AsthmaNCT00001408
Role of T-Cells in Asthma
An observational study of Asthma, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in United States.
Trial summary
This study will examine the movement of T cells (a type of white blood cell) from the blood to the lungs in patients with asthma after exposure to an allergen, such as cat dander or pollen. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Asthma
- How many people
- 250 participants
- Where
- 1 siteUnited States
- Study dates
- 14 Sep 1994to 1 Oct 1995
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18-65.
- Asthma of greater than one year duration.
- Willingness to adhere to effective contraception in women of child bearing age.
- Negative HIV test.
- Age 18-65.
- Willingness to adhere to effective contraception in women of child bearing age.
Show all 10Show fewer
- Negative HIV test.
- Age 18-65.
- Asthma as diagnosed by a physician or use of medications consistent with the treatment of asthma.
- Subjects must have a doctor outside NIH and they will provide routine and emergency care.
Who cannot join
- For blood draws of greater than 100 ml, a hemoglobin of less than 12.5 g/dl. For blood draws of 100 ml or less, performed less frequently than every 56 days, a hemoglobin of less than 10.0 g/dl.
- Current pregnancy.
- Medical history suggesting lung diseases other than asthma.
- History of immunodeficiency or HIV infection.
- For blood draws of greater than 100 ml, a hemoglobin of less than 12.5 g/dl. For blood draws of 100 ml or less, performed less frequently than every 56 days, a hemoglobin of less than 10.0 g/dl.
- Current pregnancy.
Show all 19Show fewer
- Positive skin test to one or more allergens in the battery tested.
- History of asthma or other allergic diseases, such as hay fever.
- Medical history suggesting lung diseases other than asthma.
- History of immunodeficiency or HIV infection.
- History of immunodeficiency or HIV infection.
- History of allergy to latex.
- INCLUSION CRITERIA - EXHALED BREATH CONDENSATE/HEALTHY CONTROL:
- Age 18 - 65.
- EXCLUSION CRITERIA - EXHALED BREATH CONDENSATE/HEALTHY CONTROL:
- History of asthma or other allergic diseases, such as allergic rhinitis.
- Medical history suggesting lung diseases other than asthma.
- History of allergy to latex.
- History of immunodeficiency or HIV infection.
Trial locations and contacts
1 site in 1 country.
United States1 site
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, 20892
About this study
Official title: Cytokine Expression in Allergic Asthma
This study will examine the movement of T cells (a type of white blood cell) from the blood to the lungs in patients with asthma after exposure to an allergen, such as cat dander or pollen. Asthma is in large part due to inflammation of the bronchi (the breathing tubes of the lungs), causing heat, swelling and redness. T cells play a major role in the inflammatory reaction. A better understanding of T cell migration to the lungs after allergen exposure may lead to improved therapies for asthma.
Patients between 18 and 50 years of age with mild allergic asthma may be eligible for this study. In addition, patients and healthy normal volunteers between 18 and 65 years of age may participate in a sub-study (blood draw) of this protocol. Participants will undergo the following procedures:
Read more
Visit 1 (screening visit)
- Blood tests for blood counts and HIV
- Urine pregnancy test for women of childbearing potential.
Visit 2
- Physical examination and electrocardiogram (EKG)
- Prick skin testing - A drop of allergen extract is put on the skin and the underlying skin is scratched with a needle. A positive test resembles an insect bite and may itch.
- Intradermal skin tests - Increasing concentrations of a drop of diluted allergen are injected into the skin and the allergic response is monitored until a 5-mm swelling (1/4 inch) swelling develops.
- Methacholine challenge - The subject has repeated pulmonary function (breathing) tests after breathing methacholine, a drug that temporarily (for 5 to 10 minutes) worsens asthma symptoms.
- Physician evaluation and repeat pulmonary function test
Visit 3
- Allergen bronchoprovocation - This test will be done in patients whose physical evaluation and breathing test permit them to continue with the study. A heparin lock (needle device that stays in a vein to allow multiple blood draws without repeated sticks) is placed. The subject breathes 5 breaths of allergen through a nebulizer (device that creates a mist), followed by a breathing test. This procedure will be repeated with increasingly higher allergen doses until lung function significantly declines or for a maximum of 6 doses. Subjects are monitored for 8 hours after the last dose. Blood samples of 50 ml each (3.5 tablespoons) are collected at 1, 3, 5 and 8 hours, and a physician evaluation is done at the end of the 8 hours. Additional 50-mm blood samples are collected the following two mornings.
