Pneumonia, Pneumocystis
Conditions
Keywords
Pneumocystis jirovecii, Pneumonia, Specialized Proresolving Mediators, Inflammation, prognosis
Brief summary
This study aims to evaluate specialized proresolving mediators (SPM) concentrations for the first time in subjects infected with Pneumocystis jirovecii. SPM will be measured in blood and urine in patients with favourable or unfavourable outcome of Pneumocystis pneumonia and in patients colonized by Pneumocystis jirovecii. The hypothesis is that low levels of SPM in the blood could be predictive of a negative outcome of pneumocystosis.
Detailed description
Pneumocystis pneumonia is a severe fungal disease threatening immunosuppressed subjects such as patients suffering from AIDS, oncohematological diseases or solid organ transplanted patients. The disease is characterized by an important inflammation in the infected lungs which is mainly responsible for lungs lesions. Despite an adequate treatment introduction, mortality is still around 20% which can not be explained by a treatment resistance. Specialized proresolving mediators (SPM), including lipoxins, maresins, protectins and resolvins, are newly described molecules implicated in the active process of inflammation resolution. The investigators hypothesis in this study is that high levels of SPM could be predictive of a good resolution of the harmful inflammation, thus a good evolution of the disease, in adequate pneumocystosis therapy conditions. On the contrary, low levels of SPM could be predictive of an unfavourable outcome despite a treatment targeting Pneumocystis jirovecii
Interventions
OTHERBlood sampling
6 blood sample, 3 at J0 and 3 at J7 ( 2 tubes EDTA of 7mL, 1 tube Blood RNA of 3 mL)
OTHERurine sampling
2 urine sample (1 at J0 and 1 at J7)
Sponsors
University Hospital, Toulouse
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient over 18 years old * Patient with a social security cover. * Free and informed oral consent given. * Pneumocystis infection or colonization diagnosed on BAL (Broncho-alveolar liquid) or sputum at Toulouse University hospital Mycology laboratory. * Adequate Pneumocystis therapy for infected patients (cotrimoxazole).
Exclusion criteria
* individuals placed under juridical protection, * individuals placed under guardianship, or supervision. * Pregnancy or breastfeeding.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 14,15-DHET blood level at the inclusio | Day 0 | variation of 14,15-DHET blood level at inclusion between each group |
| 14,15-DHET blood level | Day 7 | variation of 14,15-DHET blood level at day 7 between each group |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Specialized Pro-Resolving Mediators in urine | Day 0 and Day 7 | Specialized Pro-Resolving Mediators in urine at inclusion and day 7each between group |
| Expression levels of the SPM enzymes | Day 0 and day 7 | Expression levels of the enzymes implicated in SPM synthesis and catabolism in blood at D0 and day 7 |
| 14,15-DHET urine level | Day 0 and Day 7 | variation of 14,15-DHET urine level at inclusion ad day 7 between each group |
| Immune cells profile | Day 0 and day 7 | immune cell proportions in blood measured by flow cytometry |
| Inflammatory blood profile | Day 0 and day 7 | Inflammatory blood profile with composite criteria pro-inflammatory and anti-inflammatory cytokines levels measured by flow cytometry |
| Specialized Pro-Resolving Mediators in blood | Day 0 and Day 7 | Specialized Pro-Resolving Mediators in blood at inclusion and day 7 between each group |
Countries
France
Outcome results
None listed