Aspiration pneumonia

Summary

Aspiration pneumonia (MONDO:0000265) is a disease with 1 cohort gene and 43 clinical trials. Top therapeutic interventions include levofloxacin anhydrous, prucalopride, and cefepime.

At a glance

• Cohort genes: 1
• ClinVar variants: 2
• Clinical trials: 43

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

Field	Value
Canonical name	aspiration pneumonia
Mondo ID	MONDO:0000265
MeSH	D011015
DOID	DOID:0050152
SNOMED CT	422588002
UMLS	C0032290
MedGen	10814
Is cancer (heuristic)	no

Also known as: acid aspiration syndrome · acid aspiration syndromes · aspiration pneumonia · aspiration pneumonia (disease) · aspiration Pneumonias · gastric acid aspiration syndrome · inhalation pneumonia · Mendelson syndrome · Mendelson’s syndrome · Mendelsons syndrome · Pneumonias, aspiration · syndrome, acid aspiration · syndrome, Mendelson · syndrome, Mendelson’s · syndromes, acid aspiration

Data availability: 2 ClinVar variants · 1 HPO phenotype.

Disease family

Classification path: disease › human disease › disease by body system or component › respiratory system disorder › lower respiratory tract disorder › lung disorder › aspiration pneumonia

Related subtypes (32): lung abscess, pneumonic plague, pulmonary alveolar proteinosis, pulmonary systemic sclerosis, obstructive lung disease, bronchiolitis, pulmonary immaturity, rheumatoid arthritis-associated interstitial lung disease, pulmonary embolism and infarction, acute chest syndrome, fungal lung infectious disease, middle lobe syndrome, pulmonary coin lesion, pulmonary plasma cell granuloma, silo filler disease, pulmonary alveolar microlithiasis, pulmonary venoocclusive disease, acute lung injury, interstitial lung disease, hantavirus pulmonary syndrome, pulmonary non-tuberculous mycobacterial infection, respiratory failure, lung neoplasm, occupational lung disease, Wilson-Mikity syndrome, neonatal aspiration syndrome, pneumonitis, vanishing lung syndrome, restrictive pulmonary disease, shrinking lung syndrome, dystrophic pulmonary ossification, pulmonary artery disease

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

2 retrieved; paginated sample, class counts are floors:

1 pathogenic/likely pathogenic, 1 pathogenic

ClinVar	Variant (HGVS)	Gene	Classification	Review
523528	NM_020549.5(CHAT):c.1061C>T (p.Thr354Met)	CHAT	Pathogenic/Likely pathogenic	criteria provided, multiple submitters, no conflicts
523529	NM_020549.5(CHAT):c.2081C>G (p.Ser694Cys)	CHAT	Pathogenic	criteria provided, multiple submitters, no conflicts

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 0 · Orphanet: 1 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

Orphanet rare-disease linkage (cohort genes)

Gene	Orphanet ID	Rare disease
CHAT	Orphanet:98914	Presynaptic congenital myasthenic syndromes

Cohort genes → proteins

1 cohort genes, 1 distinct canonical proteins.

Evidence partition

Subset	Genes
multi_evidence	1

Cohort genes (full)

Symbol	HGNC	Ensembl	UniProt	Name	Evidence
CHAT	HGNC:1912	ENSG00000070748	P28329	Choline O-acetyltransferase	clinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

Symbol	Protein name	Function (lead sentence)
CHAT	Choline O-acetyltransferase	Catalyzes the reversible synthesis of acetylcholine (ACh) from acetyl CoA and choline at cholinergic synapses.

Protein-family classification

Druggable: 1 · Difficult: 0 · Unknown: 0 · Druggable fraction: 1.0

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

Family	Genes	Fold	FDR
Enzyme (other)	1	12.0×	0.083

Per-gene assignment

Symbol	Family	Druggable?	EC	InterPro (top 3)
CHAT	Enzyme (other)	yes	2.3.1.6	Carn_acyl_trans, CAT-like_dom_sf, Cho/carn_acyl_trans_1_2

Expression context

Cohort genes with no expression data: 0.

