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Examination of the Role of Atrial Natriuretic Peptide Polymorphisms in Allergic Rhinitis and Asthma Severity

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00584051
Recruitment Status : Terminated (investigator closed study)
First Posted : January 2, 2008
Last Update Posted : October 4, 2018
Information provided by (Responsible Party):
Richard F. Lockey, MD, University of South Florida

Brief Summary:

Asthma is an inflammatory condition of the airways in the lungs that results in obstruction of airflow in those with the condition. The disease continues to be a major worldwide health care problem and its prevalence continues to increase annually. In 2005, 20 million people were diagnosed with asthma. The disease causes significant morbidity and accounts for 5,000 deaths annually. Between 1980 and 1994 the prevalence of asthma increased 74% in the United States and, in children under age 5, the prevalence increased by 160%. The allergic etiology of airway inflammation associated with asthma is established. Bronchial washings of asthmatic subjects are most often characterized by eosinophils, mast cells, and cytokines that are associated with the Th2 (allergic) phenotype. Similarly, IgE plays a pivotal role in airway inflammation of asthmatic subjects when allergens that cross-link IgE bound to mast cells in the airways cause the release of histamine and other inflammatory mediators. The association of asthma and the IgE mediated allergic phenotype is well established and up to 70% of asthmatics also suffer from allergic disease.

Adequately treated asthma often has minimal impact of quality of life but diagnosis and proper treatment is often delayed, resulting in increased missed school days, emergency room visits, and otherwise preventable degradation in quality of life. It would therefore be highly useful to identify a biomarker that can be used to assist in the diagnosis of asthma or to identify subjects at higher risk of developing allergic disease or asthma in the future. Efforts at identifying a genetic marker for the early diagnosis of asthma have been unsuccessful, mainly due to the complexity of the pathogenesis of the disease.

Atrial natriuretic factor is a pro-hormone precursor for 4 natriuretic peptide hormones including atrial natriuretic peptide (ANP). ANP's effects on the cardiovascular system are well characterized. Less well understood is the role these hormones play in immune regulation.

Recent studies have demonstrated a role for ANP in the regulation of immune function: ANP induces release of histamine from mast cells and macrophages, stimulates migration of neutrophils, enhances the cytotoxic activity of natural killer (NK) cells, and stimulates TNF-β production. Human dendritic cells express ANP receptors (GC-a) which polarize CD4+ cells towards a Th2 phenotype.

Since allergic rhinitis and asthma are associated with a Th2 phenotype, it is possible that elevated levels of ANP can be used to predict asthma severity or to predict future predilection to atopic disease.

There are a number of ANP gene polymorphisms that have been studied and found to be associated with renal disease, heart disease, hypertension and diabetes. Several studies have investigated the potential role of these polymorphisms in cardiovascular disease and have found association between polymorphisms of the ANP gene and left ventricular remodeling, hypertension, renal disease, diabetes, and increased risk of ischemic stroke. To our knowledge, no studies evaluating the role of ANP polymorphisms in allergic disease have been performed.

The goal of this research proposal is to evaluate whether ANP levels can be utilized to assist in diagnosis of asthma and in the prediction of asthma severity. Additionally, we will investigate the potential effect of polymorphisms in the ANP gene on asthma severity and thus serve as a useful genetic marker to predict future risk of atopy and asthma.

Condition or disease
Asthma Allergic Rhinitis

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Study Type : Observational
Estimated Enrollment : 90 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: The Purpose of This Study is to Examine the Role of Atrial Natriuretic Peptide Polymorphisms in Allergic Rhinitis and Asthma Severity
Study Start Date : October 2007
Actual Primary Completion Date : October 2009
Actual Study Completion Date : October 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Asthma


Primary Outcome Measures :
  1. To determine if an overproduction of ANP is associated with atopy and asthma. [ Time Frame: 1 YEAR ]

Secondary Outcome Measures :
  1. To determine whether polymorphisms in the ANP gene contribute to the pathogenesis of the allergic condition or asthma. [ Time Frame: 1YEAR ]

Biospecimen Retention:   Samples With DNA


This study cannot be located to update the actual number of participants.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 40 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
The study will include three groups; an asthma group, an allergic rhinitis group, and a healthy control group. Participants will be between 18-40 years of age and will meet inclusion/exclusion criteria outlined below. The study will continue for a total of 1 year. Study subjects will keep a diary of symptoms using a validated asthma subjective questionnaire (Juniper). Serum levels of atrial natriuretic peptide and serum IgE, will be obtained at the initial visit and then at regular intervals depending on the study group (table 1).

Inclusion Criteria:

Inclusion criteria for asthma group

  1. Subjects between 18-40 years of age
  2. History of asthma diagnosed by a physician
  3. Have a physician documented diagnosis of allergic disease based on detection of sensitivity by either skin prick testing or RAST,
  4. Have a decreased FEV1 with 12% improvement in FEV1 documented within 12 weeks

Inclusion criteria for allergic rhinitis group

  1. Subjects between ages of 18-40
  2. Have a physician documented history of allergic rhinitis based on prior skin prick testing or a positive RAST test.

Inclusion criteria for control group

  1. Subjects between 18-40 years of age
  2. FEV1 greater than 80% predicted
  3. No history of wheezing or allergies

Exclusion Criteria:

  1. Use of systemic corticosteroids 4 weeks prior to initial visit
  2. Use of antihistamines 7 days prior to initial visit
  3. Respiratory infection 2 weeks prior to initial visit
  4. History of Xolair use or immunotherapy
  5. Current smoking, alcohol, or substance abuse
  6. Patients with primary immunodeficiency
  7. Patients currently on immunosuppressive therapy
  8. Unable to perform pulmonary function testing
  9. History of congestive heart failure
  10. Current cancer diagnosis or undergoing cancer therapy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00584051

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United States, Florida
Tampa, Florida, United States, 33613
Sponsors and Collaborators
University of South Florida
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Principal Investigator: RICHARD F LOCKEY, MD University of South Florida
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Responsible Party: Richard F. Lockey, MD, MD, University of South Florida Identifier: NCT00584051    
Other Study ID Numbers: PURCELL
First Posted: January 2, 2008    Key Record Dates
Last Update Posted: October 4, 2018
Last Verified: October 2018
Keywords provided by Richard F. Lockey, MD, University of South Florida:
Control group
Additional relevant MeSH terms:
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Rhinitis, Allergic
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Immune System Diseases
Nose Diseases
Respiratory Tract Infections
Otorhinolaryngologic Diseases