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Salomez-Ihl C, Giai J, Barbado M, Paris A, Touati S, Alcaraz JP, Tanguy S, Leroy C, Lehmann A, Degano B, Gavard M, Bedouch P, Pavese P, Moreau-Gaudry A, Roustit M, Boucher F, Cinquin P, Brion JP. H 2 inhalation therapy in patients with moderate COVID-19 (H 2COVID): a prospective ascending-dose phase I clinical trial. Antimicrob Agents Chemother 2024; 68:e0057324. [PMID: 39016593 PMCID: PMC11304737 DOI: 10.1128/aac.00573-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/12/2024] [Indexed: 07/18/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has triggered a serious global health crisis, resulting in millions of reported deaths since its initial identification in China in November 2019. The global disparities in immunization access emphasize the urgent need for ongoing research into therapeutic interventions. This study focuses on the potential use of molecular dihydrogen (H2) inhalation as an adjunctive treatment for COVID-19. H2 therapy shows promise in inhibiting intracellular signaling pathways associated with inflammation, particularly when administered early in conjunction with nasal oxygen therapy. This phase I study, characterized by an open-label, prospective, monocentric, and single ascending-dose design, seeks to assess the safety and tolerability of the procedure in individuals with confirmed SARS-CoV-2 infection. Employing a 3 + 3 design, the study includes three exposure durations (target durations): 1 day (D1), 3 days (D2), and 6 days (D3). We concluded that the maximum tolerated duration is at least 3 days. Every patient showed clinical improvement and excellent tolerance to H2 therapy. To the best of our knowledge, this phase I clinical trial is the first to establish the safety of inhaling a mixture of H2 (3.6%) and N2 (96.4%) in hospitalized COVID-19 patients. The original device and method employed ensure the absence of explosion risk. The encouraging outcomes observed in the 12 patients included in the study justify further exploration through larger, controlled clinical trials. CLINICAL TRIALS This study is registered with ClinicalTrials.gov as NCT04633980.
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Affiliation(s)
- C. Salomez-Ihl
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, UMR5525, Grenoble, France
- Department of Pharmacy, Université Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France
| | - J. Giai
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, Centre for Clinical Investigation, Grenoble, France
| | - M. Barbado
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, Centre for Clinical Investigation, Grenoble, France
| | - A. Paris
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, Centre for Clinical Investigation, Grenoble, France
| | - S. Touati
- Department of Infectious and Tropical Diseases, CHU Grenoble Alpes, Grenoble, France
| | - J. P. Alcaraz
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, UMR5525, Grenoble, France
| | - S. Tanguy
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, UMR5525, Grenoble, France
| | - C. Leroy
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, Centre for Clinical Investigation, Grenoble, France
| | - A. Lehmann
- Department of Pharmacy, Université Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France
| | - B. Degano
- Department of Pneumology, CHU Grenoble Alpes, Grenoble, France
| | - M. Gavard
- CHU Grenoble Alpes, Delegation for Clinical Research and Innovation, Grenoble, France
| | - P. Bedouch
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, UMR5525, Grenoble, France
- Department of Pharmacy, Université Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France
| | - P. Pavese
- Department of Infectious and Tropical Diseases, CHU Grenoble Alpes, Grenoble, France
| | - A. Moreau-Gaudry
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, UMR5525, Grenoble, France
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, Centre for Clinical Investigation, Grenoble, France
| | - M. Roustit
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, Centre for Clinical Investigation, Grenoble, France
| | - F. Boucher
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, UMR5525, Grenoble, France
| | - P. Cinquin
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, UMR5525, Grenoble, France
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, Centre for Clinical Investigation, Grenoble, France
| | - J. P. Brion
- Department of Infectious and Tropical Diseases, CHU Grenoble Alpes, Grenoble, France
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Grenier PA, Brun AL, Mellot F. [The contribution of artificial intelligence (AI) subsequent to the processing of thoracic imaging]. Rev Mal Respir 2024; 41:110-126. [PMID: 38129269 DOI: 10.1016/j.rmr.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
The contribution of artificial intelligence (AI) to medical imaging is currently the object of widespread experimentation. The development of deep learning (DL) methods, particularly convolution neural networks (CNNs), has led to performance gains often superior to those achieved by conventional methods such as machine learning. Radiomics is an approach aimed at extracting quantitative data not accessible to the human eye from images expressing a disease. The data subsequently feed machine learning models and produce diagnostic or prognostic probabilities. As for the multiple applications of AI methods in thoracic imaging, they are undergoing evaluation. Chest radiography is a practically ideal field for the development of DL algorithms able to automatically interpret X-rays. Current algorithms can detect up to 14 different abnormalities present either in isolation or in combination. Chest CT is another area offering numerous AI applications. Various algorithms have been specifically formed and validated for the detection and characterization of pulmonary nodules and pulmonary embolism, as well as segmentation and quantitative analysis of the extent of diffuse lung diseases (emphysema, infectious pneumonias, interstitial lung disease). In addition, the analysis of medical images can be associated with clinical, biological, and functional data (multi-omics analysis), the objective being to construct predictive approaches regarding disease prognosis and response to treatment.
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Affiliation(s)
- P A Grenier
- Délégation à la recherche clinique et l'innovation, hôpital Foch, Suresnes, France.
| | - A L Brun
- Service de radiologie, hôpital Foch, Suresnes, France
| | - F Mellot
- Service de radiologie, hôpital Foch, Suresnes, France
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