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CompletedNCT00229190Updated Apr 24, 2007

Nasal Lavage Study: Comparing Single Versus Multi Sample Lavages

An interventional study of Nasal lavage and Allergy skin testing in Nasal Lavage Fluid, Eosinophils and Reproducibility of Results, sponsored by Hamilton Health Sciences Corporation. Completed at 1 site in Canada. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2007-04-24.

Sponsored by Hamilton Health Sciences Corporation · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
21
Allocation
Randomized
Ages
18 Years and older
Sex
All
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Study summary

Nasal lavage could be an integral component of assessing airway inflammation. Research into the reproducibility of cell counts is key to understanding the value of lavage results.

The objective of this study is to evaluate and compare the reproducibility of a common nasal lavage technique and its variation in a sample of subjects with nasal symptoms (e.g. runny nose, congestion, sneezing, post nasal drip), and in individuals without nasal symptoms.

Read the detailed description

Nasal lavage is a relatively simple way to measure the degree of upper airway inflammation. It is useful in research because it is noninvasive, relatively discomfort-free, and simple to perform. Yet there is no standardized method for collecting upper airway cells. The definition of nasal lavage can differ widely between research groups. The method, and its pooled modification, chosen for this trial are based on the commonly used Naclerio technique.

Upper airway inflammation is linked to a broad spectrum of disease: nasal polyposis, seasonal and perennial allergic rhinitis, vasomotor or non-allergic rhinitis, and sinusitis. Assessing the degree of upper airway inflammation through objective measures has obvious clinical and research benefits. For example, nasal polyps contain a large number of activated eosinophils - about 20% of the constituents of nasal polyp tissue. Allergic rhinitis is also associated with elevated inflammatory cell counts - eosinophils, basophils, mast cells, lymphocytes and their mediators. The impact of treatment on nasal inflammation is a key factor in the evaluation of new nasal polyp or allergic rhinitis therapies. Therefore it is imperative that nasal inflammation measurements be evaluated for reliability.

As nasal inflammation is present in a variety of diseases, a cross section of subjects will be enrolled in this trial. Nasal lavages will be performed on nasal polyp subjects, perennial allergic rhinitis subjects, and normal subjects. This project will assess the repeatability of a single sample lavage in comparison to the repeatability of a modified version, i.e. a lavage sample conducted three times, 15 minutes apart, and then pooled, or combined. We expect to find the highest eosinophil counts in patients with nasal polyposis, intermediate levels in patients with perennial allergic rhinitis and low levels in normal subjects, based on previous work.

This project will be a single-centre, randomized trial involving three sets of seven subjects - polyp subjects, perennial allergic rhinitis subjects, and normals. All subjects will be blinded to the assessment of outcome measurements.

The study will be comprised of four clinic appointments. Appointments will be scheduled seven to 10 days apart. All subjects will be randomly assigned their lavage sampling group at their baseline visit. Group one will consist of a single sample lavage at visit one, a multiple sample lavage at visit two, a single sample lavage at visit three, and a multiple sample lavage a visit four. Group two will be the reverse order.

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Conditions studied

  • Nasal Lavage Fluid
  • Eosinophils
  • Reproducibility of Results

Keywords

  • Nasal lavage fluid
  • Eosinophils
  • Reproducibility of results
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In context

Lead sponsor

Hamilton Health Sciences Corporation is the lead sponsor of 237 studies on the registry; 35 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Subject is male or female aged 18 years or older.
  • Subject understands the research project and agrees to participate by signing an informed consent agreement.
  • Subject is able to successfully complete nasal lavage training session.

Exclusion criteria

Exclusion Criteria:

  • Subjects with severe nasal polyps which prevent collecting adequate nasal lavage sample.
  • Subjects who have undergone surgery to treat their nasal polyps (nasal polypectomy) within one year prior to visit one
  • Subjects who have a known fungal infection of the nose and/or paranasal sinuses, nasal candidiasis, acute or chronic infectious sinusitis of viral or bacterial nature.
  • Subjects who have had an upper respiratory tract infection within four weeks prior to visit one.
  • Subjects having cystic fibrosis, Young's syndrome, primary ciliary dyskinesia, known HIV infection or alcohol abuse.
  • Subjects with clinically significant, uncontrolled evidence of cardiovascular, neurological, hepatic, renal, respiratory, or any other medical condition that may interfere with the study.
  • Subjects with a recent history (within six months) of a clinically significant psychiatric disorder other than mild depression.
  • Subjects who have any clinically relevant deviation from normal in the general physical examination.
  • Subjects who have received any depot, systemic or oral corticosteroid in the previous three months prior to the start of the study.
  • Subjects who are using an intranasal steroid or antihistamine for their nasal symptoms and are unable to remain on a constant dose for four weeks prior to visit 1 or for the duration of the study.
  • Females who are pregnant or lactating or are likely to become pregnant during the study or are less than 8 weeks postpartum. Women of childbearing age may be included if, in the opinion of the investigator, they are taking adequate contraceptive measures.
  • Subjects who are unable to follow the instructions within this protocol or known inability to attend all clinic visits within the intervals stated.
  • Subjects who have participated in a clinical trial involving an investigational or marketed drug within four weeks of visit one.
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Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
21 participants

Interventions

  • ProcedureNasal lavage
  • ProcedureAllergy skin testing
  • ProcedurePeak nasal inspiratory flow
  • ProcedureAcoustic rhinometry
  • ProcedureNasal examination
  • ProcedureQuality of Life Questionnaire
  • ProcedurePhysical examination
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What researchers measure