Visit 4
- Physician evaluation, blood test for anemia and pulmonary function test
- Serial blood draws - 50 ml of blood will be drawn, followed by salt-water nebulization and another 50-ml blood draw after 1 hour. Additional 50-ml blood samples will be drawn 7 hours later and then on the next two mornings.
Participants in the sub-study portion of this protocol will undergo the screening blood test, prick skin testing, breathing test after methacholine inhalation and a 100 ml-blood draw. These tests will be done in three sessions.
Read the detailed description
In the last 10 years it has become generally accepted that asthma is an inflammatory disease of the airways. T lymphocytes play a key role in regulating this inflammatory response, through the elaboration of cytokines such as IL-4, IL-5, and IFN-gamma. IL-5 is of particular interest because it is the major eosinophil survival factor in vivo. Eosinophils are felt to be the major effector cells in asthma, causing damage to various airway structures.
The pulmonary late phase response, a worsening of airflow seen 4-8 hours after allergen inhalation, is associated with many of the inflammatory changes seen in chronic asthma. Current studies suggest that during the late phase response peripheral blood T cells traffic to the lungs and express cytokines, specifically IL-4 and IL-5.
We propose to investigate this trafficking by determining the frequencies and phenotype of cells capable of producing the above cytokines in the peripheral blood in subjects with mild allergic asthma. These studies should lead to a clearer understanding of the cells and processes that lead to T cell trafficking to the lung and may yield a tool to evaluate the proposed anti-inflammatory therapies for asthma.
- Conditions
- Asthma
- Keywords
- Lymphocytes, Asthma, Cytokines, Interleukin-5, Late Phase Response
- Medical subject headings
- Asthma
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Nov 1999 (estimated)
- Study start14 Sep 1994
- Primary completion1 Oct 1995
- Study completion1 Oct 1995
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for AsthmaStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Enrolment
- 250 participants
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00001408
- Sponsor's protocol ID
- 940203
- Other IDs
- 94-I-0203
- Status last verified
- 25 Jun 2009
- First submitted
- 3 Nov 1999
- Last updated
- 2 Jul 2017
- Results posted
- No
Publications
Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute. National Asthma Education Program. Expert Panel Report. J Allergy Clin Immunol. 1991 Sep;88(3 Pt 2):425-534. No abstract available.
PubMed 1890276Robinson D, Hamid Q, Bentley A, Ying S, Kay AB, Durham SR. Activation of CD4+ T cells, increased TH2-type cytokine mRNA expression, and eosinophil recruitment in bronchoalveolar lavage after allergen inhalation challenge in patients with atopic asthma. J Allergy Clin Immunol. 1993 Aug;92(2):313-24. doi: 10.1016/0091-6749(93)90175-f.
PubMed 8349942Gerblich AA, Campbell AE, Schuyler MR. Changes in T-lymphocyte subpopulations after antigenic bronchial provocation in asthmatics. N Engl J Med. 1984 May 24;310(21):1349-52. doi: 10.1056/NEJM198405243102103.
PubMed 6232459
Study at a glance
From the registry record, last updated by the sponsor on 2 Jul 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Cytokine Expression in Allergic Asthma
- ClinicalTrials.gov ID
- NCT00001408
- Acronym / sponsor ID
- 940203
- Conditions
- Asthma
- Keywords
- Lymphocytes, Asthma, Cytokines, Interleukin-5, Late Phase Response
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 250 participants
- Lead sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)US National Institutes of Health
- Study start
- 14 Sep 1994
- Primary completion
- 1 Oct 1995 (actual)
- Study completion
- 1 Oct 1995 (actual)
- First posted
- 4 Nov 1999 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will examine the movement of T cells (a type of white blood cell) from the blood to the lungs in patients with asthma after exposure to an allergen, such as cat dander or pollen. Asthma is in large part due to inflammation of the bronchi (the breathing tubes of the lungs), causing heat, swelling and redness. T cells play a major role in the inflammatory reaction. A better understanding of T cell migration to the lungs after allergen exposure may lead to improved therapies for asthma.
Patients between 18 and 50 years of age with mild allergic asthma may be eligible for this study. In addition, patients and healthy normal volunteers between 18 and 65 years of age may participate in a sub-study (blood draw) of this protocol. Participants will undergo the following procedures:
Visit 1 (screening visit)
- Blood tests for blood counts and HIV
- Urine pregnancy test for women of childbearing potential.