1 cohort gene are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

Bucket	Genes
narrow (1-5 tissues)	0
moderate (6-20)	0
broad (>20)	1
unknown	0

Top tissues across cohort

Tissue	Cohort genes
male germ line stem cell (sensu Vertebrata) in testis	1
primordial germ cell in gonad	1
putamen	1

Per-gene tissue summary (top 30)

Symbol	Bgee breadth	FANTOM5 breadth	SCXA	Top tissues
CHAT	68	tissue_specific	marker	primordial germ cell in gonad, male germ line stem cell (sensu Vertebrata) in testis, putamen

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

Symbol	Interactor count
CHAT	1,743

Structural data

PDB: 1 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

Symbol	UniProt	PDB entries
CHAT	P28329	8

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 2. Enrichment computed across 1 evidence-associated genes (1 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

Pathway	Cohort genes	Fold	FDR	Sample cohort genes
Acetylcholine Neurotransmitter Release Cycle	1	671.8×	0.002	CHAT
Synthesis of PC	1	407.9×	0.002	CHAT

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO term	Cohort genes	Fold	FDR	Sample cohort genes
acetylcholine biosynthetic process	1	5617.3×	7e-04	CHAT
phosphatidylcholine biosynthetic process	1	802.5×	0.002	CHAT
neuromuscular synaptic transmission	1	601.9×	0.002	CHAT
neurotransmitter transport	1	421.3×	0.002	CHAT

Therapeutics

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 1 · Phased (≥1): 1 · Undrugged: 0

Druggability breadth: 1 of 1 evidence-associated genes (100%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

Symbol	Molecules	Max phase
CHAT	1	3

Drugs targeting cohort genes (top 30)

Molecule	Max phase	Targets in cohort
COENZYME_A	3	CHAT

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 1.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

Symbol	Assays	Type breakdown
CHAT	7	Binding:7

Cohort enzymes (BRENDA EC)

Symbol	EC numbers	Names
CHAT	2.3.1.6	choline O-acetyltransferase

Pharmacogenomics

Cohort genes with a PharmGKB record: 1; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

1 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

Compound	Max phase	Cohort target (bioactivity)
COENZYME_A	3	CHAT

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

Tier	Definition	Genes	Symbols
A	Approved (phase 4 drug)	0
B	Phased (≥1) drug, not yet approved	1	CHAT
C	Druggable family + PDB, no drug	0
D	Druggable family + AlphaFold only, no drug	0
E	Difficult family or no structure, no drug	0

Undrugged target profiles

0 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

Clinical trials & evidence

Clinical trials

Clinical trials: 43.

Phase distribution (across all retrieved trials)

