The Effect of Allergen Inhalation on Sputum Myeloid and Plasmacytoid Dendritic Cells in Mild Atopic Asthmatics

Study Overview
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Brief Summary
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Summary: A picture is emerging of dendritic cells migrating through the blood to the airways following allergen inhalation in atopic asthmatics. Although the Koh and McCarthy articles present novel findings, both do not provide a comprehensive view of sputum DCs following allergen challenge. Therefore, the proposed study will examine the kinetics of mDCs and pDCs in the induced sputum of atopic asthmatics following inhalation of allergen. Hypothesis: Following allergen challenge, sputum myeloid and plasmacytoid DCs will migrate into the airway lumen in atopic asthmatics during the timeframe of the late asthmatic response. Objective: The objective of this study is to examine the kinetics of dendritic cells in induced sputum following allergen challenge in atopic asthmatic subjects.

Detailed Description
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Subjects will be put through two study periods. Each study period will consist of four visits and will be separated by 2-4 weeks. On the first visit, subjects will undergo screening procedures, including complete history and physical examination. In addition, methacholine inhalation challenge and skin-prick testing will be preformed to assess airway hyper-responsiveness and determine atopic status respectively. Lastly, sputum will be induced before challenge (0 hrs) and peripheral blood will be collected. On the second visit, subjects will inhale diluent or allergen and sputum will be collected 7 hours following inhalation challenge. Next, on the third visit, subjects will return 24 hours following inhalation challenge and sputum will be induced. On the final visit, subjects will return 72 hours following inhalation challenge and sputum will be collected, along with peripheral blood. Before the next study period begins, there will be a washout period of 2-4 weeks. On the first visit of the second study period, a methacholine challenge will be performed to ensure the return of PC20 to within one doubling dose of baseline values. Also, sputum will be induced before challenge (0hrs) and peripheral blood will be collected. On the second visit, subjects will inhale diluent or allergen and sputum will be collected 7hrs following inhalation challenge. Next, on the third visit, subjects will return 24 hours following inhalation challenge and sputum will be induced. On the final visit, subjects will return 72 hours following inhalation challenge and sputum will be collected, along with peripheral blood.

Official Title
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The Effect of Allergen Inhalation on Sputum Myeloid and Plasmacytoid Dendritic Cells in Mild Atopic Asthmatics

Conditions
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Asthma

Intervention / Treatment
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* Drug: Aeroallergen


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Mild atopic asthmatics, presently well controlled on ß2-agonists. Non-smokers. Baseline FEV1 more than 70% of predicted normal. Exclusion Criteria: Airway infection during the last 4 weeks. Exacerbation during the last 4 weeks. Inhaled or oral steroids during the last 4 weeks. Antihistamines during the last 48 hours. Asthma medication other than inhaled and/or oral ß2-agonists during the last 4 weeks. Pregnant women.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Diluent<br>Inhalation challenge preformed with diluent. | Drug: Aeroallergen<br> <br> |
| Active Comparator: Allergen<br>Inhalation challenge preformed with allergen. | Drug: Aeroallergen<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Primary Outcome Measure for This Study is the Number of Sputum Myeloid Dendritic Cells | Flow-cytometric acquisitions were used to determine the percentage of each type of mononuclear cell. These percentages were multiplied by the number of sputum mononuclear cells calculated by using total and differential cell counts of the sputum sample. | 24 hrs | 
| The Primary Outcome Measure for This Study is the Number of Sputum Plasmacytoid Dendritic Cells | Flow-cytometric acquisitions were used to determine the percentage of each type of mononuclear cell. These percentages were multiplied by the number of sputum mononuclear cells calculated by using total and differential cell counts of the sputum sample. | 24 hrs | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Secondary Outcome Measure is the Level of Specific Chemokines Released in the Sputum Supernatant. |  | Before inhalation (0hrs) | 
| The Secondary Outcome Measure is the Level of Specific Chemokines Released in the Sputum Supernatant |  | 7 hrs | 
| The Secondary Outcome Measure is the Level of Specific Chemokines Released in the Sputum Supernatant |  | 24 hrs | 
| The Secondary Outcome Measure is the Level of Specific Chemokines Released in the Sputum Supernatant |  | 72 hrs | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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asthma, atopy, allergen challenge, sputum myeloid and plasmacytoid dendritic cells