Airway Microbiome in Asthma: Relationships to Asthma Phenotype and Inhaled Corticosteroid Treatment
2016年11月17日 更新者：dave mauger、Milton S. Hershey Medical Center
There are new, very sensitive methods for detecting bacteria. These methods show that hundreds of millions of microbes (organisms that can only be seen with microscopes), especially bacteria, live in healthy people. The collection of different microbes found in a site is called a "microbiome." The investigators know that microbiomes of the skin, sinuses, mouth, gastro-intestinal tract, etc. differ from each other. The make-up of the microbiome - which bacteria are found in a site - may be necessary for good health. For example, the microbiome of the mouth is different in people with inflammation of the gums (periodontitis), and the microbiome of the bowel is different in people with inflammation of the intestinal tract (inflammatory bowel disease).
The purpose of this research study is to find out if the microbiome in the lungs is different in healthy people without asthma compared to people with asthma. This study will also find out if the microbiome of the lungs changes when people with asthma take a daily "controller" medication called an inhaled corticosteroid.
研究概览
详细说明
Two broad specific aims of this study are: 1)To evaluate whether the microbiota of the bronchial airways in atopic asthmatics and atopic healthy controls differ in microbial diversity, richness, evenness, or composition of specific bacterial taxa.
2) To determine whether inhaled corticosteroid treatment alters bronchial microbial community composition in asthmatics.
研究类型
介入性
注册 (实际的)
84
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
California
-
San Francisco、California、美国、94143-0130
- University of California, San Francisco, Adult
-
-
Colorado
-
Denver、Colorado、美国、80206
- National Jewish Health
-
-
Illinois
-
Chicago、Illinois、美国、60611
- Northwestern Memorial Hospital
-
-
Massachusetts
-
Boston、Massachusetts、美国、02115
- Brigham & Women's Hospital
-
-
Missouri
-
St. Louis、Missouri、美国、63110
- Washington University
-
-
North Carolina
-
Durham、North Carolina、美国、27110
- Duke University School of Medicine
-
Winston-Salem、North Carolina、美国、27157
- Wake Forest University Health Sciences
-
-
Pennsylvania
-
Pittsburgh、Pennsylvania、美国、15213
- University of Pittsburgh, Adult
-
-
Wisconsin
-
Madison、Wisconsin、美国、53972
- University of Wisconsin
-
-
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
18年 至 60年 (成人)
接受健康志愿者
是的
有资格学习的性别
全部
描述
Inclusion Criteria:
Asthmatic:
- History of physician-diagnosed asthma.
- Methacholine PC20 < 8mg/ml and/or FEV1 improvement ≥ 12% in response to 180 mcg albuterol.
- FEV1 ≥ 70% of predicted after 180 mcg albuterol.
- Stable asthma for ≥ 3 months prior to enrollment (no urgent care visits, no systemic corticosteroid treatment).
- Asthma Control Questionnaire 6 Score < 1.5.
- Able to provide informed consent.
- Able to perform spirometry as per ATS criteria.
- Evidence by allergen skin test of sensitivity to an aeroallergen.
- Willingness, if female and able to conceive, to utilize one medically-acceptable form of contraception.
Healthy Control:
- Evidence by allergen skin test of sensitivity to an aeroallergen.
- Able to provide informed consent.
- Able to perform spirometry as per ATS criteria.
Exclusion Criteria:
Asthmatic:
- Presence of lung disease other than asthma.
- Use of > 10 doses of nasal corticosteroids in the previous 3 months.
- Presence of significant medical illness or other chronic diseases whose treatment could affect the clinical features measured, responses to the therapies to be given in this study, or risks of participating in the study.
- History of atrial or ventricular tachyarrhythmia.
- Changes suggestive of cardiac ischemia on ECG at baseline.
- History of upper respiratory infection, sinusitis, bronchitis, or antibiotic use in the previous 3 months.
- History of chronic sinus disease.
- Smoking > 5 pack-years, or within the past year
- History of long-term controller medication use for asthma (inhaled or oral corticosteroid, leukotriene pathway antagonist, cromolyn, or theophylline within the preceding 6 months.
- History of bleeding disorder.
- Reduced creatinine clearance.
- Inability, in the opinion of the Study Investigator, to coordinate use of inhaler or otherwise comply with medication regimens.
- Contraindication to bronchoscopy on history or examination.
Healthy Control:
- History of chronic respiratory disease including asthma.
- Presence of significant medical illness or other chronic diseases whose treatment could affect the clinical features measured, responses to the therapies to be given in this study, or risks of participating in the study.
- History of atrial or ventricular tachyarrhythmia.
- Changes suggestive of cardiac ischemia on ECG at baseline.
- History of upper respiratory infection, sinusitis, bronchitis, or antibiotic use in the previous 3 months.
- Methacholine PC20 < 16 mg/ml or FEV1 improvement ≥ 12% in response to albuterol.
- History of chronic sinus disease
- Smoking > 5 pack-years, or within the past year
- Use of > 10 doses of a nasal corticosteroid preparation in the previous 3 months
- FEV1 or FVC < 80% predicted.
- History of bleeding disorder.
- Reduced creatinine clearance.
- Contraindication to bronchoscopy on history or examination.
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：四人间
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
无干预：健康控制
|
|
|
实验性的：Inhaled corticosteroid
Fluticasone (250 mcg/puff, one puff, twice a day)
|
Dry Powder Inhaler: 250 mcg/puff, one puff, twice a day
其他名称：
|
|
安慰剂比较：Placebo
Placebo fluticasone (one puff, twice a day)
|
Dry Powder Inhaler: Placebo
|
|
无干预：Atopic Non-asthmatics
|
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 |
|---|---|---|
|
Microbial Community Richness
大体时间：baseline and after 6 weeks of treatment
|
Richness is the total number of different bacterial taxa detected in the sample.
|
baseline and after 6 weeks of treatment
|
|
Microbial Community Diversity
大体时间：baseline and after 6 weeks of treatment
|
The Shannon diversity index is a type of entropy measure and is a function of the distribution of the total number of organisms across all of the species.
If S is the total number of species in the sample and p_i is the number of organisms in the i-th species divided by the total number of organisms, then Diversity = -Σ p_i log(p_i).
|
baseline and after 6 weeks of treatment
|
|
Microbial Community Evenness
大体时间：baseline and after 6 weeks of treatment
|
Pielou's evenness index is a scaled measure of biodiversity and is equal to the observed Shannon diversity index divided by the maximum possible Shannon diversity index, which would occur if all of the species in the sample were equally abundant.
Evenness = D/log(S), where D is the Shannon Diversity index and log(S) is the maximum diversity of the sample.
|
baseline and after 6 weeks of treatment
|
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：Lewis Smith, MD、Northwestern Memorial Hospital
- 首席研究员：Richard Martin, MD、National Jewish Health
- 首席研究员：Christine Sorkness, MD、University of Wisconsin, Madison
- 首席研究员：Sally Wenzel, MD、University of Pittsburgh Medical Center
- 首席研究员：Stephen Peters, MD、Wake Forest University Health Sciences
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
2012年10月1日
初级完成 (实际的)
2014年7月1日
研究完成 (实际的)
2014年7月1日
研究注册日期
首次提交
2012年2月9日
首先提交符合 QC 标准的
2012年2月16日
首次发布 (估计)
2012年2月23日
研究记录更新
最后更新发布 (估计)
2016年11月30日
上次提交的符合 QC 标准的更新
2016年11月17日
最后验证
2016年11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.