Phase	Trials
Not specified	35
PHASE4	7
PHASE3	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT05455359	PHASE4	RECRUITING	Gastrointestinal Dysmotility on Aspiration Risk
NCT00610324	PHASE4	COMPLETED	Effect of Oral Decontamination Using Chlorhexidine or Potassium Permanganate in ICU Patients
NCT02862314	PHASE4	COMPLETED	PROcalcitonin Pneumonia / Pneumonitis Associated With ASPIration
NCT03962725	PHASE4	TERMINATED	Avoiding Neuromuscular Blockers to Reduce Complications
NCT04873297	PHASE4	COMPLETED	Metoclopramide vs Placebo for Prevention of Pneumonia in Acute Stroke
NCT05079620	PHASE4	TERMINATED	Early Antibiotics After Aspiration in ICU Patients
NCT06395740	PHASE4	UNKNOWN	Aspiration Pneumonia in Cerebrovascular Stroke Patients Suffering from Bulbar Palsy
NCT02080754	PHASE3	COMPLETED	Sellick Interest in Rapid Sequence Induction
NCT05526105	Not specified	RECRUITING	Gastric US in ICU Patient
NCT05674643	Not specified	RECRUITING	Gastric Assessment of Pediatric Patients Undergoing Surgery
NCT06164639	Not specified	ENROLLING_BY_INVITATION	Potential Biomarkers and Pathogenic Mechanism for Reflux Aspiration-induced Lung Injury.
NCT06230614	Not specified	RECRUITING	Effect of Diluent Volume on Colistin Inhalation Therapy
NCT06511583	Not specified	RECRUITING	FBS-ASaP: Fibrobronchoscopy in ASpiration Pneumonia in the Emergency Department
NCT06666049	Not specified	RECRUITING	Gastric POCUS for Airway Management in Patients Using Glucagon-like Peptide-1 Receptor Agonist (Multicentric)
NCT00164957	Not specified	COMPLETED	The Effect of Continuous Versus Enteral Pump Feeding in Aspiration in Tube Fed Patients
NCT00580346	Not specified	WITHDRAWN	Dynamic Laryngotracheal Separation for Aspiration
NCT02090205	Not specified	UNKNOWN	Mechanical Ventilation During Cardiac Surgery
NCT02416219	Not specified	COMPLETED	Efficacy of Surface Landmark Palpation for Identification of the Cricoid Cartilage in Obstetric Patients
NCT02705781	Not specified	COMPLETED	Functionality and Accuracy of the smARTrack System in Real-Life ICU Settings
NCT02720029	Not specified	WITHDRAWN	Detection of Silent Aspiration Events Utilizing pH/Impedance Probes in Hospitalized Patients
NCT02858596	Not specified	COMPLETED	The Effect of Semi-solid Feeding After Percutaneous Endoscopic Gastrostomy (PEG) on the Incidence of Aspiration Pneumonia and Postoperative Length of Stay
NCT03007862	Not specified	UNKNOWN	Bronchial Alpha Amylase as a Marker for Early Aspiration Pneumonia in Therapeutic Hypothermia.
NCT03108430	Not specified	UNKNOWN	Study of Risk Factors for Developing Inhalation Pneumonia After Inhalation
NCT03198988	Not specified	TERMINATED	Functionality and Accuracy of the smART System in Real-Life ICU Settings
NCT03325725	Not specified	WITHDRAWN	Intra-laryngeal Implant for Treatment of Chronic Aspirations
NCT03573635	Not specified	COMPLETED	Continuous Supraglottic Aspiration in Intubated and Mechanically Ventilated Patients: the SUPRAtube Device
NCT03604822	Not specified	UNKNOWN	Music Therapy Protocol to Support Bulbar and Respiratory Functions in ALS
NCT03753841	Not specified	COMPLETED	FEES to Determine Neurological Intensive Care Patients’ Oral Diet
NCT03763799	Not specified	COMPLETED	Early Stop(Ruling) of the Antibiotic Treatment During Pneumopathies d’ Inhalation
NCT03844568	Not specified	WITHDRAWN	Nocturnal Nasal Continuous Positive Airway Pressure in Aspiration Pneumonia
NCT04064333	Not specified	WITHDRAWN	Slow-Stream Expiratory Muscle Strength Training for Veterans With Dysphagia Living in Long-term Care
NCT04098224	Not specified	COMPLETED	Nutrition Monitoring and Feeding Optimization With the smART+ System - Comparative Study
NCT04157998	Not specified	UNKNOWN	Ultrasound Assessment of Metoclopramide Effect on Gastric Volume in Cesarean Section
NCT04181814	Not specified	COMPLETED	Gastric Ultrasound for Preoperative Assessment of Gastric Content in Diabetic Patients
NCT04544371	Not specified	COMPLETED	Ultrasound Assessment of Gastric Residual Volume in Obese Patients
NCT04709978	Not specified	COMPLETED	Community Acquired Pneumonia in Older Adults
NCT05098808	Not specified	COMPLETED	Artificial Intelligence in Diagnosing Dysphagia Patients
NCT05290844	Not specified	COMPLETED	The Cricoid Pressure in Pediatric Patients
NCT05810688	Not specified	UNKNOWN	Eating Rehabilitation Training for Timely Removal of Nasogastric Tube in Elderly Patients
NCT06717321	Not specified	TERMINATED	Percutaneous Endoscopic Gastrostomy Versus Percutaneous Endoscopic Gastrostomy With Jejunal Extension

Drugs tested across these trials (top 30)

Molecule	Max phase	Trials referencing
LEVOFLOXACIN ANHYDROUS	4	2
PRUCALOPRIDE	4	2
CEFEPIME	4	1
CEFTRIAXONE	4	1
CHLORHEXIDINE GLUCONATE	4	1
COLISTIMETHATE SODIUM	4	1
COLISTIN	4	1
FAMOTIDINE	4	1
METOCLOPRAMIDE	4	1
OFLOXACIN	4	1
VANCOMYCIN	4	1
CHEMBL1628	0	1
CHEMBL388266	0	1
CHEMBL4299436	0	1
CHEMBL2221249	0	1
CHEMBL4793072	0	1
CHEMBL5411808	0	1
CHEMBL6151919	0	1
POTASSIUM PERMANGANATE	-1	1