Cigarette Smoke Nasal and Whole Blood Challenge in Patients With Chronic Obstructive Pulmonary Disease (COPD) - Full Text View

Purpose

This is a clinical research study to assess whether after exhaling a single cigarette smoke through the nose there are changes in the inflammatory cells and proteins of nasal secretions.

A single blood sample from each subject will be stimulated with cigarette smoke in the laboratory to see the effects on inflammatory blood cells.

Comparison of findings between smokers with COPD and "Healthy" smokers will be carried out.

We hypothesize that some subjects have amplified inflammatory response to a single cigarette, and these will be those subjects who develop chronic obstructive pulmonary disease (COPD) after decades of smoking. We hope to develop an acute challenge model that relates to the causation of COPD. When studying the effects of new drugs, these may be detected in small numbers of patients in a challenge situation, when we would need to study many more unchallenged patients to demonstrate drug effects. In clinical research on asthma and allergy, the nasal allergen challenge has been a very successful model, and we hope to validate a comparable model for COPD.

Condition	Intervention	Phase
Lung Diseases, Obstructive	Procedure: Nasal lavage Procedure: Nasal filter paper Procedure: Blood sampling	Phase I

MedlinePlus related topics:

COPD (Chronic Obstructive Pulmonary Disease) Smoking

ChemIDplus related topics:

Salicylsalicylic acid Sodium salicylate

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Diagnostic, Non-Randomized, Open Label, Uncontrolled, Parallel Assignment, Bio-equivalence Study

Official Title:	Cigarette Smoke Nasal and Whole Blood Challenge in Patients With COPD

Further study details as provided by Imperial College London:

Primary Outcome Measures:

Changes in the cytology and inflammatory mediator content of nasal exudates [ Time Frame: Single timepoint ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Comparison of nasal inflammatory response to smoke in patients with COPD with relevant controls [ Time Frame: Single timepoint ] [ Designated as safety issue: No ]
Comparison of inflammatory response in blood following cigarette smoking in patients with COPD and relevant controls [ Time Frame: Single timepoint ] [ Designated as safety issue: No ]
Comparison of nasal challenge with blood challenge [ Time Frame: Single timepoint ] [ Designated as safety issue: No ]
Develop a nasal challenge model to test novel anti-inflammatoy therapies for COPD [ Time Frame: Single timepoint ] [ Designated as safety issue: No ]
Identification of potential biomarkers for therapeutic trials in COPD [ Time Frame: Single timepoint ] [ Designated as safety issue: No ]
Definition of novel drug targets for potential new anti-inflammatory therapies [ Time Frame: Single timepoint ] [ Designated as safety issue: No ]

Enrollment:	16
Study Start Date:	September 2005
Study Completion Date:	December 2006
Primary Completion Date:	December 2006 (Final data collection date for primary outcome measure)

Intervention Details:

Nasal lavage was carried out at specified timepoints

Nasal filter paper was placed at specified timepoints

Blood sampling was performed as a routine safety check

Show Detailed Description

Eligibility

Ages Eligible for Study:	40 Years to 80 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria (COPD Smokers):

Smokers currently on at least 5 cigarettes per day, with a history of >10 pack years
Post-bronchodilator FEV1 >30% of predicted and < 80% of predicted
Pre-bronchodilator FEV1/FVC of <70%
With or without chronic simple bronchitis

Exclusion criteria (COPD Smokers):

History of asthma, allergy (including rhinitis/eczema)
Reversibility : an increase in FEV1 that is >400ml from the baseline pre- bronchodilator value (bronchodilate with salbutamol 400g delivered from a metered dose inhaler (MDI) into a spacer).

Inclusion criteria (for "Healthy" Smokers):

Smokers currently on at least 5 cigarettes per day, with a history of >10 pack years
FEV1 >90% of predicted, FEV1/FVC of >70%
Cannot have chronic simple bronchitis
Age, sex, smoking history matched to COPD Smokers

Exclusion criteria (for "Healthy" Smokers):

History of asthma, allergy (including rhinitis/eczema
Reversibility: an increase in FEV1 that is both >400ml from the baseline pre-bronchodilator value (bronchodilate with salbutamol 400mcg delivered from a metered dose inhaler (MDI) into a spacer)P
Pregnancy

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00159341

Locations


United Kingdom
	National Heart & Lung Institue Clinical Studies Unit, Imperial College London
	London, United Kingdom, SW3 6HP

Sponsors and Collaborators

Imperial College London

Millennium Pharmaceuticals

Investigators


Principal Investigator:	Trevor T Hansel, BSc MSc PhD	National Heart & Lung Institute, Imperial College London

More Information

Imperial College London website This link exits the ClinicalTrials.gov site

Publications of Results:

- Vachier I et al.Inflammatory features of nasal mucosa in smokers with and without COPD. Thorax 2004; 59:303-307. - Naclerio RM et al. Mediator release after nasal airway challenge with allergen. Am Rev Respir Dis 1983; 128:597-602. - Greiff L et al. The 'nasal pool' device applies controlled concentrations of solutes on human nasal airway mucosa and samples its surface exudations/secretions. Clin Exp Allergy 1990; 20:253-259. - Alam R et al. Development of a new technique for recovery of cytokines from inflammatory sites in situ. J Immunol Methods 1992; 155:25-29. - Weido AJ et al. Intranasal fluticasone propionate inhibits recovery of chemokines and other cytokines in nasal secretions in allergen-induced rhinitis. Ann Allergy Asthma Immunol 1996; 77:407-415. - Meltzer EO, Jalowayski AA. Nasal cytology in clinical practice. Am J Rhinol 1988; 2:47-54. - Fishwick D et al. Immunologic response to inhaled endotoxin: changes in peripheral cell surface markers in normal individuals. J Occup Environ Med 2004; 46:467-472. - Mudway IS, Kelly FJ. An investigation of inhaled ozone dose and the magnitude of airway inflammation in healthy adults. Am J Respir Crit Care Med 2004; 169:1089-1095. - Rahman I et al. Glutathione, stress responses, and redox signalling in lung inflammation. Antioxidants & Redox Signalling 2005; 7:42-59. - Koechlin C et al. Does systemic inflammation trigger local exercise-induced oxidative stress in COPD? Eur Respir J 2004; 23:538-544.

Responsible Party:	NHLI Clinical Studies Unit ( Dr Trevor Hansel )
Study ID Numbers:	05/Q0404/84
First Received:	September 8, 2005
Last Updated:	August 12, 2008
ClinicalTrials.gov Identifier:	NCT00159341
Health Authority:	United Kingdom: Research Ethics Committee

Keywords provided by Imperial College London:

cigarette smoke

nasal

whole blood

cytokines

chemokines

nasal fluid

filter paper

Study placed in the following topic categories:

Smoking

Lung Diseases, Obstructive

Respiratory Tract Diseases

Lung Diseases

Salicylsalicylic acid

Sodium Salicylate

Pulmonary Disease, Chronic Obstructive

ClinicalTrials.gov processed this record on October 10, 2008

Sponsors and Collaborators:	Imperial College London Millennium Pharmaceuticals
Information provided by:	Imperial College London
ClinicalTrials.gov Identifier:	NCT00159341