Visit 2
- Physical examination and electrocardiogram (EKG)
- Prick skin testing - A drop of allergen extract is put on the skin and the underlying skin is scratched with a needle. A positive test resembles an insect bite and may itch.
- Intradermal skin tests - Increasing concentrations of a drop of diluted allergen are injected into the skin and the allergic response is monitored until a 5-mm swelling (1/4 inch) swelling develops.
- Methacholine challenge - The subject has repeated pulmonary function (breathing) tests after breathing methacholine, a drug that temporarily (for 5 to 10 minutes) worsens asthma symptoms.
- Physician evaluation and repeat pulmonary function test
Visit 3
- Allergen bronchoprovocation - This test will be done in patients whose physical evaluation and breathing test permit them to continue with the study. A heparin lock (needle device that stays in a vein to allow multiple blood draws without repeated sticks) is placed. The subject breathes 5 breaths of allergen through a nebulizer (device that creates a mist), followed by a breathing test. This procedure will be repeated with increasingly higher allergen doses until lung function significantly declines or for a maximum of 6 doses. Subjects are monitored for 8 hours after the last dose. Blood samples of 50 ml each (3.5 tablespoons) are collected at 1, 3, 5 and 8 hours, and a physician evaluation is done at the end of the 8 hours. Additional 50-mm blood samples are collected the following two mornings.
Visit 4
- Physician evaluation, blood test for anemia and pulmonary function test
- Serial blood draws - 50 ml of blood will be drawn, followed by salt-water nebulization and another 50-ml blood draw after 1 hour. Additional 50-ml blood samples will be drawn 7 hours later and then on the next two mornings.
Participants in the sub-study portion of this protocol will undergo the screening blood test, prick skin testing, breathing test after methacholine inhalation and a 100 ml-blood draw. These tests will be done in three sessions.
Detailed description
In the last 10 years it has become generally accepted that asthma is an inflammatory disease of the airways. T lymphocytes play a key role in regulating this inflammatory response, through the elaboration of cytokines such as IL-4, IL-5, and IFN-gamma. IL-5 is of particular interest because it is the major eosinophil survival factor in vivo. Eosinophils are felt to be the major effector cells in asthma, causing damage to various airway structures.
The pulmonary late phase response, a worsening of airflow seen 4-8 hours after allergen inhalation, is associated with many of the inflammatory changes seen in chronic asthma. Current studies suggest that during the late phase response peripheral blood T cells traffic to the lungs and express cytokines, specifically IL-4 and IL-5.
We propose to investigate this trafficking by determining the frequencies and phenotype of cells capable of producing the above cytokines in the peripheral blood in subjects with mild allergic asthma. These studies should lead to a clearer understanding of the cells and processes that lead to T cell trafficking to the lung and may yield a tool to evaluate the proposed anti-inflammatory therapies for asthma.
Study design
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Age 18-65.
- Asthma of greater than one year duration.
- Willingness to adhere to effective contraception in women of child bearing age.
- Negative HIV test.
- Age 18-65.
Key exclusion criteria (19 listed)
- For blood draws of greater than 100 ml, a hemoglobin of less than 12.5 g/dl. For blood draws of 100 ml or less, performed less frequently than every 56 days, a hemoglobin of less than 10.0 g/dl.
- Current pregnancy.
- Medical history suggesting lung diseases other than asthma.
- History of immunodeficiency or HIV infection.
- For blood draws of greater than 100 ml, a hemoglobin of less than 12.5 g/dl. For blood draws of 100 ml or less, performed less frequently than every 56 days, a hemoglobin of less than 10.0 g/dl.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jul 2017.
- Background: PubMed 1890276Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute. National Asthma Education Program. Expert Panel Report. J Allergy Clin Immunol. 1991 Sep;88(3 Pt 2):425-534. No abstract available.
- Background: PubMed 8349942Robinson D, Hamid Q, Bentley A, Ying S, Kay AB, Durham SR. Activation of CD4+ T cells, increased TH2-type cytokine mRNA expression, and eosinophil recruitment in bronchoalveolar lavage after allergen inhalation challenge in patients with atopic asthma. J Allergy Clin Immunol. 1993 Aug;92(2):313-24. doi: 10.1016/0091-6749(93)90175-f.
- Background: PubMed 6232459Gerblich AA, Campbell AE, Schuyler MR. Changes in T-lymphocyte subpopulations after antigenic bronchial provocation in asthmatics. N Engl J Med. 1984 May 24;310(21):1349-52. doi: 10.1056/NEJM198405243102103.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Asthma, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 2 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00001408, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jul 2017.