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Multilevel Models of Therapeutic Response in the Lungs

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ClinicalTrials.gov Identifier: NCT02947126
Recruitment Status : Recruiting
First Posted : October 27, 2016
Last Update Posted : November 5, 2018
Sponsor:
Collaborator:
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Tim Corcoran, University of Pittsburgh

Brief Summary:
When developing new medications for lung diseases like Cystic Fibrosis (CF), scientists perform lab experiments using cells from the airways, physiology studies of how the lungs change when a drug is given, and clinical studies to determine how drugs affect overall health. The investigators of this study are seeking to develop computer models that will predict how patients will respond to drugs by just doing lab studies on cell samples from their noses. Such models would allow for medications to be developed more rapidly for all patients and allow treatments to be personalized as well. In order to develop these computer models a series of tests will be performed on patients who have CF. Tests will include sampling cells from the nose and measuring lung physiology using a combination of different imaging, breathing, and other studies performed both before and after participants take a therapy. Similar tests will be performed on people who do not have CF, and on the parents of the CF participants who carry a single CF gene because this will provide information on how specific genes might affect CF lung disease.

Condition or disease Intervention/treatment Phase
Cystic Fibrosis Drug: Hypertonic Saline Drug: Isotonic Saline Drug: Indium-DTPA Drug: Technetium Sulfur Colloid Not Applicable

Detailed Description:

The goal of this research is to develop a series of interconnected models of therapeutic response in the diseased lung, focused primarily on Cystic Fibrosis (CF), that will ultimately provide a means for predicting in vivo response based on patient-specific in vitro testing, allowing for the optimization and personalization of therapies. Investigators use both human bronchial epithelial (HBE) and more recently human nasal epithelial (HNE) cell cultures to study CF pathophysiology. The investigators performing this study have also developed functional imaging biomarkers in the lung that provide organ level quantification of CF lung physiology (mucociliary clearance and airway liquid absorption), and, more recently, in silico systems models of lung physiology at both the cell and organ level. The in silico models provide a framework of differential equations that describe how basic physiological processes interact and contribute to experimental outcomes. Their use allows these mechanisms to be more specifically differentiated. Here the investigators propose to link in vitro and in vivo response by sampling and culturing HNE cell cultures from both non-CF and CF subjects who will also perform a series of physiological assessments, including functional imaging scans. The in silico models will facilitate linking therapeutic studies in cells to therapeutic outcomes in patients.

  1. CF PATIENTS will perform 2 study days.

    Study day 1 will include:

    1. nasal potential difference measurements
    2. pulmonary function testing
    3. inert gas washout testing
    4. urine pregnancy testing
    5. nasal cell sampling
    6. nuclear MCC/ABS scan (to include inhalation of isotonic or hypertonic saline - randomized order)
    7. blood draw for CFTR genotyping if not already available.

    Study day 2 will include

    1. pulmonary function testing
    2. urine pregnancy testing
    3. nuclear MCC/ABS scan (to include inhalation of isotonic or hypertonic saline - randomized order)
  2. PARENTS OF ENROLLED CF patients who choose to participate will perform 1 study day which will include:

    1. nasal potential difference measurements
    2. pulmonary function testing
    3. inert gas washout testing
    4. urine pregnancy testing
    5. nasal cell sampling
    6. nuclear MCC/ABS scan (to include inhalation of isotonic saline)
    7. a single blood sample drawn for CFTR genotyping.
  3. HEALTHY CONTROLS will perform 1 screening and 1 study day which will include:

    1. pulmonary function testing
    2. inert gas washout testing
    3. urine pregnancy testing
    4. nasal cell sampling
    5. nuclear MCC/ABS scan (to include inhalation of isotonic saline)
    6. a single blood sample drawn for CFTR genotyping (at screening).

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 62 participants
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Basic Science
Official Title: Multilevel Models of Therapeutic Response in the Lungs
Actual Study Start Date : January 2017
Estimated Primary Completion Date : August 2020
Estimated Study Completion Date : August 2020


Arm Intervention/treatment
Experimental: Cystic Fibrosis (HS, IS)

CF subjects: ages 12 or older with a diagnosis of cystic fibrosis as determined by sweat test or genotype and clinical symptoms who are clinically stable as determined by a physician co-investigator. Subjects receive HS dose on first imaging day and IS dose on the second imaging day,

Indium-DTPA (1.5 mCi), Technetium sulfur colloid (8mCi), Inhaled isotonic saline (4ml), Inhaled Hypertonic Saline (4ml)

Drug: Hypertonic Saline
Inhaled 7% Hypertonic saline

Drug: Isotonic Saline
Inhaled 0.9% Isotonic saline

Drug: Indium-DTPA
Inhaled Indium 111 DTPA

Drug: Technetium Sulfur Colloid
Inhaled Technetium99m sulfur colloid

Experimental: Cystic Fibrosis (IS, HS)

CF subjects: ages 12 or older with a diagnosis of cystic fibrosis as determined by sweat test or genotype and clinical symptoms who are clinically stable as determined by a physician co-investigator. Subjects receive IS dose on first imaging day and HS dose on the second imaging day.

