Asthma Clinical Trial
Official title:
Optimising and Standardising Measurements of Inflammatory Markers in Exhaled Breath (EB) and Exhaled Breath Condensate (EBC)
Background: in various pediatric pulmonary diseases such as asthma, cystic fibrosis or
bronchopulmonary dysplasia an increased inflammation is present. Measuring this inflammation
is often hardly possible and requires invasive techniques such as bronchoscopy.
With the use of exhaled breath condensate (EBC) or exhaled breath (EB) analysis it is
possible to measure the inflammation in an non-invasive way. However, there is a great need
to further standardise these measurements and to identify possible confounding factors.
Background of the study:
Measurement of inflammatory markers (IM) in exhaled breath and exhaled breath condensate
(EB(C)) is a very interesting and useful non-invasive new technique to evaluate airway
inflammation. This technique is helpful for diagnostic and monitoring purposes in both
children and adults with chronic lung disease. The hypothesis of the present study is that
standardisation not only increase the reproducibility of measurements but will also enlarge
the possibility to detect differences between healthy and diseased subjects.
Objective of the study:
1. to investigate the influence of various factors on the concentration of markers in
EB(C); parameters on a subject level (e.g. breathing pattern, nose clip, inspiratory
filter, saliva contamination, physical exertion), on an apparatus level (cleaning
procedures, temperature of the condenser tube, environmental conditions, buffer bags),
and on a measurement/analysis level (sampling time, storage time, storage temperature,
protein inhibitor or bovine serum albumine) can be discriminated.
2. to assess whether the reproducibility of measurements in EB(C) can be increased by
analysing with ellipsometry, lyophilization or by standardising for exhaled volume,
sampling time, or dilution factor.
3. to investigate whether differences in inflammatory markers (IM) in EBC between healthy
and diseased subjects will increase by specific EB(C) sampling from more distal
airways. Children with asthma, cystic fibrosis (CF), primary ciliary dyskinesia (PCD),
bronchopulmonary dysplasia (BPD), and lower respiratory tract infections (LRTI) will be
included.
Study design:
Part I: Cross-sectional study assessing the random influence of presence or absence of
various factors on the concentration of IM in EB(C); Part II: A short-term prospective study
on reproducibility during five consecutive days; Part III: A cross-sectional comparative
study in several groups of children (healthy, asthma, CF, PCD, BPD, LRTI);
Study population:
Study part I and II are performed in healthy adult volunteers. Study part III is performed
in healthy children and in children with asthma, CF, PCD, BPD, and LRTI aged 2-16 years.
Primary study parameters/outcome of the study:
Study part I: Concentration of IM in EB(C). Study part II: Reproducibility as assessed by
coefficients of variations of IM in EB(C).
Study part III: Concentration of IM in EB(C) from more distal and more proximal airways.
;
Observational Model: Case Control, Time Perspective: Cross-Sectional
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