The Nasal Airway in Chronic Obstructive Pulmonary Disease

Study Overview
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Brief Summary
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The study is based on the theory of a unified airway that considers the nose and paranasal sinuses together with lower airways as one integrated unit. The upper and lower respiratory tracts function as an interdependent physiologic mechanism, and stimuli that trigger changes in one portion of the airway, can provoke similar changes throughout the airway. This is well documented in asthmatic patients but documented poorly in patients suffering from chronic obstructive lung disease (COPD). COPD is associated with sinonasal symptoms and decreased quality of life. Although nasal involvement has been found to directly affect the lower airway, sinonasal disease is under-diagnosed and under-treated in patients with COPD. This study is embedded in a larger project where the goal is to gain knowledge supporting the theory of a unified airway in patients with COPD. Here sinonasal, pulmonary and generic health related quality of life will be studied in a group of patients with COPD versus a control group. The severity of nasal airway obstruction will be linked to the the severity of pulmonary airway obstruction. Assessment of pathological changes in the nose with nasal endoscopy, as well as performing a nasal cytological brushing for the identification of nasal inflammatory responses in the nose, will be conducted in both the control and study group.

Official Title
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The Nasal Airway in Chronic Obstructive Pulmonary Disease

Conditions
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Pulmonary Disease, Chronic Obstructive

Intervention / Treatment
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* Other: Upper airway assessment, including nasal biopsy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of COPD: all stages Healthy individuals for the control group Exclusion Criteria both groups: asthma systemic disease such as Cystic Fibrosis, Kartagener syndrome, sarcoidosis upper airway infection during the last 2 weeks COPD exacerbation during the last 6 weeks previous surgery in the nose and paranasal sinuses ongoing treatment for malignant disease severe depression, Alzheimers disease and Parkinson's disease pregnancy or nursing

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| COPD patients<br>Self administered questionnaires regarding sinonasal and lung symptoms, quality of life as well as symptoms of depression and anxiety. Lower airway assessment using Spirometry with reversibility Upper airway assessment using Acoustic Rhinometry, Rhinomanometry and Peak nasal Inspiratory Flow Nasal biopsy using a nasal brush Nasal endoscopy Allergic prick-test | Other: Upper airway assessment, including nasal biopsy<br> <br> |
| Healthy subjects<br>Self administered questionnaires regarding sinonasal and lung symptoms, quality of life as well as symptoms of depression and anxiety. Lower airway assessment using Spirometry with reversibility Upper airway assessment using Acoustic Rhinometry, Rhinomanometry and Peak nasal Inspiratory Flow Nasal biopsy using a nasal brush Nasal endoscopy Allergic prick-test | Other: Upper airway assessment, including nasal biopsy<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pathological changes in the nose assessed with nasal endoscopy |  | 4 hours | 
| inflammatory responses in the nose identified by nasal cytological brushing |  | 4 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Paranasal Sinus Diseases, Nasal Obstruction