Allergies Clinical Trial
Official title:
Effect of Exposure to Allergens and Air Pollution on Lung Function and Immunity
The investigators are investigating the effects of combined exposures to diesel exhaust and allergens on lung function and on the immune system. After exposing individuals to either filtered air or carefully controlled levels of diesel exhaust in our exposure chamber, The investigators will use a procedure called bronchoscopy (whereby a thin, flexible tube is passed down the throat and into the lungs) to place a small amount of allergen directly in the lung. 48h later, the bronchoscopy will be repeated so that samples can be collected from the lungs. After 1mo, the entire procedure will be repeated with the alternate exposure.
1. Purpose/Objective:
To study the effects of diesel exhaust particles on lung function and on allergic
responses.
2. Hypotheses:
Hypothesis 1: DE exposure augments systemic oxidative stress from allergen challenge in
allergen-sensitized individuals.
Hypothesis 2: DE exposure augments allergen-specific immune response in
allergen-challenged airways in sensitized individuals. These responses will be greater
in asthmatic individuals than in non-asthmatics.
3. Justification:
The use of diesel engines is increasing because they are more fuel-efficient than
gasoline engines. However, diesel engines produce different emissions than gasoline
engines. Diesel exhaust is emitted from the tailpipe of both "on-road" diesel engine
vehicles (diesel cars, buses and trucks) and "non-road" diesel engines (locomotives,
marine vessels and some construction equipment). Diesel exhaust consists of both gaseous
and particulate air pollutants. Since people with asthma and allergic diseases appear to
be sensitive to air pollution, we would like to know how diesel exhaust (DE) can affects
your respiratory and immune systems. We are expecting that any responses that may occur
will only be detectable through careful examination of cells and tissues (e.g.,
bronchoalveolar lavage (fluid from your lungs), blood, urine). Understanding these
potentially subtle changes will help us prevent health problems associated with air
pollution in the future.
4. Research Method:
This is a blinded crossover experiment between two conditions (DE or filtered air, FA),
randomized and counter-balanced to order. Data collection for each condition will be
separated by a 4-week washout period.
Following each exposure, The investigators will use bronchoscopy (performed at the Vancouver
General Hospital Endoscopy Suite) to deliver a diluent-controlled segmental allergen
challenge (SAC). 24 h post-SAC, airway reactivity will be assessed with a methacholine
challenge. 48 h post-SAC, bronchoalveolar lavage (BAL), airway brushes and tissue biopsies
will be obtained in the same regions for analysis of immune activation. Nasal lavage samples
will also be collected to examine responses in the upper airways and blood and urine will be
studied to examine systemic responses. Spirometry and methacholine challenge will be used to
assess effects on airway function
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