Modeling Bronchial Epithelium Modifications Associated With COPD Using iPS (INVECCO)

Modeling Bronchial Epithelia Modifications Associated With Chronic Obstructive Pulmonary Disease (COPD) Using Induced Pluripotent Stemcells (iPS)

The primary objective of this study is to to verify the feasibility of obtaining and comparing two epithelia in two populations based on the following experiments:

• Differentiation of an Induced Pluripotent Stem cell (iPS) clone derived from cutaneous biopsy in a population of heavy smokers (plus patients with chronic obstructive pulmonary disease) in order to obtain differentiated bronchial epithelia in vitro.
• For each of these same patients, generation of bronchial epithelium in vitro from bronchial biopsy using human bronchial epithelial cells (HBECs) in air-liquid interface (ALI) cultures.

Study Overview

• Status: Completed
• Conditions: Smoking; Pulmonary Disease, Chronic Obstructive
• Intervention / Treatment: Procedure: Bronchial biopsy; Procedure: Skin biopsy; Procedure: Blood sample

Detailed Description

Secondary objectives:

• Confrontation of the two models of in vitro generation of bronchial epithelium by iPS and ALI in order to validate our model of study of the human bronchial epithelium COPD generated by the iPS.
• Inducing a "COPD-like" epithelial phenotype by exposing the bronchial epithelia generated from the iPS to a source of in vitro toxin (tobacco) and studying its effects by transcriptomic analysis via high-throughput sequencing (NGS) at key steps during the model.
• Demonstrate the feasibility of obtaining iPS from peripheral blood sampling.

• Study Type: Observational
• Enrollment (Actual): 11

Contacts and Locations

Study Locations

• France
  • Montpellier, France, 34295
    • Centre Hospitalier Universitaire de Montpellier

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 55 years (Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This study includes patients with chronic obstructive pulmonary disease, as well as patients without chronic obstructive pulmonary disease, but who are heavy smokers.

Description

Inclusion Criteria for COPD patients:

• The patient has given his/her signed, informed consent
• Forced expiratory volume in 1 second / forced vital capacity < 0.7 [FEV1/FVC < 0.7]
• FEV1 < 50% of predicted value
• Exclusion of other respiratory pathologies, based on anamnesis, computed tomography and complementary respiratory function tests and transthoracic ultrasound,
• Smoking >10 pack-years, ongoing or weaned
• Absence of exacerbation or intercurrent infectious episode for at least 4 weeks at time of inclusion
• Medical indication for a bronchial fibroscopy (indication validated by the physician in charge of the patient and the study investigating physician): pulmonary peripheral nodule exploration with computed tomography, interventional endoscopy for emphysema reduction, removal of foreign bodies, other indications.
• Absence of contraindications for bronchial biopsy (left to physician's discretion): not limited to: regular intake of anticoagulants or anti-platelet aggregation, hemostasis abnormalities

Inclusion Criteria for smokers:

• The patient has given his/her signed, informed consent
• Forced expiratory volume in 1 second / forced vital capacity > 0.7 [FEV1/FVC > 0.7]
• FEV1 > 80% of predicted value
• Exclusion of other respiratory pathologies, based on anamnesis, computed tomography (absence of extensive emphysema lesions defined by the presence of less than <5% relative surface area occupied by densities less than 910 UH (measured on millimeter cuts)) and respiratory function tests (Residual Volume <120%, Diffusion Capacity for Carbon Monoxide > 60% and Total Pulmonary Capacity> 120%) and transthoracic ultrasound (normal),
• Smoking >40 pack-years, ongoing or weaned
• Absence of exacerbation or intercurrent infectious episode for at least 4 weeks at time of inclusion
• Medical indication for a bronchial fibroscopy (indication validated by the physician in charge of the patient and the study investigating physician): pulmonary peripheral nodule exploration with computed tomography, interventional endoscopy for emphysema reduction, removal of foreign bodies, other indications.
• Absence of contraindications for bronchial biopsy (left to physician's discretion): not limited to: regular intake of anticoagulants or anti-platelet aggregation, hemostasis abnormalities

Exclusion Criteria:

• Contra-indication for bronchial fibroscopy and cutaneous biopsy
• Deficiency in α-1 antitrypsin
• Significant bronchiectasis on chest computed tomography scan
• Colonization of the airways by Pseudomonas Aeroginosa or Aspergillus
• Chemotherapy or other cytotoxic treatments in the last 12 months
• Systemic corticotherapy in the 4 weeks prior to inclusion
• Long-term antibiotic treatment, notably by macrolides
• Any other treatment that may affect the bronchial epithelium, this being left to the discretion of the investigating physician
• Consumer of illicit drugs or alcohol
• Participant in an exclusion period determined by a previous study
• Subject not affiliated with, or not beneficiary of, a social security plan.
• Pregnant or nursing women according to Article L1121-5 of the Public Health Code.
• Vulnerable persons according to Article L1121-6 of the Public Health Code
• An adult who is protected or incapable of giving consent in accordance with Article L1121-8 of the Public Health Code
• Subject deprived of freedom by judicial or administrative decision.
• Those patients for whom two epithelia cultures (1 from bronchial biopsy ("ALI") and 1 from fibroblast reprogrammation of redifferentiated iPS ("iALI")) were not obtained will be excluded (post-inclusion).

