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.
研究概览
详细说明
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
研究类型
介入性
注册 (实际的)
200
阶段
- 不适用
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
30年 至 80年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
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.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
其他：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
其他名称：
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Change from Baseline in inflammatory cell numbers and inflammatory markers at 3 months
大体时间：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
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
network analysis of quantitative proteomics of bronchial biopsies
大体时间：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
大体时间：3 months
|
lung function measurements (spirometry, bronchial responsiveness measurement, capsaicin test) at baseline and 3 months after treatment with budesonide
|
3 months
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Raimundas Sakalauskas, Prof.、Kaunas University of Medicine
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2004年6月1日
初级完成 (实际的)
2006年12月1日
研究完成 (实际的)
2009年6月1日
研究注册日期
首次提交
2011年5月31日
首先提交符合 QC 标准的
2011年6月20日
首次发布 (估计)
2011年6月22日
研究记录更新
最后更新发布 (估计)
2012年4月12日
上次提交的符合 QC 标准的更新
2012年4月11日
最后验证
2012年4月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.