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CompletedNCT02410096Updated Sep 5, 2016

Bronchial Inflammation and Hyperresponsiveness After Oil Supplementation

An interventional study of Exercise challenge in a cold chamber and Methacholine challenge in Exercise-induced Asthma, sponsored by Johann Wolfgang Goethe University Hospital. Completed at 1 site in Germany. Open to participants aged 12 Years to 44 Years. Per ClinicalTrials.gov, last updated 2016-09-05.

Sponsored by Johann Wolfgang Goethe University Hospital · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
73
Allocation
Randomized
Ages
12 Years to 44 Years
Sex
All
01

Study summary

The purpose of this study is to investigate the bronchial inflammation and hyperresponsiveness after oil supplementation. Before and after oil supplementation the investigators measure decrease in lung function after exercise-challenge in a cold chamber and increase of inflammatory markers in the blood.

Read the detailed description

Subjects suffering form exercise-induced bronchoconstriction (EIB) usually have a normal lung function testing at rest and show a decrease in lung function when they do sports or an exercise-challenge. In a previous study the investigators could show, that the combination of exercise test and inhalation of cold air ist more sensitive and specific than exercise-challenge in ambient temperature.

It is known that omega - 3 -fatty acids could reduce the production of inflammatory mediators.

In this study the investigators will investigate the protective effect of oil supplementation with middle-chain and polyunsaturated fatty acids in an exercise-induced asthma provocation model.

Therefore the investigators will measure the decrease in lung function and a increase of inflammatory markers in the blood before and after oil supplementation.

Before and after the exercise-challenge the investigators will measure spirometry and body plethysmography. The investigators want to examine if the body plethysmography is more sensitive in the measurement of exercise induced bronchoconstriction than spirometry.

The investigators hypothesize that the oil supplementation can reduce bronchial inflammation and hyperresponsiveness.

02

Conditions studied

  • Exercise-induced Asthma

Keywords

  • exercise-induced asthma
  • cold chamber
  • exercise challenge
  • cold air challenge
  • oil supplementation
  • middle-chain and Polyunsaturated Fatty Acids
03

Who can participate

Ages eligible
12 Years to 44 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Informed consent
  • Patients: Age ≥12 and 44 years
  • known exercise induced asthma
  • basic lung function FVC ≥ 75%, FEV1 ≥ 70%
  • decrease in FEV1 after exercise ≥ 15%

Exclusion criteria

Exclusion Criteria:

  • lung function Forced vital capacity (FVC) \<75% and Forced expiratory volume in 1 second (FEV1) \<70%
  • chronic diseases or infections (e.g. HIV, Tbc)
  • pregnancy
  • systemic corticosteroid-treatment
  • inhalative corticosteroid therapy or leukotriene antagonists
  • alcohol, substance or drug abuse
  • smokers
  • inability to capture extend and consequences of the study
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Investigator)
Enrollment
73 participants (actual)

Study arms

  • Active comparator
    Oil supplementation verum

    30 patients aged 12-44 years with a diagnosis of exercise induced asthma undergo a methacholine challenge and a prick test. After randomization patients will receive in double blind approach ones daily 1190 mg of middle-chain and polyunsaturated fatty acids for four weeks. Before and after supplementation an exercise challenge in a cold chamber will be performed.

    Other: Exercise challenge in a cold chamber · Other: Methacholine challenge · Dietary Supplement: Oil supplementation verum

  • Placebo comparator
    Oil supplementation placebo

    30 patients aged 12-44 years with a diagnosis of exercise induced asthma undergo a methacholine challenge and a prick test. After randomization patients will receive in double blind approach placebo for four weeks. Before and after placebo treatment an exercise challenge in a cold chamber will be performed.

    Other: Exercise challenge in a cold chamber · Other: Methacholine challenge · Dietary Supplement: Oil supplementation placebo

Interventions

  • OtherExercise challenge in a cold chamber

    Exercise challenge is defined as running on a treadmill for 6-8 minutes on submaximal work load in a cold chamber.

  • OtherMethacholine challenge

    Nebulized metacholine administered at following doses: 0,01mg, 0,1mg, 0,4mg, 0,8mg und 1,6mg

  • Dietary supplementOil supplementation verum

    Patients and subjects will take double blind an oil supplementation with middle-chain and polyunsaturated fatty acids for four weeks

  • Dietary supplementOil supplementation placebo

    Patients and subjects will take double blind sunflower oil for four weeks

05

What researchers measure

Primary outcomes

  1. Decrease in FEV1 after exercise challenge in cold air as measured by spirometry (FEV1, percent predicted) - comparison verum vs placebo

    The exercise challenge in cold air will be done on two timepoints. Before and after oil supplementation versus placebo supplementation. After exercise challenge spirometry will be measured. Decrease in FEV1 in verum and control group will be compared with t-test and Wilcoxon-Mann-Whitney-Test.

