Effects of Smoking on Bronchial Epithelium
Recruitment status was Not yet recruiting
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Purpose
Asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory airway diseases affecting millions of people worldwide. Inhaled corticosteroids (ICS) are by far the most effective treatment with a broad anti-inflammatory spectrum. Nevertheless, most COPD patients and a proportion of severe asthma patients are corticosteroid-resistant (CR) and to fail to respond to ICS even when higher doses are given. These corticosteroid-resistant patients suffer from persistent symptoms and repeated asthma exacerbations. It has been suggested that smoking and oxidative stress may induce corticosteroid-resistance. The reactive oxygen species (ROS) responsible for oxidative stress can be generated exogenously (air pollutants, cigarette smoke) and endogenously by metabolic reactions. After inhaling air pollutants or cigarette smoke, the bronchial epithelium is exposed. Preliminary data from our own lab suggest that smoking and oxidative stress may decrease epithelial cell-cell contact formation. This results not only in a decreased barrier function, but also in an increased production of pro-inflammatory mediators.
| Condition |
|---|
|
Asthma COPD |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Effects of Smoking on Airway Remodeling and Phenotypic Changes of the Airway Epithelium in Asthma and COPD: Strategies to Restore the Epithelial Barrier, Repair and Steroid Sensitivity. |
- Epithelial integrity as measured with ECIS [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
- Inflammatory cells and mediators [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
- Production of inflammatory cytokines [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
- Markers of epithelial integrity [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
Biospecimen Retention: Samples With DNA
Bronchial biopsies Bronchial brushes Blood
| Estimated Enrollment: | 60 |
| Study Start Date: | April 2009 |
| Estimated Study Completion Date: | April 2011 |
| Estimated Primary Completion Date: | April 2011 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
|
1
30 patients with asthma
|
|
2
30 patients with COPD
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
30 patients with asthma; 30 patients with COPD
Inclusion Criteria:
Inclusion criteria for patients with allergic asthma:
- Age between 18 and 65 years.
- < 10 packyears, no smoking in the last year.
- The presence of allergy defined as at least one positive wheal/flare reaction (2 mm relative to control) to a skin prick test with sixteen common aero-allergens).
- FEV1 > 80% predicted.
- PC20 methacholine or PC20 histamine < 8 mg/ml.
Inclusion criteria for patients with COPD:
- Age between 45-75 years.
- ≥ 10 packyears.
- FEV1 between 30% and 80% of predicted.
Exclusion criteria:
- Any disease that, as judged by the Investigator, could have affected the outcome of this study.
- A respiratory tract infection within 4 weeks of the start of the study.
- A history of life-threatening asthma, defined as exacerbation of asthma or COPD that required intubation or was associated with hypercapnea.
- History of myocardial infarction or documented myocardial ischemia.
- Pregnancy, or the possibility of being pregnant (a pregnancy test will be performed in women of childbearing potential who do not use adequate anticonception as judged by the investigator).
Contacts and Locations| Contact: Maarten van den Berge, MD, PhD | +31-50-3615260 | m.van.den.berge@int.umcg.nl |
| Netherlands | |
| University Medical Centre Groningen | Not yet recruiting |
| Groningen, Netherlands, 9713 GZ | |
| Contact: Maarten van den Berge, MD, PhD +31-50-3616161 m.van.den.berge@int.umcg.nl | |
| Principal Investigator: Maarten van den Berge, MD. PhD | |
| Principal Investigator: | Maarten van den Berge, MD, PhD | University Medical Centre Groningen |
| Study Director: | Dirkje S Postma, Professor | University Medical Centre Groningen |
More Information
No publications provided
| Responsible Party: | Maarten van den Berge, University Medical Centre Groningen |
| ClinicalTrials.gov Identifier: | NCT00849433 History of Changes |
| Other Study ID Numbers: | METc2009008 |
| Study First Received: | February 20, 2009 |
| Last Updated: | February 20, 2009 |
| Health Authority: | Netherlands: Medical Ethics Review Committee (METC) Netherlands: Dutch Health Care Inspectorate |
Keywords provided by University Medical Centre Groningen:
|
Inflammation epithelial integrity ECIS |
Additional relevant MeSH terms:
|
Asthma Pulmonary Disease, Chronic Obstructive Bronchial Diseases Respiratory Tract Diseases Lung Diseases, Obstructive |
Lung Diseases Respiratory Hypersensitivity Hypersensitivity, Immediate Hypersensitivity Immune System Diseases |
ClinicalTrials.gov processed this record on May 23, 2013