Inhaled Corticosteroids on Airway Smooth Muscle in Asthma

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: NCT00661973
Recruitment Status : Withdrawn (The study was withdrawn for administrative reasons)
First Posted : April 21, 2008
Last Update Posted : June 4, 2015
Royal Brompton & Harefield NHS Foundation Trust
Information provided by:
Imperial College London

Brief Summary:
The main objective is to evaluate how treatment with inhaled corticosteroids (ICS) affects the characteristics of airway smooth muscle (ASM) cells from asthmatic subjects. Our hypothesis is that airway smooth muscle cell dysfunction plays an important role in the pathogenesis of asthma, and that treatment with inhaled corticosteroids reverses the abnormalities in airway smooth muscle cell function.

Condition or disease Intervention/treatment Phase
Asthma Drug: budesonide Phase 4

Detailed Description:

Aims and Objectives

Most of the work published to date on the effect of steroids on ASM has been carried out in animal models or in in vitro experiments. We would like to evaluate in vivo whether abnormalities in ASM function respond to ICS. Because ASM cells can be obtained from bronchial biopsies obtained via bronchoscopy, we will examine endobronchial biopsies from corticosteroid-naïve, mild asthmatic subjects. In particular, we will examine whether ICS have any effect ASM mass, proliferation and expression of different contractile proteins (α-actin and myosin) and chemokines, and will assess in vitro the response of ASM cells to stimulation by TGF-β and IL-1β. We will also examine the effect of dexamethasone on chemokine release and induced proliferation in vitro before and after treatment with ICS.

We will examine the effect of inhaled corticosteroids in 12 subjects with mild asthma. The subjects will be studied during a baseline period and again after receiving treatment with inhaled corticosteroid therapy with Budesonide Turbohaler (400 ug bd) for 4 weeks. The results of these two periods will be compared.

There will be 5 study visits. In the first two visits, the subjects will undergo spirometry with reversibility testing, a methacholine challenge test, skin prick tests and IgE levels, measurement of exhaled nitric oxide, and subjects will complete an Asthma Control Questionnaire and an Asthma Quality of Life Questionnaire. The third visit will be the day admission for the bronchoscopy. They will be given asthma control diary cards to complete during the 4-week treatment with ICS and receive their ICS turbohaler. At visit 4, they will have repeat spirometry and methacholine challenge to assess if there has been a change secondary to treatment with ICS. The final visit will be for the second bronchoscopy, when the dairy card and ICS inhaler will be collected, and the subjects will complete the Asthma Control and Quality of Life questionnaire.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Basic Science
Official Title: The Effect of Inhaled Corticosteroids (ICS) on Airway Smooth Muscle in Asthma
Study Start Date : April 2008
Estimated Primary Completion Date : December 2010
Estimated Study Completion Date : March 2011

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Asthma Steroids
Drug Information available for: Budesonide

Intervention Details:
  • Drug: budesonide
    inhaled budesonide (turbohaler) 400 micrograms twice a day for 4 weeks
    Other Name: pulmicort

Primary Outcome Measures :
  1. Changes in ASM mass, proliferation and migration after ICS therapy; changes in chemokine release after ICS therapy [ Time Frame: 4 weeks ]

Secondary Outcome Measures :
  1. Changes in sub-basement membrane thickness and inflammatory cell count after ICS therapy [ Time Frame: 4 weeks ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Physician diagnosis of asthma
  • Age 18-60
  • Intermittent asthma symptoms < once/week
  • FEV1>80% of predicted
  • Not on inhaled corticosteroid therapy

Exclusion Criteria:

  • Previous long-term use of inhaled corticosteroids (within 1 year of entry into study)
  • Past history of hypersensitivity to budesonide
  • Current smokers, or less than 3 years since quitting smoking
  • Less than 4 weeks from an exacerbation
  • On steroid-sparing agent or immunosuppressant such as azathioprine, methotrexate and ciclosporin
  • Concomitant anti-IgE therapy
  • Pregnancy
  • Previous bronchoscopy within three months of this study

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): NCT00661973

United Kingdom
Asthma lab, Royal Brompton Hospital, Sydney Street
London, United Kingdom, SW3 6NP
Sponsors and Collaborators
Imperial College London
Royal Brompton & Harefield NHS Foundation Trust
Principal Investigator: Kian F Chung, MBBS FRCP MD DSc Imperial College London

Responsible Party: Professor Kian Fan Chung, Imperial College London Identifier: NCT00661973     History of Changes
Other Study ID Numbers: 2007-006664-29
First Posted: April 21, 2008    Key Record Dates
Last Update Posted: June 4, 2015
Last Verified: June 2011

Keywords provided by Imperial College London:
airway smooth muscle
inhaled corticosteroids

Additional relevant MeSH terms:
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Immune System Diseases
Anti-Inflammatory Agents
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Hormones, Hormone Substitutes, and Hormone Antagonists