An interventional study of Exercise induced bronchoconstriction and Inhibited EIB in Exercise Induced Asthma, sponsored by Brunel University. Status unknown at 1 site in United Kingdom. Open to participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2019-01-29.
Sponsored by Brunel University · Not applicable, Interventional, and Basic science
This study will compare the inflammatory response in induced vs inhibited exercise induced bronchoconstriction (EIB) in patients with a medical diagnosis of asthma/EIB. Urinary and plasma samples will be analysed to compare the mediator release in each condition, alongside changes in lung function.
Exercise induced-bronchoconstriction (EIB) is a transient narrowing of the airways that occurs during or shortly after strenuous exercise. The prevalence of EIB in asthmatic patients is estimated around 30-50%, but EIB can also occur in individuals without asthma (especially children, army recruit forces, and elite athletes). Controversy remains about the causative mediators in the bronchoconstrictive response. Technological advancement in mass spectrometry has opened new avenues in the quantitative measurement of small endogenous metabolites in biological fluids (including urine and blood), which may provide insights into the pathophysiology of EIB and direct future therapeutic targets.
Utilising novel techniques in the analysis of inflammatory mediators in urine and blood, this study aims to conduct the most comprehensive analysis of mediator release during EIB to date.
Participants will attend a screening visit during which they will complete an exercise challenge (to determine the presence of EIB). A skin prick test will also be conducted to establish the atopic status of the participants. Following the screening visit, patients with EIB will be invited to complete a randomised cross-over study, where they will perform two further exercise challenges on separate days: one while inhaling temperate dry air, and one while inhaling hot humid air (the latter is known to inhibit EIB). Lung function and breathing discomfort will be recorded, and urine and blood samples will be collected, before and at various time points after exercise. As a control condition, participants will also attend one visit during which no exercise will be performed.
Participants aged 18-50yr, with diagnosed asthma and/or EIB, will be included in the study. 12 participants will complete 4 visits (lasting between 90 min and 4.5h). The study will take place on Brunel University London campus, Uxbridge. Urine and blood samples will be sent to the Karolinska Institutet, Stockholm, Sweden for analysis.
50 studies on the registry are indexed under Asthma, Exercise-Induced; 3 are open to participants now.
This study's planned enrollment of 12 is below the median of 47 across 37 interventional studies indexed under Asthma, Exercise-Induced.
Browse Asthma, Exercise-Induced studies →Brunel University is the lead sponsor of 11 studies on the registry; 2 are open to participants now.
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An exercise challenge will then be performed according to international guidelines. The exercise will consist of 8 minutes of cycling on a cycle ergometer while breathing medical grade dry air from a reservoir (Douglas bag) via a two-way non-rebreathing valve. The workload will be increased progressively over the first 2 minutes, and will then be maintained for 6 minutes at a target workload (in Watts) of \[53.76 \* measured forced expiratory volume in 1 sec (FEV1)-11.07\].
Other: Exercise induced bronchoconstriction
An exercise challenge will then be performed according to international guidelines. The exercise will consist of 8 minutes of cycling on a cycle ergometer while warm-humid air from a reservoir (Douglas bag) via a two-way non-rebreathing valve. The workload will be increased progressively over the first 2 minutes, and will then be maintained for 6 minutes at a target workload (in Watts) of \[53.76 \* measured forced expiratory volume in 1 sec (FEV1)-11.07\].
Other: Inhibited EIB
Participants will attend the laboratory but no exercise trial will be performed.
Participants will exercise whilst inhaling dry-air, this is known to exacerbate the bronchoconstrictive response.
Also known as: Induced bronchoconstriction
Participants will perform the exercise-test whilst inhaling warm-humid air. This is known to inhibit the EIB response and will provide a direct comparison group for the EIB condition.
Also known as: Exercise-control
Changes in the concentration of inflammatory mediator metabolites in urine
Concentration of metabolites of prostaglandin-D2, Cysteinyl-Leukotrienes, prostaglandin-E2, prostacyclin, thromboxane and isoprostanes will be expressed as pg per mmol of creatinine.
Time frame: Urine sample will be collected 45 minutes and immediately prior to the exercise challenges (or controlled resting period) and at 45, 90, 135 and 180 minutes post-exercise.
Changes in the concentration of inflammatory mediator metabolites in blood plasma
Concentration of tryptase and pro-inflammatory cytokines measured from blood plasma samples.
Time frame: Urine sample will be collected 45 minutes and immediately prior to the exercise challenges (or controlled resting period) and at 45, 90, 135 and 180 minutes post-exercise.
Forced vital capacity (FVC) manoeuvres using spirometry
Forced expiratory volume in one second (FEV1) measured in litres will be used to determine the severity of EIB from baseline to post-exercise challenge.
Time frame: Spirometry will be performed 45 minutes and immediately prior to the exercise challenges (or controlled resting period) and at 45, 90, 135 and 180 minutes post-exercise.
Breathing rate
Breathing rate (breaths per minute) will be recorded throughout exercise to control intensity between trials.
Time frame: Continuous recording throughout 8-min exercise test using the online breath-by-breath analysis system.
Heart rate
Heart rate (beats per minute) will be recorded throughout the exercise challenge test to control intensity between trials.
Time frame: Continuous recording continuously throughout the 8-min exercise test using short-range radiotelemetry using a chest belt worn by the participant.
Rating of breathing discomfort
Modified Borg scale (0- no discomfort, 10- severe discomfort).
Time frame: Breathing discomfort severity ratings will be recorded every 2 minutes throughout the 8 min exercise test (a total of 4 measurements)
Description of breathing discomfort
Descriptors from patients to describe the level of discomfort - i.e. 'my chest is tight'.
Time frame: A description of breathing discomfort will be recorded every 2 minutes throughout the 8 min exercise test (a total of 4 measurements)
Plan to share: Undecided
No publications or documents are linked to this record.
Started Nov 2018 (actual). Primary completion is estimated for Mar 2020, 16 months after the start.
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Brunel University