Sphingosine-1-phosphate in Asthma

Asthma Clinical Trial

Official title:

Does Sphingosine-1-phosphate Constrict Human Airways? In-vivo Challenge Pilot Study.

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04134351
• Other study ID #: 223069
• Status: Recruiting
• Phase: N/A
• Start date: February 4, 2020
• Est. completion date: February 22, 2022

Study information

• Verified date: July 2021
• Source: Guy's and St Thomas' NHS Foundation Trust
• Contact: Grzegorz Woszczek, MD, PhD
• Phone: +44 2071880597
• Email: grzegorz.woszczek[@]kcl.ac.uk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is being undertaken in order to enhance our understanding how human airways are being constricted in healthy people and in individuals with asthma. There is an unmet need for identification of new pathways (mediators) related to enhanced constriction of the asthmatic airways that would reveal new targets for therapy. Sphingosine-1-phosphate (S1P) is a naturally occurring bioactive lipid molecule that has been suggested to play an important role in asthma. Physiologically, S1P can be detected in human blood but local tissue concentrations (for example in the lung) are very low. Upon activation many cells can secrete S1P. Increased concentrations of S1P have been detected in airways of asthmatic subjects after allergen inhalation. When studied in animal models, S1P did not cause contraction of airways in healthy animals but contracted airways in animal with pulmonary inflammation. In laboratory experiments S1P has been shown to be a potent constrictor of cells responsible for contraction of human airways. As yet, however, we lack evidence that S1P actually causes constriction of airways in real life. Establishing S1P as a molecule capable of causing airway constriction in humans and perhaps specifically in asthmatics will have important implications for our understanding of physiological and pathophysiological responses in human airways and could open new windows for therapeutic strategies in diseases like asthma.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 12
• Est. completion date: February 22, 2022
• Est. primary completion date: February 22, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Cases (asthmatics) inclusion criteria

1. Physician diagnosed asthma, defined as a clear history of typical symptoms and clear reversibility of the PEF/FEV1 (12% or more) within the past year and/or methacholine PC20 < 8mg/ml.

Cases Exclusion criteria

1. Pregnancy or lactation

2. Moderate / Severe asthma (FEV1/PEF < 80%of the predicted value at screening)

3. Patients with any chronic illness other than asthma and other recognised atopic diseases (eczema, rhinitis) or any other abnormality which in the opinion of the principal investigator might compromise the study findings

4. A history of recent (within the past 4 weeks) upper or lower respiratory tract infection

5. Patients receiving oral, inhaled or parenteral glucocorticoid therapy (steroid) within the last 4 weeks, long acting relievers (salmeterol, formoterol) and antileukotrienes (montelukast) within last 72 hours.

6. Inadequate contraception in women of childbearing age

7. Inability to comprehend or comply with the protocol

Controls inclusion criteria

1. Lifelong absence of asthma symptoms and lung function within the normal range.

Controls exclusion criteria

1. Pregnancy or lactation

2. Patients with any chronic illness or any other abnormality which in the opinion of the principal investigator might compromise the study findings

3. A history of recent (within the past 4 weeks) upper or lower respiratory tract infection

4. Oral, inhaled or parenteral glucocorticoid therapy (steroid) within the last 4 weeks, long acting relievers (salmeterol, formoterol) and antileukotrienes (montelukast) within last 72 hours

5. Inadequate contraception in women of childbearing age

6. Inability to comprehend or comply with the protocol

Related Conditions & MeSH terms

• Asthma

Intervention

Other:
• Bronchial challenge test
Bronchial challenge test with sphingosine-1-phosphate

Locations

Country	Name	City	State
United Kingdom	Allergy Day Care Unite, Guy's Hospital	London

Sponsors (2)

Lead Sponsor	Collaborator
Guy's and St Thomas' NHS Foundation Trust	King's College London

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Bronchoconstriction	Bronchoconstriction in response to challenge measured by spirometry (FEV1)(PC20)	1 hour after challenge