Systemic Inflammation in Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease Clinical Trial

Official title:

Acute and Chronic Inflammatory Responses Induced by Smoking in Individuals Being Susceptible and Non-Susceptible for Development of COPD: From Specific Disease Phenotyping Towards Novel Therapy (Study 2).

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT00850863
• Other study ID #: 23437
• Status: Recruiting
• Phase: N/A
• First received: February 24, 2009
• Last updated: February 24, 2009
• Start date: February 2009
• Est. completion date: January 2015

Study information

• Verified date: February 2009
• Source: Top Institute Pharma
• Contact: Leo Koenderman, Dr. Prof.
• Phone: +31 88 7557255
• Email: l.koenderman[@]umcutrecht.nl
• Is FDA regulated: No
• Health authority: Netherlands: Medical Ethics Review Committee (METC)
• Study type: Observational

Clinical Trial Summary

COPD is ranked number 3 by the WHO list of important diseases worldwide and is the only disease with increasing mortality. The pathogenesis of cigarette smoke-induced COPD is obscure, therefore more insight is needed to design effective anti-inflammatory agents. Recently it has become clear that cigarette smoke-induced inflammation is not only present in the lungs but also in the blood, and that this systemic inflammation has important consequences for the clinical expression of COPD. The investigators hypothesize that healthy individuals who are susceptible to cigarette smoking demonstrate a higher and aberrant systemic inflammatory response to cigarette smoke. This susceptibility is caused by heterogeneous factors and is associated with various polymorphic genes that interact with each other and with the environment.

Objective:

• To study systemic inflammation in individuals who are or are not susceptible to develop COPD.

• To characterize the switch to chronicity of the systemic inflmmatory response in COPD

• To determine whether the type and severity of the systemic inflammation contributes to the clinical outcome of COPD

• To compare between subjects who are or are not susceptible to develop COPD in peripheral blood, the corticosteroid responsiveness in vitro, and to unravel underlying mechanisms.

• To study the role of candidate genes that may play a role in the development of fixed airway obstruction, and to identify clues for patient's responsiveness to specific drugs

• To develop new biological and clinical markers for the early diagnosis and monitoring of COPD

• To define possible mediators involved in the early induction of COPD in susceptible smokers, and to define new drug targets

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 240
• Est. completion date: January 2015
• Est. primary completion date: January 2013
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

Age =18 and =75 years

• Age, pack years, FEV1/FVC and FEV1% predicted must fit in one of the 9 groups of the study population

• Physically and mentally able to undergo the total study protocol

• Written informed consent

Exclusion Criteria:

• Participation in another study

• Alpha-1-antitrypsin deficiency

• Selected grade 1-3 co-morbidity listed in the ACE-27

• Active pulmonary infection like tuberculosis, pneumonia, flue, tracheobronchitis

• Active extra-pulmonary infection like hepatitis A-C, cystitis, gastro-enteritis etc

• Pulmonary diseases like sarcoidosis, pulmonary fibrosis, silicosis, hypersensitivity pneumonitis, asthma

• Life threatening diseases like carcinoma, AIDS (including HIV+), acute leukaemia etc

• Medication that may affect the results of the study: NSAID's, immunosuppressive agents like prednisolon, metotrexate, azathioprine

Study Design

Observational Model: Case Control, Time Perspective: Prospective

Related Conditions & MeSH terms

• Chronic Obstructive Pulmonary Disease
• Lung Diseases
• Lung Diseases, Obstructive
• Pulmonary Disease, Chronic Obstructive

Locations

Country	Name	City	State
Netherlands	University Medical Center Utrecht	Utrecht

Sponsors (6)

Lead Sponsor	Collaborator
Top Institute Pharma	Academisch Ziekenhuis Maastricht, GlaxoSmithKline, Nycomed, UMC Utrecht, University Medical Center Groningen

Country where clinical trial is conducted

Netherlands, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Systemic inflammation assessed by measurement of expression of established and newly developed markers on innate immune cells; genomic and proteomic analysis of innate immune cells and measurement of pro- and anti-inflammatory cytokines in plasma/serum		4 years	No
Secondary	Extensive clinical characterisation of: a) young healthy individuals with low number of pack years who have a high and low familial risk to develop COPD; b) older individuals with higher number of pack years with either a normal lung function or COPD.		4 years	No
Secondary	Important clinical endpoints include symptoms, lung function, Bode-index, CT-scanning of the lung.		4 years	No
Secondary	Distribution of candidate genes (SNPs) for COPD between the different groups and relations with systemic inflammation.		4 years	No