Study Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patients likely to develop COPD; Patients in this group are relatively light smokers who have developed chronic obstructive lung disease (COPD). Intervention: Bronchial biopsy Intervention: Skin biopsy Intervention: Blood sample	Procedure: Bronchial biopsy; The bronchial biopsy is part of this study's inclusion criteria and is required during routine care for the patient. Bronchial fibroscopy is performed under general or local anesthesia. Biopsies are performed using forceps and according to current recommendations. One biopsy will be fixed immediately in RCL2 medium while the others (between 3 and 6) will be kept in isotonic saline and rapidly prepared for air-liquid-interface (ALI) cell culture.; Procedure: Skin biopsy; The skin biopsy will be performed after local anesthesia by hypodermic injection of a 1% Xylocaine solution. A single sample of a skin fragment about 3 mm in diameter will be necessary.; Procedure: Blood sample; The blood sample will be taken at the end of the cutaneous biospy, approximately 20 ml of blood will be collected.
Patients not likely to develop COPD; Patients in this group are heavy smokers who have no signs of chronic obstructive lung disease (COPD). Intervention: Bronchial biopsy Intervention: Skin biopsy Intervention: Blood sample	Procedure: Bronchial biopsy; The bronchial biopsy is part of this study's inclusion criteria and is required during routine care for the patient. Bronchial fibroscopy is performed under general or local anesthesia. Biopsies are performed using forceps and according to current recommendations. One biopsy will be fixed immediately in RCL2 medium while the others (between 3 and 6) will be kept in isotonic saline and rapidly prepared for air-liquid-interface (ALI) cell culture.; Procedure: Skin biopsy; The skin biopsy will be performed after local anesthesia by hypodermic injection of a 1% Xylocaine solution. A single sample of a skin fragment about 3 mm in diameter will be necessary.; Procedure: Blood sample; The blood sample will be taken at the end of the cutaneous biospy, approximately 20 ml of blood will be collected.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
functional bronchial epithelium from iPS?	Was a functional bronchial epithelium obtained from the patient's induced pluripotent stem cells from blood or fibroblasts? (yes/no)	Day 0 + culture (cross-sectional study)
functional bronchial epithelium from HBEC-ALI?	Was a functional bronchial epithelium obtained from the patient's bronchial biopsy: human bronchial epithelial cell culture on an air-liquid-interface? (yes/no)	Day 0 + culture (cross-sectional study)

Collaborators and Investigators

• Sponsor: University Hospital, Montpellier
• Investigators: Study Director: Arnaud Bourdin, MD, PhD, University Hospital, Montpellier

Publications and helpful links

General Publications

• Ahmed E, Fieldes M, Mianne J, Bourguignon C, Nasri A, Vachier I, Assou S, Bourdin A, De Vos J. Generation of four severe early-onset chronic obstructive pulmonary disease (COPD) patient-derived induced pluripotent stem cell lines from peripheral blood mononuclear cells. Stem Cell Res. 2021 Oct;56:102550. doi: 10.1016/j.scr.2021.102550. Epub 2021 Sep 27.
• Fieldes M, Ahmed E, Bourguignon C, Mianne J, Vernisse C, Fort A, Vachier I, Bourdin A, Assou S, De Vos J. [Modelling the bronchial epithelium in chronic obstructive pulmonary disease using human induced pluripotential stem cells]. Rev Mal Respir. 2020 Mar;37(3):197-200. doi: 10.1016/j.rmr.2020.02.003. Epub 2020 Mar 4. French.

Helpful Links

• INVECCO on the Open Science Framework

Study record dates

Study Major Dates

• Study Start (Actual): August 7, 2017
• Primary Completion (Actual): March 9, 2022
• Study Completion (Actual): March 9, 2022

Study Registration Dates

• First Submitted: June 6, 2017
• First Submitted That Met QC Criteria: June 6, 2017
• First Posted (Actual): June 8, 2017

Study Record Updates

• Last Update Posted (Actual): September 8, 2023
• Last Update Submitted That Met QC Criteria: September 7, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Disease Attributes; Lung Diseases, Obstructive; Chronic Disease; Lung Diseases; Pulmonary Disease, Chronic Obstructive
• Other Study ID Numbers: 9791; 2017-A00252-51 (Other Identifier: RCB number)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No