory Distress Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Blood samplesOther

    Blood samples for research purpose, taken whenever possible during blood sampling for routine purpose

  • Tracheal AspiratesOther

    Only for mechanically ventilated participants.

  • Surplus of Broncho-alveolar lavage fluidOther

    Only if performed for diagnosis purpose by the treating investigator : indication left at his discretion

Study groups in NCT03379207
Study groupRoleWhat they receive
"Community Acquired Pneumonia" groupParticipants admitted to Intensive Care Unit (ICU) of University Hospital of Tours (France) for Community Acquired Pneumonia. Interventions: * Blood samples for research purpose, taken whenever possible during blood sampling for routine purpose, at inclusion, day 1, 7, and every week during ICU stay Tracheal Aspirates for research purpose: only for mechanically ventilated participants, at inclusion, day 1, 7, and and every week during ICU stay * Surplus of Broncho-alveolar lavage fluid: only if performed for diagnosis purpose by the treating investigator (indication left at his discretion)
Receives: Other: Blood samples; Other: Tracheal Aspirates; Other: Surplus of Broncho-alveolar lavage fluid
"Control" groupParticipants admitted to Intensive Care Unit of University Hospital of Tours (France) for whom invasive mechanical ventilation is required for an estimated duration of at least 48h, without diagnosis of pneumonia or shock. Interventions: * Blood samples for research purpose, taken whenever possible during blood sampling for routine purpose, at inclusion, day 3, 8, and 15 during ICU stay Tracheal Aspirates for research purpose: at inclusion, day 3, 8, and 15 during invasive mechanical ventilation period, * Surplus of Broncho-alveolar lavage fluid: only if performed for diagnosis purpose by the treating investigator (indication left at his discretion)
Receives: Other: Blood samples; Other: Tracheal Aspirates; Other: Surplus of Broncho-alveolar lavage fluid

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Blood level of Non-Conventional T Lymphocytes (expressed as % CD3+ lymphocytes)

    Measured: 8 Months

  2. Airway level of Non-Conventional T Lymphocytes (expressed as % CD3+ lymphocytes)

    Measured: 8 Months

  3. Blood level of inflammatory cytokines

    Measured: 8 months

  4. Airway level of inflammatory cytokines

    Measured: 8 months

Secondary outcomes (6)
  1. Blood level of Conventional T Lymphocytes (expressed as % CD3+ lymphocytes)

    Measured: 8 months

  2. Airway level of Conventional T Lymphocytes (expressed as % CD3+ lymphocytes)

    Measured: 8 months

  3. Metabolic signature of non-conventional T lymphocytes

    Measured: 8 months

  4. Transcriptomic signature of non-conventional T lymphocytes

    Measured: 8 Months

  5. Blood level of Innate Cells (expressed as % CD45+ lymphocytes)

    Measured: 8 months

  6. AIrway level of Innate Cells (expressed as % CD45+ lymphocytes)

    Measured: 8 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Dec 2017
  2. Study start10 Jan 2018
  3. Primary completion4 Jun 2025
  4. Study completion4 Jun 2025

Why it stopped: A new project has been started. It extends ImPACT, with more financial resources and with scientific questions that have evolved.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
258 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03379207
Sponsor's protocol ID
PHAO17/YJ-ImPACT
Acronym
ImPACT
Status last verified
Nov 2025
First submitted
15 Dec 2017
Last updated
24 Nov 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

An observational study of Community-acquired Pneumonia and Acute Respiratory Distress Syndrome, run by University Hospital, Tours at 3 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 24 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: A new project has been started. It extends ImPACT, with more financial resources and with scientific questions that have evolved.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Blood level of Non-Conventional T Lymphocytes (expressed as % CD3+ lymphocytes) (time frame: 8 Months). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Nov 2025.

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