Asthma Biomarkers for Predicting Response to Therapy

Overview

Novel asthma biomarkers to predict the response to inhaled corticosteroid Brief description: This will be a single center study of asthmatic subjects and healthy controls which will investigate mechanisms underlying different response to inhaled corticosteroid, the mainstay of asthma therapy. Only about half of the asthmatic patients have improved lung function after treatment of inhaled corticosteroid. The investigators hypothesize that there are biomarkers such as epithelial cytokines (IL-25, IL-33, TSLP) in airway tissues or plasma of asthmatic patients which could predict the response of asthmatic patients to inhaled corticosteroid. Finding novel asthma biomarker will help the clinicians to choose the optimal treatment for individual asthmatic patient.

Full Title of Study: “Novel Asthma Biomarkers to Predict the Response to Inhaled Corticosteroid”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: July 2016

Interventions

  • Drug: Budesonide
    • Inhaled powder of inhaled corticosteroid, 2 puffs (200mcg) twice a day for 8 weeks

Arms, Groups and Cohorts

  • No Intervention: Healthy controls
    • Healthy controls who will be studied at baseline and serve as a control group for the bronchoscopy, induced sputum and peripheral blood collection.
  • Active Comparator: Asthmatics (treatment)
    • Steroid-naïve asthma, randomized to inhaled budesonide, 2 puffs (200mcg) twice a day for 8 weeks. These subjects will undergo bronchoscopy and induced sputum collection at baseline, undergo pulmonary function testing and peripheral blood collection at baseline, 4 and 8 weeks after treatment with inhaled corticosteroids.
  • No Intervention: Asthmatics (no treatment)
    • Steroid-naïve asthmatics randomized to no treatment for 8 weeks. These subjects will undergo bronchoscopy and induced sputum collection at baseline, undergo pulmonary function testing and peripheral blood collection at baseline, 4 and 8 weeks of no treatment.

Clinical Trial Outcome Measures

Primary Measures

  • Change from baseline airway epithelial cytokines expression, FEV1 and methacholine PD20 at 4 and 8 weeks
    • Time Frame: 8 weeks
    • The baseline expression of airway epithelial cytokines (IL-25, IL-33, TSLP) and/or Th2 cytokines (IL-4, IL-5, IL-13) in bronchial brushing, bronchial biopsy and peripheral blood in healthy control subjects and asthmatic patients. Change of forced expiratory volume of the 1st second (FEV1) and accumulated dosage of methacholine provoking a 20% fall of in forced expiratory volume in the first second (FEV1 PD20) of asthmatic patients after treatment with inhaled budesonide or non-intervention for 4 and 8 weeks.

Participating in This Clinical Trial

Group A: Inclusion Criteria:

  • Male and female subjects between the ages of 18 and 70 years – No respiratory symptoms – Normal spirometric value and methacholine PD20 >2.5mg Group B: Inclusion Criteria:

  • Male and female subjects between the ages of 18 and 70 years – History of asthma – No use of oral or inhaled corticosteroids for the treatment of asthma – No use of leukotriene antagonist for the treatment of asthma – Hyperreactivity to methacholine (PD20 FEV1 Methacholine < 2.5 mg) and/or ≥12% increase in FEV1 following inhalation of 200μg salbutamol – Asthma symptoms of episodic cough, wheeze and/or breathlessness Exclusion Criteria:

  • Current or former smokers – Pregnant women – Subjects with a history of lung disease other than asthma – Subjects with a history of a medical disease, which in the opinion of the investigator may put the subject at extra risk from study-related procedures or because the disease may influence the results of the study

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 70 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Tongji Hospital
  • Provider of Information About this Clinical Study
    • Principal Investigator: Guohua Zhen, MD, Professor – Tongji Hospital

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