Tobacco Abuse Smoke Clinical Trial
Official title:
Effect of an Inhaled Glucocorticosteroid (ICS) on Endothelial Dysfunction in Cigarette Smokers
The hypothesis underlying the proposed study is that the blunted endothelium-dependent vasodilation seen in the airway of current smokers is also present in the brachial artery, and that the same inhaled corticosteroid (ICS) treatment regime that reversed endothelial function in the airway of current smokers will also restore endothelium-dependent relaxation in the brachial artery. Non-smokers will be used as controls and will not receive any intervention or treatment.
Cigarette smoking can lead to systemic endothelial dysfunction. Since the airway circulation
is exposed to a high concentration of cigarette smoke constituents, we reasoned that airway
vascular endothelial dysfunction could be present in healthy smokers without systemic
endothelial dysfunction.
The purpose of this study was to compare airway and systemic endothelial function and
measure markers of systemic inflammation in lung-healthy current smokers. Since endothelial
dysfunction in smokers has been related to systemic inflammation, we also investigated its
response to an inhaled glucocorticosteroid (ICS).
Vascular endothelial function was assessed in the airway by the airway blood-flow (Qaw)
response to inhaled albuterol (ΔQaw) and in the extrapulmonary circulation by brachial
arterial flow-mediated vasodilation (FMD). Venous blood was collected for C-reactive protein
and IL-6.
Qaw was measured with a noninvasive inhaled soluble gas uptake technique. The uptake of the
gas from the anatomical deadspace reflecting airways perfused by the airway circulation was
quantitated.
Qaw was express as μL/min normalized for anatomical deadspace: μL/min/mL.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator)
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