NCT01847768

Brief Summary

In this study, the following subjects will be exposed to human rhinovirus (HRV):

  • those with classification of mild-moderate asthma
  • healthy control subjects. The investigators will study the kinetics of HRV-induced inflammatory and remodeling responses in a well characterized group of asthmatic subjects and compare these outcomes to those in a healthy, non-asthmatic control group.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2

participants targeted

Target at below P25 for not_applicable asthma

Timeline
Completed

Started Apr 2013

Typical duration for not_applicable asthma

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

April 1, 2013

Completed
1 month until next milestone

First Submitted

Initial submission to the registry

May 1, 2013

Completed
6 days until next milestone

First Posted

Study publicly available on registry

May 7, 2013

Completed
2.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2015

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2015

Completed
Last Updated

August 14, 2015

Status Verified

August 1, 2015

Enrollment Period

2.2 years

First QC Date

May 1, 2013

Last Update Submit

August 12, 2015

Conditions

Keywords

asthmarhinovirusremodeling mediatorshuman rhinovirus infection

Outcome Measures

Primary Outcomes (1)

  • Bronchial Alveolar Lavage (BAL) Fluid Protein Levels

    The primary endpoint will be the protein levels in BAL fluid at Day 4 (post-infection) minus the value at Day -7 (pre-infection) for each of MMP-9, VEGF amphiregulin and activin A.

    Day -7 and Day 4

Secondary Outcomes (4)

  • Quantitative Changes in Gene Expression Between Groups

    Day -7 and Day 4

  • Changes in symptom scores, viral titers, spirometry, airway responsiveness (PC20 methacholine) and FeNO levels.

    Day -7 and Day 4

  • Quantification of inflammatory cells in the lower airways, assessed in BAL fluid and bronchial biopsies.

    Day -7 and Day 4

  • Correlation of gene expression and protein levels of selected mediators with viral titer, symptom scores and numbers of inflammatory cells in the upper and lower airways.

    Day -7 and Day 4

Study Arms (2)

Asthmatic Group

EXPERIMENTAL

Subjects with well-controlled, mild-moderate allergic asthma.Subjects will be inoculated with a total dose of 1000 TCID50 of HRV- 39. The inoculum is diluted, as appropriate, in lactated Ringer's solution and delivered via the following procedure: 0.5 ml per nostril is administered by pipette while the subject tilts their head back.

Biological: GMP-grade HRV-39Procedure: Bronchoalveolar LavageDrug: Methacholine Inhalation ChallengeProcedure: Nasal LavageProcedure: Nasal ScrapingsProcedure: Bronchial BrushingsProcedure: Lung Mucosal BiopsyProcedure: Allergen Skin Prick TestingProcedure: VenipunctureProcedure: BronchoscopyProcedure: Spirometry

Healthy Non-Asthmatic Control Group

ACTIVE COMPARATOR

Healthy volunteers. Subjects will be inoculated with a total dose of 1000 TCID50 of HRV- 39. The inoculum is diluted, as appropriate, in lactated Ringer's solution and delivered via the following procedure: 0.5 ml per nostril is administered by pipette while the subject tilts their head back.

Biological: GMP-grade HRV-39Procedure: Bronchoalveolar LavageDrug: Methacholine Inhalation ChallengeProcedure: Nasal LavageProcedure: Nasal ScrapingsProcedure: Bronchial BrushingsProcedure: Lung Mucosal BiopsyProcedure: Allergen Skin Prick TestingProcedure: VenipunctureProcedure: BronchoscopyProcedure: Spirometry

Interventions

Experimental rhinovirus infection: an FDA approved, GMP-grade HRV-39 stock (gift from Dr. Ronald B. Turner, University of Virginia), which has now been approved by Health Canada for human experimental use, will be used in this study.

Also known as: human rhinovirus, common cold
Asthmatic GroupHealthy Non-Asthmatic Control Group
Asthmatic GroupHealthy Non-Asthmatic Control Group

The purpose of this test is to determine if lung airways narrow by more than 20%, which confirms an asthma diagnosis.

Asthmatic GroupHealthy Non-Asthmatic Control Group
Nasal LavagePROCEDURE
Asthmatic GroupHealthy Non-Asthmatic Control Group

This process uses a rhinoprobe to gently scrape the mucosal lining of the nose

Asthmatic GroupHealthy Non-Asthmatic Control Group
Asthmatic GroupHealthy Non-Asthmatic Control Group
Asthmatic GroupHealthy Non-Asthmatic Control Group

For the purposes of this study, allergy skin testing will be done with the following aero-allergens: cat epidermis, dog epidermis, horse, grass mix, tree mix, weed mix, ragweed and house dust mite, along with a histamine positive control and a buffer \& glycerol negative control.

Asthmatic GroupHealthy Non-Asthmatic Control Group
VenipuncturePROCEDURE

Peripheral blood for assessment of neutralizing antibodies to HRV-39

Also known as: Blood draw
Asthmatic GroupHealthy Non-Asthmatic Control Group
BronchoscopyPROCEDURE

A small flexible tube the size of a pencil, with a video-camera built into the tip (called a bronchoscope), will be inserted through the nose or mouth and down into the lungs.

