Interrelation Between Bronchial Asthma and Smoking

NCT ID: NCT03207620

Last Updated: 2022-01-11

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

COMPLETED

Total Enrollment

117 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-08-09

Study Completion Date

2021-08-10

Brief Summary

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Smoking occurs frequently in patients with asthma. Recent surveys on smoking prevalence report 21-26% current smokers in populations of patients with asthma. Detrimental effects of active smoking in asthma include worse asthma control, an impaired response to corticosteroids and accelerated lung function decline.

Detailed Description

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The mechanisms by which cigarette smoking contributes to disease severity in asthma are incompletely understood, but it has been suggested that cigarette smoking may change inflammation and airway remodelling in asthma to become more similar to that in COPD (chronic obstructive pulmonary disease).

Any form of tobacco use, especially cigarette smoking, plays an important role in this disease. Asthmatic smokers are prone to several negative outcomes. Cigarette smoking by itself is associated with airway inflammation and features of airway remodelling including increased epithelial proliferation, squamous cell metaplasia, goblet cell hyperplasia, smooth muscle hypertrophy, and increases in bronchial glands mass.

Corticosteroid insensitivity is an important clinical feature of asthma, particularly in patients with severe disease and smokers. The mechanisms of corticosteroid insensitivity in asthmatic patients are poorly understood.

One of the major problems in the treatment of smoking asthma patients is the lack of efficacy data in this group of patients as smokers have almost always been excluded from studies on asthma due to perceived concerns about recruiting patients with COPD. Therefore, there is a lack of specific information about the treatment of asthma in smokers. The asthmatic smoker is a special phenotype with important therapeutic and prognostic clinical implications.

Conditions

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Bronchial Asthma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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smoker asthmatics

* Asthma control questionnaire (ACQ) score
* Spirometry
* Sputum cytology

using serum periostin and eotaxin-2 level

Intervention Type DIAGNOSTIC_TEST

collect serum sample from each group and detection of serum periostin and eotaxin-2 are using Eliza kits.

each group is divided into two groups (patients who are already using ICS and patients who do not use ICS) and we compare between to groups in airway hypersensitivity.

airway corticosteroid sensitivity

Intervention Type DIAGNOSTIC_TEST

each group is divided into two groups (patients who are already using inhaled corticosteroid ICS and patients who do not use ICS) and we compare between to groups in airway hypersensitivity.

non-smoker asthmatics

* Asthma control questionnaire (ACQ) score
* Spirometry
* Sputum cytology

using serum periostin and eotaxin-2 level

Intervention Type DIAGNOSTIC_TEST

collect serum sample from each group and detection of serum periostin and eotaxin-2 are using Eliza kits.

each group is divided into two groups (patients who are already using ICS and patients who do not use ICS) and we compare between to groups in airway hypersensitivity.

airway corticosteroid sensitivity

Intervention Type DIAGNOSTIC_TEST

each group is divided into two groups (patients who are already using inhaled corticosteroid ICS and patients who do not use ICS) and we compare between to groups in airway hypersensitivity.

Interventions

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using serum periostin and eotaxin-2 level

collect serum sample from each group and detection of serum periostin and eotaxin-2 are using Eliza kits.

each group is divided into two groups (patients who are already using ICS and patients who do not use ICS) and we compare between to groups in airway hypersensitivity.

Intervention Type DIAGNOSTIC_TEST

airway corticosteroid sensitivity

each group is divided into two groups (patients who are already using inhaled corticosteroid ICS and patients who do not use ICS) and we compare between to groups in airway hypersensitivity.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Stable asthmatic patients (however smokers, or non-smokers) will be included (stable asthmatic defined as no emergency clinic or hospital visit, oral corticosteroid prescription, or change in asthma treatment in the past month) and (Current smoking was defined as 5 or more cigarettes per day and a smoking history of 5 pack years or greater).
2. Treatment with long-acting b2-agonists, and leukotriene receptor antagonists was allowed.

Exclusion Criteria

1. Acute severe asthma.
2. Causes of airway obstruction other than asthma as COPD patients, bronchiectasis……etc.
3. Age \<18 and \>45 years old.
4. Body mass index \>35.
5. Requirement for treatment with or the presence of conditions likely to be exacerbated by oral corticosteroids
6. The intention to stop smoking. Eligibility for the study required demonstration of reversible airflow obstruction (FEV1 bronchodilator response to b2 agonist of \>12% \[and \>200 mL\]) or a positive methacholine test result. All lung function assessments met relevant international consensus guidelines.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Safaa Abd El-gayed Eid

principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Safaa A Eid, master

Role: PRINCIPAL_INVESTIGATOR

Assiut University

Locations

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Assuit University Hospital

Asyut, , Egypt

Site Status

Countries

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Egypt

References

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Reference Type BACKGROUND
PMID: 15486340 (View on PubMed)

Lange P, Scharling H, Ulrik CS, Vestbo J. Inhaled corticosteroids and decline of lung function in community residents with asthma. Thorax. 2006 Feb;61(2):100-4. doi: 10.1136/thx.2004.037978.

