ARDS, Human Clinical Trial
Official title:
Study of the Effects of Bronchoalveolar Lavage Liquid in the ARDS on the Functioning of the Neutrophil Polynuclear System
Firstly, the study assesses the effect of bronchoalveolar lavage fluid (BAL) from patients in
(acute respiratory distress syndrome (ARDS) on the life span of PNNs and on the phagocytosis
of apoptotic cells by macrophages and polynuclear neutrophil (PNN).
Then, the effect of an antibody directed against "high-mobility group box 1" protein (HMGB1)
and the effect of metformin on efferocytosis are studied.
ARDS (acute respiratory distress syndrome) is a syndrome that causes significant mortality
and morbidity. This syndrome is characterized by an alveolitis with polynuclear neutrophil
(PNN). PNNs play an important role in the persistence and in injuries induced by ARDS.
Several animal studies have shown that lesional edema can be increased by two important
mechanisms: the increase in the lifespan of PNNs in the lung and the decrease in the
phagocytosis capacities of apoptotic cells (efferocytosis) by macrophages and PNNs.
However, confirmation of these data in humans does not exist, and knowledge of the mechanisms
that may increase lung damage during ARDS will limit it and thus reduce the mechanical
ventilation time of these patients as well as the mortality associated with ARDS.
" high-mobility group box 1 " (HMGB1) protein may be involved in reducing efferocytosis
capacity. Similarly, activation of AMP-activated protein kinase (AMPk) could restore the
clearance capacity of apoptotic cells in macrophages and PNNs.
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