Novel Inflammatory Markers in Different Phenotypes of Severe Asthma

NCT ID: NCT04888910

Last Updated: 2021-05-21

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

Total Enrollment

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-03-01

Study Completion Date

2023-02-28

Brief Summary

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Asthma is a highly prevalent chronic airway inflammatory disease characterized by airway hyper-responsiveness, reversible airflow obstruction and increased mucus secretion, involving large and small airways. An emerging sub-phenotype of severe asthma is the late onset disease associated with nasal polyposis, a frequent co-morbidity that significantly impacts lung function and symptom control. On the basis of the infiltrate found in the sputum, asthma can be divided into four distinct phenotypes: eosinophilic, neutrophilic, mixed granulocytic and pauci-granulocytic. The majority of patients with eosinophilic asthma are sensitive to corticosteroids, and biological therapies targeting eosinophils (anti-Interleukin (IL)-5 and anti-IL5R) have been recently approved. However, it is known that some asthmatics, particularly those who have severe disease and are resistant to corticosteroids, have elevated neutrophil counts in the airway where they play a vital role in the exacerbation of the disease. However, the precise role of neutrophils in severe asthma and the mechanisms involved in neutrophil-induced tissue damage have not been clarified yet.

The hypothesis of the study is that neutrophils and eosinophils can contribute to the severity of asthma by changing their phenotypes according to the airway environment. Thus, a better understanding of the roles of neutrophils and eosinophils in severe asthma may lead to the identification of novel biomarkers and the development of new therapeutic approaches in different phenotypes of severe asthma.

Detailed Description

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Conditions

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Asthma Nasal Polyps

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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asthma with nasal polyps

severe asthma with involvement of the upper airways (chronic rhinosinusitis with nasal polyps)

observational

Intervention Type OTHER

observation of biomarkers in different asthma groups

severe asthma without nasal polyps

severe asthma without involvement of the upper airways

observational

Intervention Type OTHER

observation of biomarkers in different asthma groups

Interventions

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observational

observation of biomarkers in different asthma groups

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Male or female
* age (18-65 years)
* Diagnosis of severe asthma according to the European Respiratory Society (ERS) and American Thoracic Society (ATS) definition, with and without nasal symptoms
* normal pulmonary function post-therapy (FEV1 post-bronchodilation: greater than 80% of the predicted value, with FEV1/ vital capacity (VC) \> 88-89% - for males and females, respectively - of the predicted value)
* non reversible chronic airflow limitation (FEV1 post-bronchodilation: lower than 70% of the predicted value, with FEV1/VC \< 88-89% of the predicted value)
* Signing of the informed consent

Exclusion Criteria

* Referred Pregnancy
* Use of therapy with beta-blockers
* Smoking (current or within the previous 3 months)
* Negation to participate to the study
* Current upper and lower airways infectious diseases
* Current systemic infectious diseases
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Pisa

OTHER

Sponsor Role lead

Responsible Party

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Ilaria Puxeddu

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Pisa University

Pisa, Tuscany, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Ilaria Puxeddu, MD, PhD

Role: CONTACT

+393394740912

Facility Contacts

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Ilaria Puxeddu, MD, PhD

Role: primary

+393394740912

References

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Wu W, Bleecker E, Moore W, Busse WW, Castro M, Chung KF, Calhoun WJ, Erzurum S, Gaston B, Israel E, Curran-Everett D, Wenzel SE. Unsupervised phenotyping of Severe Asthma Research Program participants using expanded lung data. J Allergy Clin Immunol. 2014 May;133(5):1280-8. doi: 10.1016/j.jaci.2013.11.042. Epub 2014 Feb 28.

Reference Type RESULT
PMID: 24589344 (View on PubMed)

Wenzel SE, Jayawardena S, Graham NM, Pirozzi G, Teper A. Severe asthma and asthma-chronic obstructive pulmonary disease syndrome - Authors' reply. Lancet. 2016 Dec 3;388(10061):2742. doi: 10.1016/S0140-6736(16)31720-2. Epub 2016 Dec 2. No abstract available.

Reference Type RESULT
PMID: 27924776 (View on PubMed)

Ray A, Kolls JK. Neutrophilic Inflammation in Asthma and Association with Disease Severity. Trends Immunol. 2017 Dec;38(12):942-954. doi: 10.1016/j.it.2017.07.003. Epub 2017 Aug 4.

Reference Type RESULT
PMID: 28784414 (View on PubMed)

Other Identifiers

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NIMISA

Identifier Type: -

Identifier Source: org_study_id

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