BROnchoalveolar Investigations of Never-smokers With Chronic Obstruction From the Swedish CardioPulmonary bioImage Study

NCT ID: NCT03049202

Last Updated: 2025-04-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-02-01

Study Completion Date

2030-12-31

Brief Summary

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Obstructive lung disease is an increasing global health problem of pandemic proportions, with COPD alone affecting \>10% of the population. Smoking is the main and most well studies risk factor for developing COPD. However, chronic airway obstruction also in never-smoking populations has recently been recognized as an increasing health problem.

In the clinical segment (PI: Prof. C. Magnus Skold), 1000 subjects from the Swedish national SCAPIS study will be clinically well characterized in one of the six Swedish University Hospital Respiratory clinics (clinical site PIs: Anders Andersson, Leif Bjermer, Anders Blomberg, Christer Janson, Lennart Persson, Magnus Skold). This first screening includes all never-smokers with COPD identified in the SCAPIS study. A subset of 300 subjects from the groups of Healthy never-smokers, current-smokers with normal lung function, current-smokers with COPD, ex-smokers with COPD, and never-smokers with COPD will be selected for the Bronchoscopy segment, were sampling will be performed from a number of anatomical locations, including bronchial biopsies, airway epithelial brushings, and bronchoalveolar lavage. Serum, plasma, and urine samples will also be collected.

In the systems medicine segment (PI: Assoc. prof Asa M. Wheelock), alterations at the epigenetic, mRNA, microRNA, proteome, metabolome and microbiome level will be performed from multiple lung compartments (airway epithelium, alveolar macrophages, exosomes, and bronchoalveolar exudates). By means of biostatistics and bioinformatics approaches, specific mediators and molecular pathways critical in the pathological mechanisms of obstructive lung disease related to never-smoker disease phenotypes will be identified.

In the immunohistochemistry segment (PI: Prof. Jonas Erjefalt), a number of molecules of relevance for disease pathology will be investigated in bronchial biopsies collected from the 300 subjects in the Bronchoscopy segment.

Detailed Description

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Chronic Obstructive Pulmonary Disease (COPD) is an umbrella diagnosis defined by obstructive lung function impairments, and is likely to be caused by a multitude of etiologies including environmental exposures, genetic predispositions and developmental factors. Due to the heterogeneity of the disease, molecular and mechanistic sub-phenotyping of COPD represents an essential step to facilitate the development of relevant diagnostic and treatment options for this constantly growing patient group. In the BRONCHO-SCAPIS study, molecular sub-phenotypes of smoking-induced COPD are investigated. A particular focus relates to recent epidemiological indications of an increasing proportion of never-smokers developing the disease. The study encompasses profiling of mRNA, miRNA, proteomes, metabolomes and lipid mediators of from multiple lung compartments (airway epithelium, alveolar macrophages, exosomes, and bronchoalveolar exudates) using a range of 'omics platforms, in combination with extensive clinical phenotyping of early stage COPD patients, never-smokers, and smokers with normal lung function from both genders. The primary objective of the study is to identify molecular sub-phenotypes of never-smokers with COPD, specifically by correlating clinical phenotypes multi-molecular 'omics profiling from multiple lung compartments of early stage COPD patients compared to healthy and at-risk control populations. Secondary goals involve identification of subsets of prognostic/diagnostic biomarkers for classification of the defined subgroups, as well as relevant pharmaceutical targets.

Conditions

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Chronic Obstructive Pulmonary Disease Emphysema Chronic Bronchitis Airway Obstruction Smoking, Tobacco Gender

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Never-smoker COPD participants

COPD patients with mild-to-moderate COPD (GOLD I-II) that have never smoked. Definition of never-smoker: Lifetime consumption of \<100 cigarettes. No cigarettes the past 2 years.

No interventions assigned to this group

Ex-smoker COPD participants

COPD patients with mild-to-moderate COPD (GOLD I-II) that stopped smoking. Definition of smoking: \> 10 pack years. Definition of ex-smoker: \> 2 years since smoke cessation.

No interventions assigned to this group

Current-smoker COPD participants

COPD patients with mild-to-moderate COPD (GOLD I-II) that are currently smoking. Definition of smoking: \> 10 pack years. Definition of current-smoker: \> 10/cigarettes/dat the past 6 months.

No interventions assigned to this group

Current-smoker healthy controls

Current-smokers that are otherwise healthy, with normal lung function. Definition of smoking: \> 10 pack years. Definition of current-smoker: \> 10/cigarettes/dat the past 6 months.

No interventions assigned to this group

Never-smoker healthy controls

Healthy participants that have never smoked. Definition of never-smoker: Lifetime consumption of \<100 cigarettes. No cigarettes the past 2 years.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Spirometry of postbronchodilator forced expiratory volume in 1 second (FEV1) \>50% of predicted level for all groups.
* Spirometry of postbronchodilator FEV1 \>80% of predicted level and FEV1/FVC ratio \>0.70 for Healthy control groups
* Spirometry of postbronchodilator FEV1/FVC ratio \<0.70 for COPD groups.

Exclusion Criteria

* Smoking (for never-smoker groups)
* Other lung diseases
* Received antibiotics in the 3 months prior to study entry
* Treatment with oral or inhaled glucocorticoids within past 3 months prior to study entry
Minimum Eligible Age

50 Years

Maximum Eligible Age

68 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Swedish Heart Lung Foundation

OTHER

Sponsor Role collaborator

Lund University

OTHER

Sponsor Role collaborator

Göteborg University

OTHER

Sponsor Role collaborator

Linkoeping University

OTHER_GOV

Sponsor Role collaborator

Uppsala University

OTHER

Sponsor Role collaborator

Umeå University

OTHER

Sponsor Role collaborator

Karolinska University Hospital

OTHER

Sponsor Role collaborator

Lund University Hospital

OTHER

Sponsor Role collaborator

Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

University Hospital, Linkoeping

OTHER

Sponsor Role collaborator

Uppsala University Hospital

OTHER

Sponsor Role collaborator

University Hospital, Umeå

OTHER

Sponsor Role collaborator

Region Stockholm

OTHER_GOV

Sponsor Role collaborator

Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

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Asa Wheelock

Associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Magnus Skold, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet /Karolinska University Hospital

Locations

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Karolinska Institutet/Karolinska University Hospital Solna

Stockholm, Sverige, Sweden

Site Status

Göteborg University / Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Linköping Unversity /Linköping University Hospital

Linköping, , Sweden

Site Status

Lund University / Lund University Hospital

Lund, , Sweden

Site Status

Umeå University / Umeå University Hospital

Umeå, , Sweden

Site Status

Uppsala University / Uppsala University Hospital

Uppsala, , Sweden

Site Status

Countries

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Sweden

Other Identifiers

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2016/841-31/2

Identifier Type: -

Identifier Source: org_study_id

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