Pathogenetic Mechanisms of Chronic Obstructive Pulmonary Diseases (CAPTA)
2012年4月11日 更新者：Raimundas Sakalauskas、Lithuanian University of Health Sciences
Evaluation of Pathogenetic Mechanisms of Chronic Obstructive Pulmonary Diseases
Asthma and chronic obstructive pulmonary disease(COPD) are common diseases, which tend to even increase in many countries.
Both from a clinical and a pathophysiological point of view, this is an important issue.
However, an understanding of the relationship between the complex array of cells and mediators involved in asthma and COPD is not yet fully dissected which makes difficult to find a specific and sensitive panel of biomarkers that can reflect intensity of these pathological processes and can help to predict the individual outcome.
調査の概要
詳細な説明
Objectives:
To evaluate the patterns of pathophysiology and genetic predisposition of COPD and asthma
Tasks:
To evaluate patients that respond to corticosteroids and those who do not
Compare the inflammatory markers:
- of COPD and asthma patients before and after treatment with inhaled glucocorticoids
- of COPD and asthma patients that respond to inhaled glucocorticoids and those who do not
- of nonsmokers and smokers asthma patients
To identify a small set of markers that can be used to predict corticosteroid-treatment response in patients with COPD.
To evaluate epigenetic factors
To compare gene mutation and polymorphism between study groups
To evaluate the relationship between genetic predisposition and pathophysiology, clinical symptoms
To evaluate the relationship between patterns of pathophysiology and clinical symptoms, lung function, quality of life in patients with chronic obstructive pulmonary diseases.
Visit 1 Written informed consent will be obtained
- A full medical, surgical, smoking, labour history. A physical examination will be performed
- Resting SaO2 will be measured, exhaled nitric oxide (FENO)
- Chest X-ray
- Patient will fulfil questionnaires
- Spirometry and bronchodilatation test
- Sputum induction and samples will be performed
Visit 2 • Blood samples for blood clotting test and immunological markers will be taken• Cough inhalation challenge
Visit 3
- Patient will be hospitalized to the Department of Pulmonology and Immunology
- Blood samples for genetic analysis will be taken
- Urinary samples will be taken• Methacholine challenge test Polysomnography
- Bronchoscopy (biopsy and BAL)
- Study drug administration
Visit 4 and 5
- Adverse events, COPD or asthma exacerbation, concomitant medications will be recorded, exhaled nitric oxide (FENO)
- Spirometry
- Patient will fulfil questionnaires
- Cough inhalation challenge
Visit 6
- Patient will fulfil questionnaires
- Spirometry and bronchodilatation test.
- Sputum induction and samples will be performed
Visit 7
• Blood samples for blood clotting test, immunological and genetic analysis will be taken• Cough inhalation challenge
Visit 8
- Patient will be hospitalized to the Department of Pulmonology and Immunology
- Urinary samples will be taken• Methacholine challenge test Polysomnography
- Bronchoscopy (biopsy and BAL)
- Further treatment administration
研究の種類
介入
入学 (実際)
200
段階
- 適用できない
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
30年～80年 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
- Male or female outpatients aged 40-80 years inclusive.
- An established clinical history of COPD as defined by the GOLD guidelines.
- COPD patients with a baseline (pre-bronchodilator) FEV1 40-80% of predicted normal value; post-bronchodilator FEV1/FVC ratio ≤ 70% predicted.
- COPD patients with a smoking history (current or ex-smoker) of ≥10 pack years or those who have exposure to occupational dust and chemicals
- An established clinical history of asthma defined by the GINA recommendations.
- Subjects with out hypoxemia (all subjects must have an O2 saturation ≥88% on room air).
Control (healthy) subjects with baseline FEV1 >80% of predicted normal value
- A female is eligible to participate this study if she is of non-childbearing potential, or childbearing potential has a negative pregnancy test.
- Patients who did not use inhaled and oral corticosteroids 6 weeks and/or long acting bronchodilators 4 weeks before study.
Exclusion Criteria:
- There is a current respiratory disorder other than COPD and asthma (e.g. lung cancer, sarcoidosis, active tuberculosis etc.)
- Subjects who have had a COPD and asthma exacerbation or respiratory infection in the 4 weeks before Visit 1.
- Subjects with a chest X-ray indicating diagnosis other than COPD or asthma that might interfere with the study.
- Subjects who are unable to stop treatment with inhaled, and oral corticosteroids 6 weeks and/or long acting bronchodilators 4 weeks before study.
- Subjects receiving treatment with cromolyn sodium or nedocromil, oral beta2 - agonists, long acting anticholinergic, leucotriene modifiers
- Subjects who have had lung surgery.
- Subjects with bleeding diathesis.
- Subjects receiving treatment with long-term oxygen therapy.
- Subjects with serious, uncontrolled diseases those are uncontrolled on permitted therapy.
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
他の：Budesonide
patients who gave their agreement were randomised to 3 months treatment with either inhaled budesonide (400 µg BD) or placebo
|
inhaled budesonide (400 µg BD) or placebo BD
他の名前：
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change from Baseline in inflammatory cell numbers and inflammatory markers at 3 months
時間枠：3 months
|
inflammatory cell numbers and inflammatory markers (cytokines, chemokines, etc.) in different tissue compartments (induced sputum, BAL, bronchial biopsies, blood) will be measured at baseline and 3 months after treatment with budesonide and compared with those from healthy subjects
|
3 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
network analysis of quantitative proteomics of bronchial biopsies
時間枠：3 months
|
pathways analysis will be performed on proteins obtained from bronchial biopsies from asthmatics and COPD patients at baseline and 3 months after treatment
|
3 months
|
|
change of lung function, exNO after 3 months of treatment
時間枠：3 months
|
lung function measurements (spirometry, bronchial responsiveness measurement, capsaicin test) at baseline and 3 months after treatment with budesonide
|
3 months
|
協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
捜査官
- 主任研究者：Raimundas Sakalauskas, Prof.、Kaunas University of Medicine
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2004年6月1日
一次修了 (実際)
2006年12月1日
研究の完了 (実際)
2009年6月1日
試験登録日
最初に提出
2011年5月31日
QC基準を満たした最初の提出物
2011年6月20日
最初の投稿 (見積もり)
2011年6月22日
学習記録の更新
投稿された最後の更新 (見積もり)
2012年4月12日
QC基準を満たした最後の更新が送信されました
2012年4月11日
最終確認日
2012年4月1日
詳しくは
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