Development and Validation of a Sputum Biomarker mRNA Panel for the Diagnostic Work-up of Asthma 2

Overview

The main objectives of the study are: -to unravel the importance of molecular phenotyping in predicting the response to classical anti-asthma treatment (inhaled corticosteroids) The investigators have developed a non-invasive technique based on mRNA analysis of induced sputum that enables us to study airway inflammation in detail. This technique forms the basis for our current project based on the following hypotheses: 1. different molecular asthma phenotypes exist: a Th2 phenotype and a non Th2 phenotype as reported by Woodruff and colleagues (Woodruff PG et al). Sputum mRNA cytokine levels can be used to diagnose Th2 asthma and discriminate this from non-Th2 asthma. 2. Based on our previous research and preliminary data that non-Th2 asthma can be further divided in Th17 asthma and Th1+Th2 asthma; besides these, a fourth group without Th2, Th17 or Th1 characteristics also exist. The investigators hypothesize that the epithelial cell cytokine, TSLP, can be increased as an early marker of airway inflammation in this latter group. 3. these subgroups have different responses to anti-inflammatory treatment.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: February 2015

Interventions

  • Drug: Beclomethasone
    • 400 microgram of beclomethasone will be given to the patients in arm 1. During the last 4 weeks, the patients will receive additional 400 microgram of Qvar.

Arms, Groups and Cohorts

  • Active Comparator: Qvar 100
    • Patients will be randomized to receive either the active arm (3/4) or a SABA as rescue medication (1/4). The patient will be asked to take Qvar 100 (2puffs) in the morning and in the evening. Daily dose (400 microgram).
  • No Intervention: Control
    • Patients are allowed to use their SABA as rescue medication only. During the last 4 weeks, the patients will receive 400 microgram of Qvar.

Clinical Trial Outcome Measures

Primary Measures

  • sputum cytokine mRNA levels
    • Time Frame: 6 and 10 weeks

Secondary Measures

  • steroid-responsiveness
    • Time Frame: 6 and 10 weeks
    • We will evaluate steroid-responsiveness both by objective measurements (lung function parameters) and asthma scores

Participating in This Clinical Trial

Inclusion Criteria

  • steroid naive asthmatics Exclusion Criteria:

  • viral/bacterial/fungal infection +fever(<1month) – asthma exacerbation (<3months) – other airway diseases (CF, ciliary dyskinesia, bronchiectasis)

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Universitaire Ziekenhuizen KU Leuven
  • Provider of Information About this Clinical Study
    • Principal Investigator: Dominque Bullens, prof. dr. – Universitaire Ziekenhuizen KU Leuven
  • Overall Official(s)
    • Dominique MA Bullens, MD, PhD, Principal Investigator, Lab of clinical immunology, O&N I Herestraat 49 – bus 811, 3000 Leuven, België
    • Sven F Seys, MSc, Study Director, Lab of clinical immunology, O&N I Herestraat 49 – bus 811, 3000 Leuven, België

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