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Sponsors and Collaborators: |
National Institute of Environmental Health Sciences (NIEHS) National Center for Research Resources (NCRR) |
Information provided by: | National Institute of Environmental Health Sciences (NIEHS) |
ClinicalTrials.gov Identifier: | NCT00018096 |
In this project, we hypothesize that polymorphisms of genes expressed by the airway epithelia in asthmatics following specific airway challenges predispose individuals to the development of asthma. To test this hypothesis, we identify the genes that are differentially expressed by airway epithelial cells following challenge with stimuli that induce acquired (house dust mite) or innate (LPS) immune responses, and then determine whether polymorphisms in these genes are associated with the development of asthma in a separate, well characterized, familial cohort of asthmatics. This is a powerful approach that is designed to identify novel genes that are associated with both asthma pathogenesis (differentially expressed in the exposure-response study) and asthma susceptibility (genetically associated with asthma in a linkage/association study).
Condition | Intervention |
Asthma |
Biological: LPS endotoxin, saline, HDM |
MedlinePlus related topics: | Asthma |
Drug Information available for: | Sodium chloride |
Study Type: | Interventional |
Study Design: | Basic Science, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety Study |
Official Title: | The Genetics of Environmental Asthma |
Enrollment: | 176 |
Study Start Date: | June 2001 |
Study Completion Date: | December 2007 |
Primary Completion Date: | December 2007 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
bronchoscopy: Experimental
2 bronchoscopies 4 hours apart; The first to instill the 3 experimental biologic agents in separate airways (HDM, LPS and saline-placebo), the second to perform BAL and brush biopsies 4 hours later in the same airways.
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Biological: LPS endotoxin, saline, HDM
instillation of interventional products during bronchoscopy each down a different airway, each subject acts as their own control.
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The overall goal of this project is to identify genes that are involved in the development of airflow obstruction and airway inflammation in asthmatics, and to determine whether polymorphisms in these differentially expressed genes predispose individuals to develop asthma. Asthma is a complex genetic disorder that is caused by a number of unique gene-gene and gene-environment interactions. The search for asthma susceptibility genes has been complicated by the broad clinical phenotype of asthma, the polygenic inheritance pattern of this disease, and the substantial role of environmental exposures in the development and progression of asthma. Inhaled environmental agents induce several biologic responses in asthmatics; including the induction of acquired and innate immunity that leads to acute and chronic forms of airway inflammation and airway remodeling. Acquired immune responses to protein antigens, such as house dust mite allergen, often induce type 2 T lymphocyte-driven responses (Th2) which appear to be important in atopic asthma. Recent studies by our group and others demonstrate that innate immunity, initiated by inhalation of bacterial and viral pathogens, organic dusts, endotoxin or lipopolysaccharide (LPS), air pollution particulate matter, and ozone, can also cause acute and chronic forms of airflow obstruction, airway inflammation, and even airway remodeling. Emerging evidence indicates that both acquired and innate immune responses in the lung may be influenced by polymorphic genes. For instance, functional polymorphisms in the IL-4 receptor gene are thought to preferentially stimulate acquired Th2 immune responses to inhaled allergens, and we have recently shown that common co-segregating mutations in TLR4 (a transmembrane receptor for LPS) are associated with diminished airway responsiveness to inhaled LPS. These observations suggest that environmental challenges can be used to narrow the phenotype of asthma and investigate genetic susceptibility in biologically specific forms of asthma.
Ages Eligible for Study: | 18 Years to 40 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Exclusion Criteria:
United States, North Carolina | |||||
Duke University Medical Center | |||||
Durham, North Carolina, United States, 27710 |
National Institute of Environmental Health Sciences (NIEHS) |
National Center for Research Resources (NCRR) |
Principal Investigator: | Sundy S. Sundy, MD. PhD. | Duke University |
Responsible Party: | Duke University Medical Center ( John S. Sundy M.D., PhD. ) |
Study ID Numbers: | NCRR-M01RR00030-0183, 2357 |
First Received: | July 2, 2001 |
Last Updated: | May 5, 2008 |
ClinicalTrials.gov Identifier: | NCT00018096 |
Health Authority: | United States: Federal Government; United States: Institutional Review Board; United States: Food and Drug Administration |
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