Exacerbations in severe asthma patients: mechanisms and biomarkers
Research type
Research Study
Full title
Exacerbations in severe asthma patients: mechanisms and biomarkers
IRAS ID
130420
Contact name
Kian Fan Chung Chung
Contact email
Sponsor organisation
Imperial College
Research summary
Asthma is punctuated by exacerbations defined as an increase in symptoms that can occur over a period of days and that necessitate additional treatments at home or in the hospital. Severe asthma patients continue to suffer from symptoms of asthma despite taking asthma treatments such as inhaled bronchodilators and steroids and more than half have experienced 3 or more of these exacerbations in one year. Studies have isolated respiratory viruses such as rhinoviruses during these exacerbations. Bacterial infections may be an important causal factor. A cell called macrophage present in the airway tubes is less capable of taking up bacteria. Steroids put on macrophages from patients with severe asthma in the test tube are less capable of preventing these cells to produce substances that increase inflammation. We propose to study 60 such patients over a one-year period. We will also call these patients to our Research laboratory during one exacerbation to do some measurements and to take samples of blood and sputum which we will examine for various clues as to the cause. We will look for viruses and bacteria, measure the immune response to these infections, see how the macrophage behave during an exacerbation, how the blood cells respond to steroids given in the test-tube, and the degree of oxidation products that can be measured in the blood or in the sputum. Careful measurements of the lung function and of a gas called nitric oxide measured in the breath and recording of symptoms will be made. Within 2 weeks of the exacerbation visit, the patient will be asked to return for a repeat of the tests to document the recovery phase. Finally, with these observations, we will try and understand whether there are different types of exacerbations by analysing the features detected with each exacerbation.
REC name
London - Riverside Research Ethics Committee
REC reference
13/LO/1198
Date of REC Opinion
11 Sep 2013
REC opinion
Favourable Opinion