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| ID | Type | Description | Link |
|---|---|---|---|
| 5U19AI077439 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute of Allergy and Infectious Diseases (NIAID) | NIH |
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This protocol describes a single site mechanistic study to investigate microRNAs (miRNAs) that are differentially expressed in the airway epithelium of patients with asthma at baseline and in response to allergen challenge. We hypothesize that allergen exposure enhances airway smooth muscle contractility and epithelial cell mRNA/miRNA production as a consequence of locally increased T-cell derived cytokine production. The study will involve three visits over the course of approximately 14 days. At Visit 1, participants will be characterized in detail with lung function testing, methacholine challenge testing, and allergen skin prick testing. At Visit 2, participants will undergo bronchoscopy with segmental allergen administration of either cat or dust mite standardized allergen extract. At Visit 3 (either 24 hours later or 7 days later), bronchoscopy will be performed to collect airway samples including bronchoalveolar lavage (BAL), epithelial brushings and endobronchial biopsies. Sample analysis will include measurement of miRNA and mRNA expression in epithelial brushings (RNAseq and qPCR); analysis of cell surface markers on BAL cells and blood cells; and collection of endobronchial biopsies for immunostaining of immune cells localization, immunoblotting of smooth cell protein phosphorylation, analysis of mucin content and smooth muscle cell subculture. A total of 38 subjects (26 asthmatics with stable or well-controlled asthma, 6 allergic non-asthmatics and 6 non-allergic non-asthmatics) will complete the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Allergen challenge subjects | Experimental | Intervention: Segmental airway allergen challenge Three types of subjects are studied in this arm: 1) Volunteers with neither asthma nor allergy (as established by skin prick testing); 2) Volunteers with allergy (as established by skin prick testing) but without asthma; and 3) Volunteers with both asthma and allergy (as established by skin prick testing) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Segmental airway allergen challenge | Biological |
| ||
| Bronchoscopy |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in Expression of Epithelial miRNAs (in Read Counts) 24 Hours After Allergen-challenge as Compared to 24 Hours After Diluent Challenge in Participants With Allergic Asthma | For each participant with Allergic Asthma, a baseline airway epithelial brushing was performed, allergen was instilled into one segment of the lung, and diluent (control) was instilled into another segment. Both segments were brushed for epithelial cells 24 hours later. After processing brushes to RNA and generating RNA sequencing data, the RNA transcript read counts for each gene underwent variance stabilized log normalization. Then we built a regression model which estimated the difference in miRNA read count in the allergen challenged as compared to the baseline sample and the difference in miRNA read count in the diluent challenged segment as compared to baseline for each participant. The change from baseline read count for each miRNA in the allergen samples was compared to the change in the diluent samples and statistical significance was assessed using the unadjusted p-value(<0.05). The direction of change does not have clinical significance; this was a mechanistic study. | 24 hours |
