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To evaluate the relationship between airway structure and function in patients with chronic bronchitis treated with metered cryospray (MCS).
To identify the molecular and cellular targets of MCS treatment and determine the mechanistic relationship to airways remodelling in patients with chronic bronchitis. Phenotype, characterise and correlate clinical, physiological, histological and molecular parameters in patients with chronic bronchitis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment | Active Comparator | MCS |
|
| Sham Control | Sham Comparator | Sham |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| RejuvenAir System | Device | Bronchial metered cryospray using RejuvenAir® System. |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Goblet cell density | Difference in change relative to baseline in goblet cell density per mm of basement membrane in endobronchial cryobiopsies at 6-months between treatment and sham-control groups | 6-months post treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Histopathological examination of endobronchial cryobiopsies to determine Inflammatory cells and subtype density per mm of basement membrane | Proportion of inflammatory cells per mm of basement membrane for Neutrophil and Lymphocyte sequencing (RNA-seq) | 6-months post treatment |
| Histopathological examination of endobronchial cryobiopsies to determine epithelial cell density and area (including respiratory epithelial, goblet and basal cells) per mm of basement membrane |
| Measure | Description | Time Frame |
|---|---|---|
| Microvesicle quantification | Microvesicle quantification | 6-months post treatment |
| Lobar volumes and gas trapping as determined by quantitative CT and parametric response mapping | Lobar volumes and gas trapping as determined by quantitative CT and parametric response mapping |
Inclusion Criteria:
Each Subject must meet the following criteria to be enrolled in the study:
Exclusion Criteria:
A potential subject who meets any of the following criteria will be excluded from participation in this study:
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| Name | Affiliation | Role |
|---|---|---|
| Pallav Shah, MD | The Royal Brompton Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Medical Center Groningen | Groningen | Netherlands | ||||
| The Royal Brompton Hospital |
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| ID | Term |
|---|---|
| D029424 | Pulmonary Disease, Chronic Obstructive |
| D029481 | Bronchitis, Chronic |
| ID | Term |
|---|---|
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002908 | Chronic Disease |
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| ID | Term |
|---|---|
| C005703 | salicylhydroxamic acid |
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Prospective, multi-centre, randomised, blinded, sham controlled trial with 1:1 randomisation. Sham-control arm subjects are eligible to receive treatment after the 6-month visit.
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Sham controlled.
| Sham |
| Other |
Sham control procedure |
|
Proportion of epithelial cells per mm of basement membrane for Ciliary and Goblet cells |
| 6-months post treatment |
| Transcriptomics: Epithelial gene expression as measured by global gene expression sequencing (RNA-seq) | Transcriptomics: Epithelial gene expression as measured by global gene expression sequencing (RNA-seq) | 6-months post treatment |
| Pulmonary function tests including spirometry, body plethysmography and transfer factors KCO and TLCO | Pulmonary function tests including spirometry, body plethysmography and transfer factors KCO and TLCO | 6-months post treatment |
| Patient reported outcome measures including SGRQ, mMRC, CAT and Cough Questionnaires | Patient reported outcome measures including SGRQ, mMRC, CAT and Cough Questionnaires | 6-months post treatment |
| Health care utilisation assessments including number of respiratory exacerbations, emergency room visits, hospital and intensive care unit admissions related to respiratory adverse events | Health care utilisation assessments including number of respiratory exacerbations, emergency room visits, hospital and intensive care unit admissions related to respiratory adverse events | 6-months post treatment |
| The 6-minute walk tests | The 6-minute walk tests | 6-months post treatment |
| 6-months post treatment |
| Small airways function as assessed by Impulse Oscillometry (IOS) | Small airways function as assessed by Impulse Oscillometry (IOS) | 6-months post treatment |
| Composition of epithelial ultrastructure as assessed by transmission electron microscopy | Composition of epithelial ultrastructure as assessed by transmission electron microscopy | 6-months post treatment |
| London |
| SW3 6NP |
| United Kingdom |
| D020969 |
| Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001991 | Bronchitis |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D001982 | Bronchial Diseases |