Indium-DTPA (1.5 mCi), Technetium sulfur colloid (8mCi), Inhaled isotonic saline (4ml), Inhaled Hypertonic Saline (4ml)

Drug: Hypertonic Saline
Inhaled 7% Hypertonic saline

Drug: Isotonic Saline
Inhaled 0.9% Isotonic saline

Drug: Indium-DTPA
Inhaled Indium 111 DTPA

Drug: Technetium Sulfur Colloid
Inhaled Technetium99m sulfur colloid

Experimental: Parents of CF subjects

Ages 18 and older, biological parent of a CF patient who is also enrolled in the study

Indium-DTPA (1.5 mCi), Technetium sulfur colloid (8mCi), Inhaled isotonic saline (4ml)

Drug: Isotonic Saline
Inhaled 0.9% Isotonic saline

Drug: Indium-DTPA
Inhaled Indium 111 DTPA

Drug: Technetium Sulfur Colloid
Inhaled Technetium99m sulfur colloid

Experimental: non CF controls

Ages 18 and older with no history of lung disease

Indium-DTPA (1.5 mCi), Technetium sulfur colloid (8mCi), Inhaled isotonic saline (4ml).

Drug: Isotonic Saline
Inhaled 0.9% Isotonic saline

Drug: Indium-DTPA
Inhaled Indium 111 DTPA

Drug: Technetium Sulfur Colloid
Inhaled Technetium99m sulfur colloid




Primary Outcome Measures :
  1. Mucociliary Clearance [ Time Frame: 80 minutes ]
    Clearance rate of Technetium sulfur colloid from the lungs

  2. DTPA absorption rate [ Time Frame: 80 minutes ]
    DTPA absorption rate from the lungs (difference between total In-DTPA clearance rate and mucociliary clearance rate)



Information from the National Library of Medicine

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Ages Eligible for Study:   12 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Cystic Fibrosis Subjects: Inclusion Criteria

  • Ages 12 or older
  • Diagnosis of cystic fibrosis as determined by sweat test or genotype
  • Clinically stable as determined by a physician co-investigator

Cystic Fibrosis Subjects: Exclusion Criteria

  • Smokers or users of electronic cigarettes
  • FEV1%p <30% of predicted
  • Nursing, pregnant or unwilling to test for pregnancy
  • Intolerant to hypertonic saline
  • Unable or unwilling to discontinue hypertonic saline, Pulmozyme, and long acting bronchodilators for 24 hrs before testing and short acting bronchodilators on testing days.

CF parents: Inclusion Criteria

  • Ages 18 and older
  • Biological parent of a CF patient who is also enrolled in the study

CF parents: Exclusion Criteria

  • Smokers or users of electronic cigarettes
  • FEV1%p <30% of predicted
  • Nursing, pregnant or unwilling to test for pregnancy
  • Unwilling to discontinue long acting bronchodilators for 24 hrs before testing and short acting bronchodilators on testing days.
  • Unwilling to perform CFTR genotyping.

Healthy controls: Inclusion Criteria

  • Ages 18 and older
  • No history of lung disease

Healthy Controls: Exclusion Criteria

  • Smokers or users of electronic cigarettes
  • FEV1%p <70% of predicted
  • Nursing, pregnant or unwilling to test for pregnancy
  • Carriers of known disease causing CFTR mutations
  • Unwilling to perform CFTR genotyping.

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 ClinicalTrials.gov identifier (NCT number): NCT02947126


Contacts
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Contact: Elizabeth Hartigan, RN MPH 412-692-7060 elizabeth.hartigan@chp.edu

Locations
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United States, Pennsylvania
University of Pittsburgh Medical Center Recruiting
Pittsburgh, Pennsylvania, United States, 15213
Contact: Elizabeth Hartigan, RN, MPH    412-692-7060    Elizabeth.Hartigan@chp.edu   
Principal Investigator: Tim Corcoran, Ph.D.         
Sponsors and Collaborators
University of Pittsburgh
National Heart, Lung, and Blood Institute (NHLBI)
Investigators
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Principal Investigator: Tim Corcoran, Ph.D. University of Pittsburgh

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Responsible Party: Tim Corcoran, Associate Professor of Medicine, University of Pittsburgh
ClinicalTrials.gov Identifier: NCT02947126     History of Changes
Other Study ID Numbers: PRO15070376
1U01HL131046-01 ( U.S. NIH Grant/Contract )
First Posted: October 27, 2016    Key Record Dates
Last Update Posted: November 5, 2018
Last Verified: November 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by Tim Corcoran, University of Pittsburgh:
cystic fibrosis
mucociliary clearance
CFTR
Additional relevant MeSH terms:
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Cystic Fibrosis
Fibrosis
Pathologic Processes
Pancreatic Diseases
Digestive System Diseases
Lung Diseases
Respiratory Tract Diseases
Genetic Diseases, Inborn
Infant, Newborn, Diseases
Edetic Acid
Pentetic Acid
Technetium Tc 99m Sulfur Colloid
Antidotes
Protective Agents
Physiological Effects of Drugs
Chelating Agents
Sequestering Agents
Molecular Mechanisms of Pharmacological Action
Iron Chelating Agents
Radiopharmaceuticals
Anticoagulants
Calcium Chelating Agents