| Difference in Expression of Epithelial miRNAs (in Read Counts) 7 Days After Allergen-challenge as Compared to 7 Days After Diluent Challenge | For each participant with Allergic Asthma, a baseline airway epithelial brushing was performed, allergen was instilled into one segment of the lung, and diluent (control) was instilled into another segment. Both segments were brushed for epithelial cells 7 days later. After processing the brushes to RNA and generating RNA sequencing data, the RNA transcript read counts for each gene underwent variance stabilized log normalization. Then we built a regression model which estimated the difference in miRNA read count in the allergen challenged as compared to the baseline sample and the difference in miRNA read count in the diluent challenged segment as compared to baseline for each participant. The change from baseline read count for each miRNA in the allergen samples was compared to the change in the diluent samples and statistical significance was assessed using the unadjusted p-value(<0.05). The direction of change does not have clinical significance; this was a mechanistic study. | 7 days |
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Allergic/Non-Asthmatic subjects and Allergic/Asthmatic subjects
Inclusion Criteria:
Non-Allergic/Non-Asthmatic subjects
Inclusion Criteria:
All groups
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Prescott G Woodruff, MD, MPH | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California, San Francisco | San Francisco | California | 94143 | United States |
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| Label | URL |
|---|---|
| UCSF Airway Clinical Research Center | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Allergic Asthmatics(AA) | Volunteers with both asthma and allergy (as established by skin prick testing) |
| FG001 | Allergic Non-Asthmatics(ANA) | Volunteers with allergy (as established by skin prick testing) but without asthma; |
| FG002 | Non-Allergic Non-Asthmatics(NANA) | Volunteers with neither asthma nor allergy (as established by skin prick testing) |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Allergic Non-asthmatics(ANA) | ) Volunteers with allergy (as established by skin prick testing) but without asthma |
| BG001 | Non-allergic Non-asthmatics(NANA) | Volunteers with neither asthma nor allergy (as established by skin prick testing) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Difference in Expression of Epithelial miRNAs (in Read Counts) 24 Hours After Allergen-challenge as Compared to 24 Hours After Diluent Challenge in Participants With Allergic Asthma | For each participant with Allergic Asthma, a baseline airway epithelial brushing was performed, allergen was instilled into one segment of the lung, and diluent (control) was instilled into another segment. Both segments were brushed for epithelial cells 24 hours later. After processing brushes to RNA and generating RNA sequencing data, the RNA transcript read counts for each gene underwent variance stabilized log normalization. Then we built a regression model which estimated the difference in miRNA read count in the allergen challenged as compared to the baseline sample and the difference in miRNA read count in the diluent challenged segment as compared to baseline for each participant. The change from baseline read count for each miRNA in the allergen samples was compared to the change in the diluent samples and statistical significance was assessed using the unadjusted p-value(<0.05). The direction of change does not have clinical significance; this was a mechanistic study. | Our pre-specified primary outcome was limited to Allergic Asthmatics only. The rationale for this is that participants without allergy or asthma do not respond to Allergen Challenge and therefore the changes in miRNA are uninformative. | Posted | Mean | Standard Deviation | Normalized log2 copy number | 24 hours |
Adverse event data were prospectively collected from the first visit until 48 hours after the last study visit in all participants and until the resolution of any potential adverse event reported by a subject after a study procedure, up to 6 months.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Allergic Asthmatics(AA) | Volunteers with both asthma and allergy (as established by skin prick testing) |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pregnancy identified during study enrollment | Pregnancy, puerperium and perinatal conditions | Systematic Assessment | Participant was not pregnant upon enrollment (confirmed via urine pregnancy test). Participant later notified study team of pregnancy and was withdrawn prior to Visit 2 and Visit 3 bronchoscopies. Event was reported to sponsor and medical monitor. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Increased systolic blood pressure post-bronchoscopy | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| PI: Prescott G. Woodruff, MD, MPH | University of California, San Francisco | 415-514-2061 | prescott.woodruff@ucsf.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 1, 2014 | Apr 21, 2022 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D001249 | Asthma |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