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O'Byrne PM, Lamm CJ, Busse WW, Tan WC, Pedersen S; START Investigators Group. The effects of inhaled budesonide on lung function in smokers and nonsmokers with mild persistent asthma. Chest. 2009 Dec;136(6):1514-1520. doi: 10.1378/chest.09-1049. Epub 2009 Aug 26.

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Chatkin JM, Dullius CR. The management of asthmatic smokers. Asthma Res Pract. 2016 Jun 20;2:10. doi: 10.1186/s40733-016-0025-7. eCollection 2016.

Reference Type BACKGROUND
PMID: 27965778 (View on PubMed)

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Mathe G, Santelli G, Gouveia J, Lemaigre G, Misset JL, Gros F, Homasson JP, Kim B, Sudre MC, Gaget H. Correlation of bronchial epidermoid metaplasia with level of tobacco consumption in heavy smokers. Cancer Detect Prev. 1986;9(1-2):79-81.

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Niewoehner DE, Kleinerman J, Rice DB. Pathologic changes in the peripheral airways of young cigarette smokers. N Engl J Med. 1974 Oct 10;291(15):755-8. doi: 10.1056/NEJM197410102911503. No abstract available.

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McSharry C, Spears M, Chaudhuri R, Cameron EJ, Husi H, Thomson NC. Increased sputum endotoxin levels are associated with an impaired lung function response to oral steroids in asthmatic patients. J Allergy Clin Immunol. 2014 Nov;134(5):1068-75. doi: 10.1016/j.jaci.2014.08.022. Epub 2014 Sep 26.

Reference Type BACKGROUND
PMID: 25262463 (View on PubMed)

Decramer M, Louis R, Joos G, De Vuyst P, Mast B, Mehuys A; Pulmonary Advisory Board. (Ex-)smoking asthma patients in general and specialized Belgian practice. Respir Med. 2011 Aug;105(8):1203-10. doi: 10.1016/j.rmed.2011.02.017. Epub 2011 Mar 16.

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Cerveri I, Cazzoletti L, Corsico AG, Marcon A, Niniano R, Grosso A, Ronzoni V, Accordini S, Janson C, Pin I, Siroux V, de Marco R. The impact of cigarette smoking on asthma: a population-based international cohort study. Int Arch Allergy Immunol. 2012;158(2):175-83. doi: 10.1159/000330900. Epub 2012 Jan 26.

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Chaudhuri R, McSharry C, McCoard A, Livingston E, Hothersall E, Spears M, Lafferty J, Thomson NC. Role of symptoms and lung function in determining asthma control in smokers with asthma. Allergy. 2008 Jan;63(1):132-5. doi: 10.1111/j.1398-9995.2007.01538.x.

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Clatworthy J, Price D, Ryan D, Haughney J, Horne R. The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control. Prim Care Respir J. 2009 Dec;18(4):300-5. doi: 10.4104/pcrj.2009.00037.

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Chalmers GW, Macleod KJ, Little SA, Thomson LJ, McSharry CP, Thomson NC. Influence of cigarette smoking on inhaled corticosteroid treatment in mild asthma. Thorax. 2002 Mar;57(3):226-30. doi: 10.1136/thorax.57.3.226.

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Lazarus SC, Chinchilli VM, Rollings NJ, Boushey HA, Cherniack R, Craig TJ, Deykin A, DiMango E, Fish JE, Ford JG, Israel E, Kiley J, Kraft M, Lemanske RF Jr, Leone FT, Martin RJ, Pesola GR, Peters SP, Sorkness CA, Szefler SJ, Wechsler ME, Fahy JV; National Heart Lung and Blood Institute's Asthma Clinical Research Network. Smoking affects response to inhaled corticosteroids or leukotriene receptor antagonists in asthma. Am J Respir Crit Care Med. 2007 Apr 15;175(8):783-90. doi: 10.1164/rccm.200511-1746OC. Epub 2007 Jan 4.

Reference Type BACKGROUND
PMID: 17204725 (View on PubMed)

Other Identifiers

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IBBAAS

Identifier Type: -

Identifier Source: org_study_id

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