- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00135681
Immune Dysregulation in Children and Adults With Asthma
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
BACKGROUND:
Asthma is a result of a dysregulated immune response to inhaled antigens. The development of an immune response dominated by T cells (Th2) that secrete interleukin 4 (IL-4) and IL-5 results in the constellation of findings associated with asthma, including elevated IgE and increased blood eosinophilia. Epidemiological studies indicate that there are several predisposing factors that may dictate whether asthma may develop in certain individuals including genetic, environmental, and age-related factors. Any one factor alone may not determine whether an inappropriate immune response develops with subsequent development of asthma; rather, asthma likely results from a combination of factors. However, once a Th2 response in the lung has occurred, the hypothesis is that it dominates and results in the development of Th2 response to inhaled neoantigens. Further, the acquired predisposition to a Th2 response may override other preexisting predisposing factors and therefore becomes the prime target for asthma therapy.
DESIGN NARRATIVE:
The study was a subproject in a Specialized Center of Research (SCOR) in Fibrotic Lung Disease from 1997 through 2001. Both normal and asthmatic subjects were immunized with a neoantigen, keyhole limpet hemocyanin (KLH), via intrapulmonary and subcutaneous routes and observed for the type of antibody and T cell response that developed. Furthermore, the effect of inhaled anti-inflammatory medications on primary immune responses to KLH was assessed. Additional studies examined the effect of regional pulmonary Th2 responses on peripheral blood asthma-associated effector cells, basophils and eosinophils. Finally, the investigators determined whether chronic therapy of asthmatic children with either nedocromil or budesonide modulated their immune response to a systemically administered neoantigen, hepatitis B vaccine. These studies were designed to provide important information on the regulation of immune responses in humans with asthma. Furthermore, they helped to determine whether anti-inflammatory medications could inhibit development of a Th2 responses or only prevent inflammatory events downstream from Th2 development.
The subproject had three specific aims. The first was to test the hypothesis that the lower respiratory tracts of asthmatics would respond differently to a neo-antigen. In part A of specific aim 1, the lower respiratory tracts of asthmatics were challenged with KLH. Bronchoalveolar lavage (BAL) was repeated after 12 days and blood samples collected after a number of time points. Immunoglobulins were measured in blood and BAL, and lymphocytes were collected from the BAL and assayed for response to antigen in an in vitro test. In part B, individuals were treated with six weeks of anti-inflammatory therapy after which responses to intrapulmonary antigen were assessed.
Specific aim 2 assessed the role of acute challenge of the lung with antigen on eosinophil and basophil responsiveness. The lung was challenged by intrapulmonary installation of antigen through the bronchoscope and samples were collected from the peripheral blood at various time points. An allergen challenge was performed after six weeks of therapy with nedocromil budesonide or placebo.
In specific aim 3, asthmatic children were tested in two stages. In stage one, a preliminary study was performed in children with relatively mild asthma who were immunized with hepatitis vaccine. Samples were collected at various time points and assayed for antigen-specific antibody. The hypothesis that asthmatic children would have a Th2 type response rather than the Th1 type response in normal children was evaluated by determining times at which samples could be collected from the larger Childhood Asthma Management Program (CAMP) study.
Study Type
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Mark Schuyler (Subproject PI), University of New Mexico
Study record dates
Study Major Dates
Study Start
Study Completion
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Immune System Diseases
- Hypersensitivity, Immediate
- Bronchial Diseases
- Lung Diseases, Obstructive
- Respiratory Hypersensitivity
- Hypersensitivity
- Lung Diseases
- Asthma
- Physiological Effects of Drugs
- Autonomic Agents
- Peripheral Nervous System Agents
- Anti-Inflammatory Agents
- Immunologic Factors
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Bronchodilator Agents
- Anti-Asthmatic Agents
- Respiratory System Agents
- Anti-Allergic Agents
- Mast Cell Stabilizers
- Budesonide
- Nedocromil
Other Study ID Numbers
- 244
- P50HL056384 (U.S. NIH Grant/Contract)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Lung Diseases
-
Guangzhou Institute of Respiratory DiseaseUnknownInterstitial Lung Disease | Transbronchial Lung Cryobiopsy | Surgical Lung Biopsy
-
Aveiro UniversityFundação para a Ciência e a TecnologiaNot yet recruitingInterstitial Lung DiseasesPortugal
-
RWTH Aachen UniversityCompletedObstructive Lung DiseasesGermany
-
Bastiaan DriehuysNational Heart, Lung, and Blood Institute (NHLBI); University of Iowa; Children... and other collaboratorsRecruitingInterstitial Lung DiseasesUnited States
-
Shanghai East HospitalRegend TherapeuticsCompletedInterstitial Lung DiseasesChina
-
China-Japan Friendship HospitalXiangya Hospital of Central South University; Peking Union Medical College... and other collaboratorsUnknown
-
Academisch Medisch Centrum - Universiteit van Amsterdam...CompletedInterstitial Lung DiseasesNetherlands
-
Centre Hospitalier Universitaire de Saint EtienneCompleted
-
Aveiro UniversityFundação para a Ciência e a Tecnologia; Centro Hospitalar do Baixo VougaRecruitingInterstitial Lung Diseases (ILD)Portugal
-
China-Japan Friendship HospitalNot yet recruitingTransbronchial Lung Cryobiopsy
Clinical Trials on nedocromil budesonide
-
Johns Hopkins Bloomberg School of Public HealthNational Heart, Lung, and Blood Institute (NHLBI); CAMP Steering CommitteeCompleted
-
West Penn Allegheny Health SystemCompleted
-
University of MiamiAstraZenecaCompleted
-
Meir Medical CenterUnknown
-
Research in Real-Life LtdOrion Corporation, Orion PharmaCompleted
-
Aquilon Pharmaceuticals S.A.Completed
-
St. Paul's Hospital, CanadaUnknown
-
AstraZenecaCompleted
-
Dr. Falk Pharma GmbHCompletedEosinophilic EsophagitisGermany