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| ID | Term |
|---|---|
| D001999 | Bronchoscopy |
| D013147 | Spirometry |
| ID | Term |
|---|---|
| D003948 | Diagnostic Techniques, Respiratory System |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D004724 | Endoscopy |
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Single group before and after administration of allergen
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| Procedure |
|
| Methacholine challenge test | Diagnostic Test |
|
| Spirometry | Diagnostic Test |
|
| Allergen skin prick test | Diagnostic Test |
|
| Physician Decision |
|
| BG002 | Allergic Asthmatics(AA) | Volunteers with both asthma and allergy (as established by skin prick testing) |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| FEV1 | Mean | Standard Deviation | liters |
|
|
|
|
|
| Primary | Difference in Expression of Epithelial miRNAs (in Read Counts) 7 Days After Allergen-challenge as Compared to 7 Days After Diluent Challenge | For each participant with Allergic Asthma, a baseline airway epithelial brushing was performed, allergen was instilled into one segment of the lung, and diluent (control) was instilled into another segment. Both segments were brushed for epithelial cells 7 days later. After processing the brushes to RNA and generating RNA sequencing data, the RNA transcript read counts for each gene underwent variance stabilized log normalization. Then we built a regression model which estimated the difference in miRNA read count in the allergen challenged as compared to the baseline sample and the difference in miRNA read count in the diluent challenged segment as compared to baseline for each participant. The change from baseline read count for each miRNA in the allergen samples was compared to the change in the diluent samples and statistical significance was assessed using the unadjusted p-value(<0.05). The direction of change does not have clinical significance; this was a mechanistic study. | Our pre-specified primary outcome was limited to Allergic Asthmatics only. The rationale for this is that participants without allergy or asthma do not respond to Allergen Challenge and therefore the changes in miRNA are uninformative. | Posted | Mean | Standard Deviation | Normalized log2 copy number | 7 days |
|
|
|
|
| 0 |
| 22 |
| 1 |
| 22 |
| 2 |
| 22 |
| EG001 | Allergic Non-Asthmatics(ANA) | Volunteers with allergy (as established by skin prick testing) but without asthma; | 0 | 2 | 0 | 2 | 0 | 2 |
| EG002 | Non-Allergic Non-Asthmatics(NANA) | Volunteers with neither asthma nor allergy (as established by skin prick testing) | 0 | 4 | 0 | 4 | 0 | 4 |
|
| Respiratory infection post-bronchoscopy | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
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| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D003949 | Diagnostic Techniques, Surgical |
| D019060 | Minimally Invasive Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
| D013510 | Pulmonary Surgical Procedures |
| D019616 | Thoracic Surgical Procedures |
| D012129 | Respiratory Function Tests |
| miR3912 |
|
| miR15b |
|
| miR127 |
|
| miR146a |
|
| miR449b |
|
| miR21-5p |
|
| miR6842 |
|
| miR142-5p |
|
| miR21 |
|
| miR493 |
|
| miR193a |
|
| miR149 |
|
| miR449a |
|
| miR6511a |
|
| miR6843 |
|
| miR671 |
|
| miR6503 |
|
| miR450b |
|
| miR485 |
|
| miR6806 |
|
| miR3182 |
|
| miR142-3p |
|
| miR320d |
|
| miR3928 |
|
| miR744 |
|
| miR206 |
|
| miR30e |
|
| miR4500 |
|
| miR125a |
|
| miR99b |
|
| miR1 |
|
| miR146b |
|
| miR1255a |
|
| miR223 |
|
| miR642a |
|
| miR548ae |
|
| miR146b-3p |
|
| miR877 |
|
| miR181a |
