Target Validation and Discovery in Idiopathic Bronchiectasis

NCT ID: NCT03750734

Last Updated: 2022-04-04

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 13 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-09-10
• Study Completion Date: 2021-08-09

Brief Summary

Bronchiectasis is a long-term lung condition where the airways become abnormally enlarged, leading to a build-up of mucus and inflammation that makes the lungs more susceptible to recurrent infection. Patients with bronchiectasis have subtle abnormalities in the way their airway cells respond to infection that are, in part, responsible for the development of their condition. At present there are no licensed treatments for bronchiectasis.

This study will aim to characterise in depth some of these abnormalities with a view to future studies that will try to develop treatments that can directly target those abnormalities at a molecular level.

Patients known to have bronchiectasis who have provided written informed consent will be enrolled alongside healthy volunteers and patients with chronic obstructive pulmonary disease and cystic fibrosis, for comparison. Participants will give a blood sample and have a bronchoscopy. This is a thin telescopic tube, passed through the nose or mouth, under sedation, into the airways that will allow a sample of bronchial epithelial cells to be taken.

The main objective of the study is to achieve a greater understanding of some of the key biological processes/pathways and disease marker genes that play a role in the development of bronchiectasis. This is important because, at present, little is known about the underlying disease mechanisms and there are no licensed treatments for bronchiectasis.

The investigator's hope this in-depth characterisation of specific bronchial epithelial cell abnormalities in bronchiectasis will shed light on novel targets for future drug discovery.

Conditions

Bronchiectasis; Idiopathic Bronchiectasis

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Idiopathic bronchiectasis

Idiopathic bronchiectasis participants

Bronchoscopy

Intervention Type: DIAGNOSTIC_TEST

Flexible bronchoscopy will be performed under sedation (typically a sedative such as intravenous midazolam and/or fentanyl) with local anaesthetic to the throat and vocal cords. Bronchial epithelial tissue (via bronchial brushing and biopsy forceps) and bronchial lavage samples will be taken for analysis.

Blood test

Intervention Type: DIAGNOSTIC_TEST

Peripheral blood will be taken to collect peripheral blood monocytes, which will then allow the production of induced pluripotent stem cell derived bronchial epithelial tissues.

Healthy volunteers

Healthy volunteers

Bronchoscopy

Intervention Type: DIAGNOSTIC_TEST

Flexible bronchoscopy will be performed under sedation (typically a sedative such as intravenous midazolam and/or fentanyl) with local anaesthetic to the throat and vocal cords. Bronchial epithelial tissue (via bronchial brushing and biopsy forceps) and bronchial lavage samples will be taken for analysis.

Blood test

Intervention Type: DIAGNOSTIC_TEST

Peripheral blood will be taken to collect peripheral blood monocytes, which will then allow the production of induced pluripotent stem cell derived bronchial epithelial tissues.

Interventions

Bronchoscopy

Flexible bronchoscopy will be performed under sedation (typically a sedative such as intravenous midazolam and/or fentanyl) with local anaesthetic to the throat and vocal cords. Bronchial epithelial tissue (via bronchial brushing and biopsy forceps) and bronchial lavage samples will be taken for analysis.

Intervention Type: DIAGNOSTIC_TEST

Blood test

Peripheral blood will be taken to collect peripheral blood monocytes, which will then allow the production of induced pluripotent stem cell derived bronchial epithelial tissues.

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

Inclusion Criteria

Bronchiectasis participants

1. Confirmed HRCT diagnosis of bronchiectasis in more than 1 lobe

2. Bronchiectasis not attributable to another cause, e.g. cystic fibrosis/ABPA/PCD

3. Absence of significant emphysema, COPD or asthma

4. Have provided written informed consent that they are willing to participate in the study prior to sample collection

COPD participants (disease controls)

1. Confirmed diagnosis of COPD according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria (FEV1/FVC ratio < 0.70)

2. Absence of significant bronchiectasis on HRCT

3. Have provided written informed consent that they are willing to participate in the study prior to sample collection

Cystic fibrosis participants (disease controls)

1. Have a confirmed diagnosis of cystic fibrosis

2. Have provided written informed consent that they are willing to participate in the study prior to sample collection

Healthy controls

1. No history or diagnosis of clinically significant lung disease

2. Be a non-smoker for > 1 year at screening and have < 5 pack year history of smoking

3. Have provided written informed consent that they are willing to participate in the study prior to sample collection

Exclusion Criteria

1. Any clinically significant acute illness, including recent exacerbation of lung disease requiring treatment with oral or intravenous antibiotics, in 6 weeks prior to screening

2. Any contraindication to safe bronchoscopy as judged by CI or clinical team (FEV1 < 30% predicted, oxygen saturations < 92% on room air etc.)

3. Any clinically significant bleeding disorder or use of anticoagulant/antiplatelet therapy that could place participants at risk of bleeding

4. Any contraindication to sedation or local anaesthetic medications used for bronchoscopy

5. Current smoking within 6 months prior to screening (defined as someone who has smoked at least one cigarette per day (or pipe, cigar, or cannabis) for ≥ 30 days within 6 months prior to screening)

6. Acute MI, acute stroke or major surgery within 6 months prior to screening

7. History of uncontrolled ischaemic heart disease that place participants at risk during bronchoscopy

8. History of ventilatory failure or hypercapnia that may complicate bronchoscopy

9. Any known active tuberculous or non-tuberculous mycobacterial infection

10. Any use of oral corticosteroids within 4 weeks of screening

11. Any systemic immunomodulatory or immunosuppressive therapy within 3 months of screening

12. Known current malignancy or current evaluation for a potential malignancy

13. Any other clinically significant medical disease that is uncontrolled despite treatment, that is likely, in the opinion of the investigators, to impact the patient's ability to safely participate in the study

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

GlaxoSmithKline

INDUSTRY

Sponsor Role: collaborator

Papworth Hospital NHS Foundation Trust

OTHER_GOV

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Dr W Flowers

Role: PRINCIPAL_INVESTIGATOR

Royal Papworth Hospital

Locations

Royal Papworth Hospital

Cambridge, , United Kingdom

Countries

United Kingdom

Other Identifiers

P02437

Identifier Type: -

Identifier Source: org_study_id