The Circadian Biology of Asthma. Version 1
Research type
Research Study
Full title
The Circadain Biology of Asthma: An analysis of timed samples.
IRAS ID
255311
Contact name
Hannah J Durrington
Contact email
Sponsor organisation
University of Manchester
Clinicaltrials.gov Identifier
14/NW/1352, A Study to Investigate the Circadian Biology of Asthma REC reference:
Duration of Study in the UK
10 years, 0 months, 0 days
Research summary
The Circadian Biology of Asthma: An analysis of timed samples.
Background: Asthma is a common, chronic, inflammatory disease of the lung resulting in variable airway narrowing. The symptoms of asthma show a strong time of day signature, worsening in the early hours of the morning (4am), this is coincident with a marked increase in narrowing of the airway. In a previous study we have shown that sputum eosinophils (a key effector cell in asthma) vary significantly during the day in asthma, being highest at 4am and lowest at 4pm. Eosinophilic inflammation in asthma is often sensitive to treatment with inhaled steroids. Traditionally inhaled steroids are prescribed to be taken in the morning and in the evening for twice daily dosing. However, several small studies suggest that the optimal time of day for inhaled steroids to be taken is in fact around mid-afternoon (3-4pm). There is no mechanistic evidence as to why this should be the case, and without such evidence clinical practice is unlikely to change. Steroids remain the cornerstone of treatment in asthma; however there is an increasing problem of steroid resistance particularly in severe asthma. We are interested in determining if steroid resistance changes during the day in asthma, and if there is a window of time during the day in which steroids might be more effective in treating asthma.
Hypothesis: Responsiveness to steroids varies diurnally in asthma; steroids are more effective if taken in the afternoon.
Aims:
1. To determine if steroid responsive pathways vary by time of day in asthma
2. To determine whether clock gene expression is upregulated in asthma compared to healthy participants.
Methods: We will analyse previously collected timed samples to determine if steroid responsiveness changes with time of day in asthma.Funding: North West Lung Centre Charity
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
19/WM/0057
Date of REC Opinion
19 Feb 2019
REC opinion
Favourable Opinion