|
| miR4467 |
|
| miR1249 |
|
| miR766 |
|
| miR29c |
|
| miR370 |
|
| 0 |
| Mean Difference (Net) |
| -2.09 |
| 2-Sided |
| Superiority |
| miR3912 | t-test, 2 sided | 0 | Mean Difference (Net) | -5.75 | 2-Sided | Superiority |
| miR15b | t-test, 2 sided | 0 | Median Difference (Net) | 1.93 | 2-Sided | Superiority |
| miR127 | t-test, 2 sided | 0 | Mean Difference (Net) | -2.35 | 2-Sided | Superiority |
| miR146a | t-test, 2 sided | 0 | Mean Difference (Net) | 1.59 | 2-Sided | Superiority |
| miR449b | t-test, 2 sided | 0 | Mean Difference (Net) | 1.21 | 2-Sided | Superiority |
| miR21-5p | t-test, 2 sided | 0.01 | Mean Difference (Net) | 0.85 | 2-Sided | Superiority |
| miR6842 | t-test, 2 sided | 0.01 | Mean Difference (Net) | -1.29 | 2-Sided | Superiority |
| miR142-5p | t-test, 2 sided | 0.01 | Mean Difference (Net) | 1.24 | 2-Sided | Superiority |
| miR21 | t-test, 2 sided | 0.01 | Mean Difference (Net) | 1.67 | 2-Sided | Superiority |
| miR493 | t-test, 2 sided | 0.01 | Mean Difference (Net) | -4.24 | 2-Sided | Superiority |
| miR193a | t-test, 2 sided | 0.01 | Mean Difference (Net) | -1.46 | 2-Sided | Superiority |
| miR149 | t-test, 2 sided | 0.01 | Mean Difference (Net) | -0.89 | 2-Sided | Superiority |
| miR449a | t-test, 2 sided | 0.01 | Mean Difference (Net) | 1.06 | 2-Sided | Superiority |
| miR6511a | t-test, 2 sided | 0.01 | Mean Difference (Net) | -2.1 | 2-Sided | Superiority |
| miR6843 | t-test, 2 sided | 0.01 | Mean Difference (Net) | -1.59 | 2-Sided | Superiority |
| miR671 | t-test, 2 sided | 0.01 | Mean Difference (Net) | -0.95 | 2-Sided | Superiority |
| miR6503 | t-test, 2 sided | 0.02 | Mean Difference (Net) | -4.65 | 2-Sided | Superiority |
| miR450b | t-test, 2 sided | 0.02 | Mean Difference (Net) | 2.84 | 2-Sided | Superiority |
| miR485 | t-test, 2 sided | 0.02 | Mean Difference (Net) | -4.92 | 2-Sided | Superiority |
| miR6806 | t-test, 2 sided | 0.02 | Mean Difference (Net) | -2.49 | 2-Sided | Superiority |
| miR3182 | t-test, 2 sided | 0.02 | Mean Difference (Net) | 2.18 | 2-Sided | Superiority |
| miR142-3p | t-test, 2 sided | 0.02 | Mean Difference (Net) | 1.28 | 2-Sided | Superiority |
| miR320d | t-test, 2 sided | 0.02 | Mean Difference (Net) | -1.23 | 2-Sided | Superiority |
| miR3928 | t-test, 2 sided | 0.02 | Mean Difference (Net) | 2.73 | 2-Sided | Superiority |
| miR744 | t-test, 2 sided | 0.02 | Mean Difference (Net) | 4.59 | 2-Sided | Superiority |
| miR206 | t-test, 2 sided | 0.02 | Median Difference (Net) | 3.42 | 2-Sided | Superiority |
| miR30e | t-test, 2 sided | 0.03 | Mean Difference (Net) | 0.9 | 2-Sided | Superiority |
| miR4500 | t-test, 2 sided | 0.03 | Mean Difference (Net) | 1.52 | 2-Sided | Superiority |
| miR125a | t-test, 2 sided | 0.03 | Mean Difference (Net) | -0.98 | 2-Sided | Superiority |
| miR99b | t-test, 2 sided | 0.03 | Mean Difference (Net) | -0.6 | 2-Sided | Superiority |
| miR1 | t-test, 2 sided | 0.03 | Mean Difference (Net) | 2.67 | 2-Sided | Superiority |
| miR146b | t-test, 2 sided | 0.03 | Mean Difference (Net) | -0.77 | 2-Sided | Superiority |
| miR1255a | t-test, 2 sided | 0.03 | Mean Difference (Net) | -3.17 | 2-Sided | Superiority |
| miR223 | t-test, 2 sided | 0.03 | Mean Difference (Net) | 1.02 | 2-Sided | Superiority |
| miR642a | t-test, 2 sided | 0.03 | Mean Difference (Net) | -0.78 | 2-Sided | Superiority |
| miR548ae | t-test, 2 sided | 0.4 | Mean Difference (Net) | 2.17 | 2-Sided | Superiority |
| miR146b | t-test, 2 sided | 0.04 | Mean Difference (Net) | -0.79 | 2-Sided | Superiority |
| miR877 | t-test, 2 sided | 0.04 | Mean Difference (Net) | -2.52 | 2-Sided | Superiority |
| miR181a | t-test, 2 sided | 0.04 | Mean Difference (Net) | -0.69 | 2-Sided | Superiority |
| miR4467 | t-test, 2 sided | 0.04 | Mean Difference (Net) | -3.4 | 2-Sided | Superiority |
| miR1249 | t-test, 2 sided | 0.04 | Mean Difference (Net) | -2.48 | 2-Sided | Superiority |
| miR766 | t-test, 2 sided | 0.04 | Mean Difference (Net) | 3.87 | 2-Sided | Superiority |
| miR29c | t-test, 2 sided | 0.048 | Mean Difference (Net) | 1.07 | 2-Sided | Superiority |
| miR370 | t-test, 2 sided | -1.75 | Mean Difference (Net) | -1.75 | 2-Sided | Superiority |