Exploration of Metabolome in Patients With Interstitial Lung Disease and Pulmonary Hypertension With or Without Specific Pulmonary Hypertension Treatment

Sponsor
Hospices Civils de Lyon
Study ID
NCT07254338
Status
Recruiting
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Conditions

  • Interstitial Lung Disease
  • Precapillar Pulmonary Hypertension

Eligibility Criteria

Sex
ALL
Age
18 Years - N/A
Healthy Volunteers
Accepted

Interventions

  • Blood sampling for metabolomic profiling — OTHER
    Blood (veinous) will be collected under standard care conditions, in a dry red blood tube without additional gel (4 mL) to obtain serum after centrifugation for 10 minutes at 1500g, in the form of 500µL aliquots, labelled with the patient's code in the study. This sampling will be performed at baseline in both group; and after follow up completion in Group 1 (4-6 month)
  • Urine sampling for metabolomic profiling — OTHER
    Urine collected from patient into a dry powder compact in the waiting room before or after the consultation. Preparation of two cryotubes containing at least 1 mL per sample, labelled with the patient's code in the study. In the absence of a calling point, strict aseptic conditions are not required, as the use of chemicals or antiseptic soaps can interfere with the dosages. This sampling will be performed in Group 1 and 2 at baseline; and in Group 1 at 2-month and after completion of follow-up time (4-6 month).

Study Details

Fibrosing interstitial lung diseases (FILDs) encompass a group of rare diseases characterized by progressive pulmonary fibrosis leading to respiratory failure. Current treatments primarily aim to slow disease progression but remain limited, making lung transplantation the ultimate recourse. The development of pulmonary hypertension (PH) in the context of FILDs significantly worsens morbidity and mortality and drastically reduces patients' life expectancy. Conventional treatments for PH are generally ineffective in this setting. Nevertheless, some promising therapeutic agents are currently under investigation, particularly inhaled prostacyclin analogs such as treprostinil, which have demonstrated efficacy in recent clinical studies. Our study aims to explore, in a minimally invasive manner, variations in metabolites in the serum and urine of patients with PH secondary to FILDs, before and during treatment. The main objective is to better understand the systemic effect of these treatments. Furthermore, the identification of metabolomic signatures will allow us to differentiate responders from non-responders, thus providing valuable prognostic and predictive criteria. To date, some patients do not benefit from the available treatments, and better selection of responders could prevent iatrogenic effects in patients whose clinical condition is already fragile. In addition, characterizing the systemic mode of action of these treatments could pave the way for new clinical research focused on the profiles of responding patients. Finally, a thorough understanding of the efficacy of the studied therapies is essential. Indeed, effective treatment of PH in the context of FILDs could not only slow disease progression but also reduce the need for lung transplantation, a major challenge in a context of organ shortage.

Key Dates

First listed
Nov 28, 2025
Start date
Feb 16, 2026
Status verified
Feb 2026
Primary completion
Aug 16, 2029
Completion
Aug 16, 2029

Study Design

Enrollment
80 participants (estimated)

Arms

  • Arm: Group "intervention"
    Patients who suffer from ILD and ILD-PH from this group will be given specific treatments (especially inhaled TREPROSTINIL, up to 3 breath per use; 4 uses a day) for ILD-PH after usual independent collegial consultation Those patients will have before and after treatment blood and urine metabolomic profile. They will have baseline and follow up blood and urine sampling. They will be offer possibility to perform up to 6 auto-sampling at home.
  • Arm: Group " control "
    Patients who suffer from ILD and ILD-PH from this group will not be given specific ILD-PH treatment based on insufficient haemodynamic data or clinical contraindications after independent collegial consultation. They will have only baseline blood and urine sampling.

Primary Outcome Measure

Comparison of urinary metabolite concentrations before and after initiation of treatment measured centrally by proton nuclear magnetic resonance spectroscopy (¹H-NMR). [ Time Frame: Outcome is measured when all patients will have their 4-6 months follow-up completed. ]

Central Contacts

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