Airway Temperature



Status:Recruiting
Conditions:Asthma
Therapuetic Areas:Pulmonary / Respiratory Diseases
Healthy:No
Age Range:18 - 60
Updated:2/17/2019
Start Date:November 8, 2018
End Date:December 2020
Contact:Dianne Richeson
Email:dmri223@uky.edu
Phone:859-323-2093

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Role of Airway Tissue Temperature in Asthma Exacerbation

Airway irritation, cough and bronchial spasm are common symptoms in patients with airway
inflammatory diseases such as asthma. The primary focus of this exploratory study is to
determine if there is an increase in tissue temperature in airway mucosa during asthma
exacerbation. The results of this study will bring a better understanding of the potential
involvement of an increase in airway mucosa temperature in the pathogenesis of various
symptoms in these patients. The finding should help to advance the development of new
therapeutic strategies for these debilitating diseases.

A total of eight participants will be enrolled into this study. We will take direct
measurements of bronchial mucosa temperature. This can only be tested accurately in asthma
participants because anesthesia is known to lower the body temperature. The proposed study
using and experimental procedure called a segmental bronchoprovocation challenge with
allergen in asthmatic patients offers a unique approach to test our hypothesis.

Individuals enrolled into this study will participate for eight weeks and will take part in
four visits each estimated to last 2 and 8 hours. Participants will also participant in one
follow-up phone call following Test day 2.

Patients with asthma and healthy participants will be recruited to participate in this study
through advertisement postings in the Kentucky Clinic and/or the University of Kentucky
Hospital as well as on main campus. The study will also be added to a website using the same
posting.

Patients with asthma who have been prescribed for a diagnostic or therapeutic bronchoscopy
procedure at the UK Pulmonary Clinic will be identified and recruited by qualified physicians
in that clinic. The medical history and records of the patients will be made available which
includes data form a complete spirometry test and other clinical tests, physical examination,
smoking history, symptoms, current medication use, drug allergies, laboratory and imaging
data.

After eligible patients are identified and meet proper inclusion criteria, informed consent
will be obtained.

Participants will receive an explanation of the research project including any potential
risks. In addition, the participant will be shown the actual size of the temperature probe to
be used in this procedure. The participation of these individuals in the study will in no way
affect their current treatment. No bias will be held against the individual by any clinical
staff if they elect not to participate in the study. Informed consent will be obtained after
the potential participant is fully informed via verbal/written information of the procedures
and nature of the research, the risks involved, and their rights as a research subject.

The experimental procedure will be carried out in the University of Kentucky A.B. Chandler
Hospital.

Direct measurements of the airway mucosal temperature will be performed before and at ten
minutes after the SBP-Ag challenge. This miniature probe will be positioned in the airway
lumen using an Olympus fiberoptic bronchoscope (model MP160F), and connected via a cable to a
battery-operated thermometer (model FLL) manufactured also by Physitemp Instrument Inc. The
probe (outside diameter of 0.4 mm) will be passed through the instrument channel (inner
diameter: 2.0 mm) of the bronchoscope. By maneuvering the control knob of the bronchoscope,
the blunted tip of the probe will be gently pressed against the airway mucosa at 5-6
different positions in segmental and sub-segmental bronchi, each for five to ten seconds. The
entire protocol of the temperature measurement will require no more than 5 minutes to
complete. The contact of the temperature probe on the airway mucosa should not cause any
tissue damage, and is relatively non-invasive compared to other procedures involved in the
routine bronchoscopy such as biopsy, cytology brushing, etc

Physical Examination: It will include assessment of subject's general condition, head and
neck, chest and respiratory auscultation, cardiac auscultation, and limited abdominal,
extremity and neurological exams.

Vital signs: Heart rate, blood pressure, body temperature and arterial oxygen saturation.

Screening Visits 1 and 2: Following procedures will occur on the screening visit after
obtaining written informed consent.

- Collection of demographic information (Demographic data to be collected on screening
visit will include name, initials, address, social security number, coded study number,
medical record number, height, weight, age, race, ethnicity, gender, telephone number
and email address.)

- Collection of medical and medication history

- Urine pregnancy test

- Vital signs

- Skin prick test

- Spirometry

- Limited physical examination

- Study eligibility review

- Whole lung allergen inhalation challenge

- Adverse Event assessment

- Concomitant medication

Visit 3 (Test Day 1)

- Review eligibility criteria

- Vital signs

- Spirometry

- Urine pregnancy test

- Physical examination

- Bronchoscopy with lavage

- Segmental allergen challenge

- Adverse Event assessment

- Concomitant medication

Visit 4 (Test Day 2)

- Review eligibility criteria

- Vital signs

- Spirometry

- Physical examination

- Bronchoscopy with lavage

- Adverse Event assessment

- Concomitant medication

Follow-up Phone Call. A follow-up phone call will take place 1 day following the last study
visit. During this phone call the participant will be asked questions regarding any adverse
events they may have experienced since the last visit along with the use of any concomitant
medications.

Inclusion Criteria:

- 18-60 years of age

- Diagnosis of well-controlled airway allergy with mild-intermittent asthma (a stable
clinical condition with good asthma control) and demonstrating an allergen-specific
airway response to inhaled allergen provocation.

- Pre-albuterol forced expiratory volume in the first second (FEV1) of >70% of the
predicted value.

- Skin test positive to house dust mite, ragweed or cat hair.

- At least a 20% decrease in FEV1 during the immediate response following inhaled
antigen challenge.

- Competent to understand and willing to grant written informed consent.

Exclusion Criteria:

- Inability to perform pulmonary function testing.

- History of any lung disease or disorder other than asthma.

- Major health problems such as autoimmune disease, heart disease, coronary artery
disease, type I or type II diabetes, or uncontrolled hypertension.

- Pre-existing chronic infectious disease.

- Medication that is taken for other than for asthma, allergies or contraception.

- Inhaled corticosteroids or oral corticosteroids within 1 month of screening.

- Upper and lower respiratory infection within 1 month of screening.

- Unstable asthma as indicated by self report of increased symptoms or increased
beta-agonist use over the 2 weeks preceding the screening visit.

- Pregnant or lactating females.

- History of smoking.

- History of noncompliance with medical regiments or subjects who are considered
unreliable.

- Use of anti-platelet (i.e., aspirin, clopidogrel, etc) or anti-coagulant(coumadin,
heparin, Xarelto®, etc) medication 5 days prior to bronchoscopy.

It is required that the subjects undergoing bronchoscopy are not on any anti-platelets
(such as aspirin, clopidogrel, etc.) or anticoagulants (such as coumadin, heparin,
Xarelto®, etc.) at least 5 days prior to the bronchoscopy. As such, subjects receiving any
of these medications will be excluded from the study.
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