Primary outcomes

  1. Eosinophil per cent of cells recovered in lavage fluid

Secondary outcomes

  1. Albumen concentration in lavage fluid

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Study locations

1 site
  • Hamilton Health Sciences Corporation, McMaster Site
    Hamilton, Ontario L8N 3Z5, Canada
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References and documents

Publications

  • Naclerio RM, Meier HL, Kagey-Sobotka A, Adkinson NF Jr, Meyers DA, Norman PS, Lichtenstein LM. Mediator release after nasal airway challenge with allergen. Am Rev Respir Dis. 1983 Oct;128(4):597-602. doi: 10.1164/arrd.1983.128.4.597. PubMed 6354022 ↗
  • Finotto S, Dolovich J, Denburg JA, Jordana M, Marshall JS. Functional heterogeneity of mast cells isolated from different microenvironments within nasal polyp tissue. Clin Exp Immunol. 1994 Feb;95(2):343-50. doi: 10.1111/j.1365-2249.1994.tb06535.x. PubMed 7508349 ↗
  • Koren HS, Hatch GE, Graham DE. Nasal lavage as a tool in assessing acute inflammation in response to inhaled pollutants. Toxicology. 1990 Jan-Feb;60(1-2):15-25. doi: 10.1016/0300-483x(90)90159-e. PubMed 2315937 ↗
  • Miadonna A, Milazzo N, Gibelli S, Salmaso C, Lorini M, Tedeschi A. Nasal response to a single antigen challenge in patients with allergic rhinitis - inflammatory cell recruitment persists up to 48 hours. Clin Exp Allergy. 1999 Jul;29(7):941-9. doi: 10.1046/j.1365-2222.1999.00609.x. PubMed 10383595 ↗
  • Noah TL, Henderson FW, Henry MM, Peden DB, Devlin RB. Nasal lavage cytokines in normal, allergic, and asthmatic school-age children. Am J Respir Crit Care Med. 1995 Oct;152(4 Pt 1):1290-6. doi: 10.1164/ajrccm.152.4.7551384. PubMed 7551384 ↗
  • Nikasinovic-Fournier L, Just J, Seta N, Callais F, Sahraoui F, Grimfeld A, Momas I. Nasal lavage as a tool for the assessment of upper-airway inflammation in adults and children. J Lab Clin Med. 2002 Mar;139(3):173-80. doi: 10.1067/mlc.2002.121661. PubMed 11944028 ↗
  • Belda J, Parameswaran K, Keith PK, Hargreave FE. Repeatability and validity of cell and fluid-phase measurements in nasal fluid: a comparison of two methods of nasal lavage. Clin Exp Allergy. 2001 Jul;31(7):1111-5. doi: 10.1046/j.1365-2222.2001.01133.x. PubMed 11468003 ↗
  • Greiff L, Pipkorn U, Alkner U, Persson CG. The 'nasal pool' device applies controlled concentrations of solutes on human nasal airway mucosa and samples its surface exudations/secretions. Clin Exp Allergy. 1990 May;20(3):253-9. doi: 10.1111/j.1365-2222.1990.tb02680.x. PubMed 2364306 ↗
  • Hauser R, Garcia-Closas M, Kelsey KT, Christiani DC. Variability of nasal lavage polymorphonuclear leukocyte counts in unexposed subjects: its potential utility for epidemiology. Arch Environ Health. 1994 Jul-Aug;49(4):267-72. doi: 10.1080/00039896.1994.9937478. PubMed 8031183 ↗
  • Sulakvelidze I, Conway M, Evans S, Stetsko PI, Djuric V, Dolovich J. Clinical and nasal irrigation fluid findings in perennial allergic rhinitis. Am J Rhinol. 1997 Nov-Dec;11(6):435-41. doi: 10.2500/105065897780914965. PubMed 9438056 ↗
  • Keith PK, Conway M, Evans S, Wong DA, Jordana G, Pengelly D, Dolovich J. Nasal polyps: effects of seasonal allergen exposure. J Allergy Clin Immunol. 1994 Mar;93(3):567-74. doi: 10.1016/s0091-6749(94)70068-0. PubMed 8151059 ↗
  • Austin CE, Foreman JC. Acoustic rhinometry compared with posterior rhinomanometry in the measurement of histamine- and bradykinin-induced changes in nasal airway patency. Br J Clin Pharmacol. 1994 Jan;37(1):33-7. doi: 10.1111/j.1365-2125.1994.tb04235.x. PubMed 8148216 ↗
  • Juniper EF. Measuring health-related quality of life in rhinitis. J Allergy Clin Immunol. 1997 Feb;99(2):S742-9. doi: 10.1016/s0091-6749(97)90000-2. PubMed 9042066 ↗
  • Keith PK, Conway M, Dolovich J.Development and validation of a nasal-polyposis quality of life questionniare. Journal of Allergy and Clinical Immunology 1996;97:192 (Abstract)
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 24, 2007, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00229190
Lead sponsor
Hamilton Health Sciences Corporation
Collaborators
Firestone Institute for Respiratory Health
First posted
Sep 29, 2005
Start date
Sep 2004
Completion
May 2005
Last update
Apr 24, 2007

Study contacts

Paul Keith, MD MSc FRCPC
principal investigator · Hamilton Health Sciences Corporation, McMaster Site

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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