Asthmatic GroupHealthy Non-Asthmatic Control Group
SpirometryPROCEDURE
Asthmatic GroupHealthy Non-Asthmatic Control Group

Eligibility Criteria

Age18 Years - 50 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Asthmatics:
  • Male or female volunteers with intermittent or persistent mild to moderate allergic asthma, as defined by GINA guidelines 39.
  • Between ≥18 and ≤ 50 years of age.
  • Objective evidence of variable airflow limitation (≥12% and at least 200mL post-bronchodilator reversibility from baseline), or airway hyperresponsiveness (PC20 methacholine \<16mg/ml) at the screening visit or within past 24 months.
  • Pre-bronchodilator spirometry at baseline; FEV1 ≥70% of predicted; FEV1/VC ≥50%.
  • Atopic, as evidenced by positive skin prick tests to ≥1 common aero-allergen, where positive is defined by a wheal of ≥2 mm compared to the negative control.
  • Not be exposed to sensitizing seasonal allergens for at least 4 weeks before the study. Chronic exposure to perennial allergens will be permitted.
  • Asthma symptoms controlled by either inhaled β22-agonists alone, or by low or moderate dose ICS (≤800mcg of budesonide or equivalent per day), administered either as monotherapy or in a fixed-dose combination with a long-acting β22-agonist (LABA). The doses of these maintenance medications should have remained stable for the 4 weeks prior to the study screening phase (Visit 2).
  • Stable asthma symptoms, with no history of asthma exacerbation requiring short burst prednisone treatment within the 3 months prior to study entry.
  • Be a non-smoker, as defined as no smoking in past 12 months, and have a lifetime ≤ 10 pack-year smoking history.
  • In good general health (other than asthma) without clinically significant medical history of other co-morbidities, and a BMI of ≤ 30 kg/m2.
  • Have no history of any life threatening episode of asthma, as judged by the study physician; this may include, but not be limited to, prior ICU admission or intubation.
  • Subjects, or their partners, must be using a reliable form of contraception continuously from 4 weeks prior, to 4 weeks post participation.
  • Non-Asthmatics:
  • Male or female volunteers, ≥18 and ≤ 50 years of age, in good general health, without a clinically significant medical history and a BMI of ≤ 30 kg/m2.
  • +6 more criteria

You may not qualify if:

  • Presence of neutralizing antibodies to HRV-39 at the screening visit to a titer of ≥ 1:2.
  • Have symptoms of an active viral respiratory tract infection (cold symptoms), corroborated by a score of 3 or higher on the Jackson cold symptom questionnaire, during the screening phase (Visit 3).
  • Current pregnancy or positive urine pregnancy test at screening or during the study.
  • Use of any of the following medications in preceding 4 weeks prior to study entry and during the study: : oral and topical antihistamines, leukotriene receptor antagonists, inhaled anticholinergics, non-steroidal anti-inflammatory drugs (NSAIDS), antibiotics and anti-viral medications, over the counter 'cold' and influenza remedies, including decongestants, and oral anticoagulants.
  • Use of prednisone within the last 3 months.
  • Current acute or chronic illness (including infection) or recent recovery (within 4 weeks) from acute illness which could, in the opinion of the study physician, alter inflammatory responses (e.g., influenza, cold or other respiratory infection, etc.). • Autoimmune disease or immunodeficiency, or any household contacts who are known to be immune deficient.
  • Known allergy to lidocaine.
  • Any other significant concomitant medical issue, or findings on physical examination or laboratory testing that, in the opinion of the study physician, may pose additional risks from participation in the study (including undergoing bronchoscopy), or which may impact the quality or interpretation of the data obtained from the study.
  • Clinically significant pre-bronchoscopy safety assessment laboratory tests (CBC, INR, electrolytes and creatinine), as well as a positive urine pregnancy test on all female subjects of child-bearing age, will be done at visit 2 (day -26) and visit 5 (Day 0) prior to bronchoscopy on Day -7 and Day 4.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Calgary

Calgary, Alberta, T2N 4Z6, Canada

Location

MeSH Terms

Conditions

Asthma

Interventions

viral protein 1, rhinovirusCold TemperatureBronchoalveolar LavageNasal LavagePhlebotomyBlood Specimen CollectionBronchoscopy

Condition Hierarchy (Ancestors)

Bronchial DiseasesRespiratory Tract DiseasesLung Diseases, ObstructiveLung DiseasesRespiratory HypersensitivityHypersensitivity, ImmediateHypersensitivityImmune System Diseases

Intervention Hierarchy (Ancestors)

TemperatureThermodynamicsPhysical PhenomenaWeatherAtmosphereEnvironmentEcological and Environmental PhenomenaBiological PhenomenaMeteorological ConceptsEnvironment and Public HealthTherapeutic IrrigationInvestigative TechniquesSpecimen HandlingClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisPuncturesTherapeuticsSurgical Procedures, OperativeDiagnostic Techniques, Respiratory SystemEndoscopyDiagnostic Techniques, SurgicalMinimally Invasive Surgical ProceduresPulmonary Surgical ProceduresThoracic Surgical Procedures

Study Officials

  • David Proud, PhD

    University of Calgary

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
BASIC SCIENCE
Intervention Model
PARALLEL
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 1, 2013

First Posted

May 7, 2013

Study Start

April 1, 2013

Primary Completion

July 1, 2015

Study Completion

July 1, 2015

Last Updated

August 14, 2015

Record last verified: 2015-08

Locations