Asthma Clinical Trial
Official title:
Effects of Green Tea Extract (GTE) on Systemic Oxidative and Antioxidative Status in Chinese Patients With Stable Asthma
Asthma is a disease characterized by chronic inflammation in the airways. Recent research
has demonstrated that one of the reasons for the chronic inflammatory state is an imbalance
between oxidative stress and antioxidative defenses in patients with asthma.
Green tea is a common beverage consumed by Chinese patients from all walks of life. Green
tea contains chemical components that are thought to have immunomodulatory actions in
chronic inflammation.
The investigators propose to recruit 35 patients with stable asthma. Recruited subject will
be given oral tablets containing Green tea extract (GTE) to be taken daily for three months.
Clinical follow up and assessment will be done at baseline, on completion of GTE intake at
three months, and at three months after GTE intake has been stopped. A questionnaire on
their health status and the frequency of symptoms and use of bronchodilators and inhaled
steroids will be completed, spirometry will be done and a venous blood sample will be taken
during recruitment and during each reassessment at 3 and 6 months. Measurement of
oxidants/antioxidants (GSH, GSSG, SOD, CAT and GPx) will be carried out on the blood
samples. Oxidants/antioxidants will be compared and correlated with lung function results.
This study would provide us with pilot data as to whether GTE, a strong antioxidant with
immunomodulatory actions, has any effect on reducing the oxidative stress and improving the
antioxidant status in patients with asthma and whether these changes are accompanied
improvement in clinical status.
Hypothesis Green tea extract (GTE) reduces oxidative stress and improves antioxidant
defenses in Chinese patients with asthma
1. Background
Asthma constitutes a significant health problem both in Hong Kong and worldwide (1).
Different risk factors for asthma have been identified. These include atopy (2), family
history of asthma, exposure to indoor aeroallergens (3) air pollution (4) and exposure
to environmental tobacco smoke (5).
Asthma is associated with a chronic inflammatory state in the airway. The inflammatory
component is thought to result from an imbalance between an increased free radical
formation (oxidative stress) and a reduction of antioxidative defenses. Reactive oxygen
species (ROS) such as superoxide radicals and hydrogen peroxide were found to be
increased in patients with asthma indicating the presence of oxidative stress, and the
increased level of ROS has also been found to correlate with asthma severity (6).
The airway displays a wide range of enzymatic and non-enzymatic antioxidant defenses,
including reduced glutathione (GSH), superoxide dismutase (SOD), catalase and
glutathione peroxidase (GPx). There is evidence of reduced antioxidant defenses, namely
GPx and SOD activity, in asthma patients (6). Furthermore, the measurement of the
oxidized form of glutathione, (glutathione disulfide, GSSG) could be used as an index
to reflect the degree of oxidative stress in asthma and the level of GSSG has been
reported to be high in the bronchial washings of asthma patients (7). We have reported
that patients with asthma showed significantly increased erythrocyte GSSG, SOD and
catalase activities with concomitant reduction of erythrocyte GPx (8). These results
indicate a state of increased oxidative stress accompanied by an altered state of
systemic antioxidant status in asthma patients.
Green tea represents one of the common beverages consumed by people from all walks of
life. Epigallocatechin gallate (EGCG) is the major polyphenol (catechin) in green tea.
Green tea extract (GTE) demonstrates anti-inflammatory and immunomodulatory activities.
GTE has been shown to damp down neutrophil chemotaxis and attenuates
interleukin-mediated inflammatory reaction cascades (9). It has also been shown to
attenuate lung injury in experimental mouse model (10).
This proposal is to investigate the effects of GTE on systemic oxidative and
antioxidative status, and whether these changes are associated with changes in clinical
status in local Chinese patients with stable asthma.
2. Research plan and methodology
Aims of the study
1. To determine and compare erythrocyte levels of GSSG, SOD, CAT and GPx in patients with
asthma after 3 months of treatment with GTE and after GTE has been stopped for an
equivalent period.
2. To determine and compare plasma levels of inflammatory marker C-reactive protein (CRP)
and inflammatory mediators, interleukin-6 (IL-6) and IL-8 in these patients.
Study design This is an intervention study with patients serving as their own control
Material and Methods Patients
The investigators propose to recruit out-patients with asthma in stable clinical condition
and have no acute asthmatic attack in the recent 3 months prior to recruitment. After
initial assessment, recruited patients will be given GTE to be taken three times a day for 3
months. They will be reassessed at 3 months when GTE will be stopped and again at the end of
6 months. The clinical status and biochemical parameters when they are on GTE will be
compared with similar parameters when they are not on GTE.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
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