    Time frame: 4 weeks

Secondary outcomes

  1. Comparison of decrease in exhaled nitric oxide (eNO) as measured by Niox Mino (parts per billion, ppb)

    Comparison of decrease in eNO before and after supplementation in verum and placebo group

    Time frame: 4 weeks

  2. Comparison of change in lipids in serum as measured by capillary gas chromatography (weight percent, wt%)

    Comparison of increase eicosapentaenoic acid and docosahexaenoic acid and decrease of triglycerides before and after supplementation in verum and placebo group

    Time frame: 4 weeks

Other outcomes

  1. Comparison of two methods of lung function testing as measured by spirometry (FEV1, percent predicted) and body plethysmography (specific airway resistance, sRAW, kPa*sec)

    Both methods will be done in parallel before and 4 times after exercise challenge in cold air. Afterwards the investigators can compare both methods and calculate the sensitivity for both methods to indicate exercise induced bronchoconstriction.

    Time frame: 4 weeks

06

Study locations

1 site
  • Goethe University Hospital Frankfurt
    Frankfurt, Hessen 60590, Germany
07

References and documents

Publications

  • Schubert R, Kitz R, Beermann C, Rose MA, Lieb A, Sommerer PC, Moskovits J, Alberternst H, Bohles HJ, Schulze J, Zielen S. Effect of n-3 polyunsaturated fatty acids in asthma after low-dose allergen challenge. Int Arch Allergy Immunol. 2009;148(4):321-9. doi: 10.1159/000170386. Epub 2008 Nov 11. PubMed 19001792 ↗
  • Schulze J, Smith HJ, Fuchs J, Herrmann E, Dressler M, Rose MA, Zielen S. Methacholine challenge in young children as evaluated by spirometry and impulse oscillometry. Respir Med. 2012 May;106(5):627-34. doi: 10.1016/j.rmed.2012.01.007. Epub 2012 Feb 10. PubMed 22326606 ↗
  • Nensa F, Kotschy-Lang N, Smith HJ, Marek W, Merget R. Assessment of airway hyperresponsiveness: comparison of spirometry and body plethysmography. Adv Exp Med Biol. 2013;755:1-9. doi: 10.1007/978-94-007-4546-9_1. PubMed 22826043 ↗
  • Schulze J, Rosewich M, Riemer C, Dressler M, Rose MA, Zielen S. Methacholine challenge--comparison of an ATS protocol to a new rapid single concentration technique. Respir Med. 2009 Dec;103(12):1898-903. doi: 10.1016/j.rmed.2009.06.007. Epub 2009 Jul 10. PubMed 19596563 ↗
  • Dyerberg J, Bang HO. Lipid metabolism, atherogenesis, and haemostasis in Eskimos: the role of the prostaglandin-3 family. Haemostasis. 1979;8(3-5):227-33. doi: 10.1159/000214314. PubMed 511010 ↗
  • Endres S, Ghorbani R, Kelley VE, Georgilis K, Lonnemann G, van der Meer JW, Cannon JG, Rogers TS, Klempner MS, Weber PC, et al. The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. N Engl J Med. 1989 Feb 2;320(5):265-71. doi: 10.1056/NEJM198902023200501. PubMed 2783477 ↗
  • Mickleborough TD, Murray RL, Ionescu AA, Lindley MR. Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes. Am J Respir Crit Care Med. 2003 Nov 15;168(10):1181-9. doi: 10.1164/rccm.200303-373OC. Epub 2003 Aug 6. PubMed 12904324 ↗
  • Parsons JP, Hallstrand TS, Mastronarde JG, Kaminsky DA, Rundell KW, Hull JH, Storms WW, Weiler JM, Cheek FM, Wilson KC, Anderson SD; American Thoracic Society Subcommittee on Exercise-induced Bronchoconstriction. An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction. Am J Respir Crit Care Med. 2013 May 1;187(9):1016-27. doi: 10.1164/rccm.201303-0437ST. PubMed 23634861 ↗
  • Dressler M, Fussbroich D, Bohler L, Herrmann E, Benker N, Tytyk M, Schulze J, Schubert R, Beermann C, Zielen S. Oil supplementation with a special combination of n-3 and n-6 long-chain polyunsaturated fatty acids does not protect for exercise induced asthma: a double-blind placebo-controlled trial. Lipids Health Dis. 2020 Jul 13;19(1):167. doi: 10.1186/s12944-020-01343-2. PubMed 32660564 ↗
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Registry details

Key details

Study ID
NCT02410096
Lead sponsor
Johann Wolfgang Goethe University Hospital
Responsible party
Johannes Schulze MD (Consultant Pediatric Allergy and Pneumology, Johann Wolfgang Goethe University Hospital) — Principal investigator
First posted
Apr 7, 2015
Start date
Apr 2015
Primary completion
Feb 2016
Completion
Jul 2016
Last update
Sep 5, 2016

Study contacts

Johannes Schulze, MD
principal investigator · Johann Wolfgang Goethe University Hospital

Oversight

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

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