Mediator Release During Exercise-induced Bronchoconstriction

NCT ID: NCT03524053

Last Updated: 2019-01-29

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-01

Study Completion Date

2020-03-31

Brief Summary

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This study will compare the inflammatory response in induced vs inhibited exercise induced bronchoconstriction (EIB) in patients with a medical diagnosis of asthma/EIB. Urinary and plasma samples will be analysed to compare the mediator release in each condition, alongside changes in lung function.

Detailed Description

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Exercise induced-bronchoconstriction (EIB) is a transient narrowing of the airways that occurs during or shortly after strenuous exercise. The prevalence of EIB in asthmatic patients is estimated around 30-50%, but EIB can also occur in individuals without asthma (especially children, army recruit forces, and elite athletes). Controversy remains about the causative mediators in the bronchoconstrictive response. Technological advancement in mass spectrometry has opened new avenues in the quantitative measurement of small endogenous metabolites in biological fluids (including urine and blood), which may provide insights into the pathophysiology of EIB and direct future therapeutic targets.

Utilising novel techniques in the analysis of inflammatory mediators in urine and blood, this study aims to conduct the most comprehensive analysis of mediator release during EIB to date.

Participants will attend a screening visit during which they will complete an exercise challenge (to determine the presence of EIB). A skin prick test will also be conducted to establish the atopic status of the participants. Following the screening visit, patients with EIB will be invited to complete a randomised cross-over study, where they will perform two further exercise challenges on separate days: one while inhaling temperate dry air, and one while inhaling hot humid air (the latter is known to inhibit EIB). Lung function and breathing discomfort will be recorded, and urine and blood samples will be collected, before and at various time points after exercise. As a control condition, participants will also attend one visit during which no exercise will be performed.

Participants aged 18-50yr, with diagnosed asthma and/or EIB, will be included in the study. 12 participants will complete 4 visits (lasting between 90 min and 4.5h). The study will take place on Brunel University London campus, Uxbridge. Urine and blood samples will be sent to the Karolinska Institutet, Stockholm, Sweden for analysis.

Conditions

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Exercise Induced Asthma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Patients will undertake 3 separate conditions in a randomised order.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Exercise induced bronchoconstriction

An exercise challenge will then be performed according to international guidelines. The exercise will consist of 8 minutes of cycling on a cycle ergometer while breathing medical grade dry air from a reservoir (Douglas bag) via a two-way non-rebreathing valve. The workload will be increased progressively over the first 2 minutes, and will then be maintained for 6 minutes at a target workload (in Watts) of \[53.76 \* measured forced expiratory volume in 1 sec (FEV1)-11.07\].

Group Type EXPERIMENTAL

Exercise induced bronchoconstriction

Intervention Type OTHER

Participants will exercise whilst inhaling dry-air, this is known to exacerbate the bronchoconstrictive response.

Inhibited EIB

An exercise challenge will then be performed according to international guidelines. The exercise will consist of 8 minutes of cycling on a cycle ergometer while warm-humid air from a reservoir (Douglas bag) via a two-way non-rebreathing valve. The workload will be increased progressively over the first 2 minutes, and will then be maintained for 6 minutes at a target workload (in Watts) of \[53.76 \* measured forced expiratory volume in 1 sec (FEV1)-11.07\].

Group Type ACTIVE_COMPARATOR

Inhibited EIB

Intervention Type OTHER

Participants will perform the exercise-test whilst inhaling warm-humid air. This is known to inhibit the EIB response and will provide a direct comparison group for the EIB condition.

Control

Participants will attend the laboratory but no exercise trial will be performed.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Exercise induced bronchoconstriction

Participants will exercise whilst inhaling dry-air, this is known to exacerbate the bronchoconstrictive response.

Intervention Type OTHER

Inhibited EIB

Participants will perform the exercise-test whilst inhaling warm-humid air. This is known to inhibit the EIB response and will provide a direct comparison group for the EIB condition.

Intervention Type OTHER

Other Intervention Names

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Induced bronchoconstriction Exercise-control

Eligibility Criteria

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Inclusion Criteria

* Able to understand the study instructions
* Willing and able to give informed consent
* Aged 18-50yr
* Physician-diagnosed asthma and/or EIB
* Participants that demonstrate EIB at the screening visit (i.e., those who have a fall in FEV1 20% to 50%) will be eligible for the full study.

Exclusion Criteria

* Any chronic medical condition other than asthma or EIB
* Baseline FEV1 \<70% predicted
* Exacerbation of asthma or respiratory infection within the last 4 wk
* Individuals who have varied their inhaled corticosteroid medication within the last 4 wk
* History of anaphylaxis
* Current smokers
* Pregnancy
* History of cardiovascular disease
* Injury that would prevent exercise on a cycle ergometer
* Medical contraindication to perform strenuous exercise
* Required oral corticosteroids in the past 3 months
* Any blood borne disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Karolinska Institutet

OTHER

Sponsor Role collaborator

Brunel University

OTHER

Sponsor Role lead

Responsible Party

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Hannah Marshall

PhD Research Student

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hannah Marshall, MSc

Role: PRINCIPAL_INVESTIGATOR

Brunel University

Locations

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Brunel University London

Uxbridge, Middlesex, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Hannah Marshall, MSc

Role: CONTACT

+447584168742

Pascale Kippelen, PhD

Role: CONTACT

01895267649

Facility Contacts

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Hannah Marshall, MSc

Role: primary

+447584168742

Pascale Kippelen, PhD

Role: backup

01895267649

Other Identifiers

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8666

Identifier Type: -

Identifier Source: org_study_id

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