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Pathogenetic Mechanisms of Chronic Obstructive Pulmonary Diseases (CAPTA)

11. april 2012 oppdatert av: 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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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

Studietype

Intervensjonell

Registrering (Faktiske)

200

Fase

  • Ikke aktuelt

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

30 år til 80 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Annen: Budesonide
patients who gave their agreement were randomised to 3 months treatment with either inhaled budesonide (400 µg BD) or placebo
Legemiddel: comparison of treatment effect on different markers
inhaled budesonide (400 µg BD) or placebo BD
Andre navn:
  • Budesonid

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change from Baseline in inflammatory cell numbers and inflammatory markers at 3 months
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
network analysis of quantitative proteomics of bronchial biopsies
Tidsramme: 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
Tidsramme: 3 months
lung function measurements (spirometry, bronchial responsiveness measurement, capsaicin test) at baseline and 3 months after treatment with budesonide
3 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Lithuanian University of Health Sciences

Samarbeidspartnere

Göteborg University

Etterforskere

  • Hovedetterforsker: Raimundas Sakalauskas, Prof., Kaunas University of Medicine

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. juni 2004

Primær fullføring (Faktiske)

1. desember 2006

Studiet fullført (Faktiske)

1. juni 2009

Datoer for studieregistrering

Først innsendt

31. mai 2011

Først innsendt som oppfylte QC-kriteriene

20. juni 2011

Først lagt ut (Anslag)

22. juni 2011

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

12. april 2012

Siste oppdatering sendt inn som oppfylte QC-kriteriene

11. april 2012

Sist bekreftet

1. april 2012

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 48/2004

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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