- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03062917
Nasal and Bronchial Absorption Sampling in RSV Bronchiolitis (RSV-SAM)
Validation of Nasal and Bronchial Absorption Sampling Methods for the Assessment of RSV Bronchiolitis in Babies and Children
Study Overview
Status
Intervention / Treatment
Detailed Description
In conjunction with a specialist medical device manufacturing company (Hunt Developments (Midhurst, West Sussex) we have produced novel nasosorption and bronchosorption kits that have CE marking. Both nasosorption and bronchosorption methods use synthetic absorptive matrix (SAM) strips: that look and feel like blotting paper, and will be placed onto the mucosal surface. These are comfortable to use and can be used at frequent intervals over extended periods of time. This non-invasive technique is ideal for infants and children, and it is possible to obtain neat mucosal lining fluid (MLF) even from normal healthy noses. The eluates contain cytokines and chemokines at high detectable levels on multiplex immunoassay.
We would like to use these SAMs to take MLF samples from the nasal and bronchial mucosal surfaces to see if these novel techniques can overcome the problems with current sampling methods. We plan to use these absorption techniques to measure RSV viral load. We also aim to look at the immune response in terms of the anti-viral interferon response (IFN-γ, IFN-λ, IFN-α2a, IP10, ITAC). In therapeutic studies in the future, it may be possible to document levels of drug (pharmacokinetics) in nasal MLF.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
London, United Kingdom, W2 1NY
- Imperial College NHS Healthcare Trust
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Group 1 and Group 2
Inclusion Criteria
- Infants aged 2 weeks-24 months
- Presentation to the Emergency Department with any upper respiratory tract infection (URTI) in the RSV season (Oct-March).
OR • Documented RSV infection, admitted to the paediatric wards at St Mary's Hospital.
Exclusion Criteria
- Any local or systemic factor that would influence the safety of nasal sampling.
- Bilateral indwelling nasal catheters or local nasal pathology preventing access for nasal sampling.
- Bleeding disorders.
- The baby is taking part in another interventional study.
- The parents or guardians not able to sign the informed consent from due to limited English or comprehension despite the use of independent interpreter services.
- Limited life expectancy of the baby,
Group 3
Inclusion criteria
- Hospitalised Infants admitted to the PICU at St. Mary's Hospital, aged 2 weeks-24 months with documented RSV infection (by rapid test and/or PCR).
- Infants of weight >2kg.
- On a conventional ventilator with an Endotracheal Tube (ETT) of >3.0mmm diameter
Exclusion criteria
- Any local or systemic factor that would influence the safety of nasal sampling.
- Bilateral nasal catheters or local nasal pathology preventing access for nasal sampling.
- The baby is taking part in another interventional study.
- Prematurity - corrected gestational age <36 weeks, weight <2kg
- Significant hypoxia or instability precluding ventilator disconnection
- ETT < 3mm internal diameter
- Transcutaneous oxygen saturation of <95% on 60% oxygen
- Risk of bleeding
- Pneumothorax
- Infants receiving oral corticosteroid therapy at any time in past month
- Parents or guardians not able to sign informed consent from due to limited English or understanding despite the use of independent interpreter services.
- Limited life expectancy or a decision to limit management,
Control Group 1 Inclusion criteria
• Babies, aged 2 weeks-24 months, attending routine outpatient appointments or undergoing elective surgical procedures.
Exclusion criteria
- Any respiratory symptoms
- All other exclusion are the same as Groups 1 and 2
Control Group 2
Inclusion criteria
- Infants aged 2 weeks-24 months.
- Infants ventilated on the PICU for any condition
- Confirmed RSV negative by PCR of respiratory tract samples
Exclusion Criteria
- All exclusions are the same as Group 3
- In addition - any concern about raised intracranial pressure
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Emergency Department
Babies with suspected respiratory tract infection (RTI) in the ED
|
Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.
|
Other: Paediatric Wards
Babies with diagnosed RSV infection admitted to paediatric wards
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Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.
|
Other: Paediatric Intensive Care
Babies with diagnosed severe RSV infection in PICU requiring mechanical ventilation
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Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.
|
Other: Health Controls
Babies without respiratory symptoms, attending routine outpatient appointments or undergoing elective surgical procedures
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Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.
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Other: Controls in Paediatric Intensive Care
Babies without RSV infection but requiring mechanical ventilation in PICU
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Nasal Absorption sampling, Bronchial sampling, Nasal Pharageal Aspirates, Blood sampling.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Number of Sampling Visits on Which Participants Are Willing to Undergo Nasosorption and/or NPA Sampling
Time Frame: Throughout symptomatic respiratory infection, up to 1 month
|
To determine the difference in tolerability of nasosorption compared to NPA by assessment of acceptance by infants and families.
Samples were collected from participants up to twice daily throughout study involvement, as such each participant could have >1 sampling visits.
|
Throughout symptomatic respiratory infection, up to 1 month
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Accuracy of Nasosorption for Viral Load Measurement
Time Frame: Throughout symptomatic respiratory infection, up to 1 month
|
To determine the difference in accuracy of nasosorption compared to NPA by assessment of level of viral load (measured by qPCR).
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Throughout symptomatic respiratory infection, up to 1 month
|
Accuracy of Bronchosorption for Viral Load Measurement, Compared to Tracheal Aspirate
Time Frame: Throughout symptomatic respiratory infection, up to 1 month
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To determine the difference in accuracy of bronchosorption (BSAM) compared to tracheal aspirate (TA) by assessment of level of viral load (measured by qPCR).
|
Throughout symptomatic respiratory infection, up to 1 month
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Immune Response
Time Frame: Throughout symptomatic respiratory infection, up to 1 month
|
Establishing the use of nasal and bronchial sampling to measure the host immune response to RSV.
We will determine cytokine and inflammatory mediator concentrations by immunoassay of eluted fluid from nasosorption and compare with NPA.
|
Throughout symptomatic respiratory infection, up to 1 month
|
Collaborators and Investigators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- RNA Virus Infections
- Virus Diseases
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Respiration Disorders
- Lung Diseases
- Bronchial Diseases
- Paramyxoviridae Infections
- Mononegavirales Infections
- Lung Diseases, Obstructive
- Pneumovirus Infections
- Bronchitis
- Respiratory Insufficiency
- Respiratory Syncytial Virus Infections
- Bronchiolitis
- Bronchiolitis, Viral
Other Study ID Numbers
- 15/WM/0343
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
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