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Non-coding RNAs Analysis of Eosinophil Subtypes in Asthma

Primary Purpose

Allergic Asthma, Severe Eosinophilic Asthma

Status
Unknown status
Phase
Not Applicable
Locations
Lithuania
Study Type
Interventional
Intervention
Dermatophagoides pteronyssinus allergen
Blood sampling
Bronchial challenge with allergen
Sponsored by
Lithuanian University of Health Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Allergic Asthma focused on measuring Eosinophils subtypes, Non-coding RNA, Exosome

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Men and women between the ages of 18-70 years;
  • Allergic asthma and sensitization to house dust mites (D. pteronyssinus) allergen, approved with: 1) medical history and symptoms more than one year; 2) skin prick test positive for D. pteronyssinus (positive wheals are those exceeding 3 mm in diameter greater than the negative control); 3) positive bronchial challenge with methacholine or documented reversible bronchial obstruction;
  • Severe eosinophilic asthma;
  • Premenopausal women if pregnancy test is negative;
  • Healthy subjects without allergic and other chronic respiratory diseases (control group);
  • Participants who gave his/her informed written consent.

Exclusion Criteria:

  • Asthma exacerbation 1 month prior to study;
  • Clinically significant permanent allergy symptoms (ex. cat or dog dander induced allergy);
  • Contraindications to perform an allergy skin test and/or bronchial provocation test: 1) active airway infection 1 month prior the study; 2) used medicaments: inhaled glucocorticoids intake 1 month prior the study, antihistamines intake 7 days prior the study; 3) short acting β2 agonists 12 hours prior the study; 4) long acting β2 agonists 2 days prior the study; 5) leukotriene receptor antagonists prior 14 days;
  • Contraindications for epinephrine;
  • Other significant mental and / or internal diseases and conditions, which could be as exclusion criteria due to the opinion of the researcher;
  • Alcohol or narcotic abuse;
  • Pregnancy;
  • Breast-feeding.

Sites / Locations

  • Lithuanian University of Health Sciences, Pulmonology DepartmentRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Allergic asthma patients

Severe eosinophilic asthma patients

Healthy subjects as a control group

Arm Description

Allergic asthma patients and sensitization to house dust mites (D. pteronyssinus) allergen.

Healthy subjects without allergic and other chronic respiratory diseases (control group).

Outcomes

Primary Outcome Measures

Fold changes of ncRNA expression between eosinophils subtypes
Validated ncRNA expression of rEOS and iEOS in severe and non-severe eosinophilic asthma patients and healthy subjects.
ncRNA levels in rEOS- and iEOS-derived exosomes
Qualitative and quantitative selected ncRNA levels in rEOS- and iEOS-derived exosomes of all investigated groups.

Secondary Outcome Measures

Fold changes of ncRNA profiles of distinct eosinophil subtypes
Non-validated whole ncRNA profiles of distinct eosinophil subtypes in severe and non-severe eosinophilic asthma patients and healthy subjects.
The fold changes of rEOS and iEOS surface integrins expression
The gene expression of selected outer-membrane integrins in eosinophil subtypes.
The fold changes of rEOS and iEOS eosinophilopoietins receptors expression
The gene expression of interleukin (IL)-5, IL-3, and granulocyte-macrophage colony-stimulating factor in eosinophil subtypes.
The efficiency of iEOS and rEOS adhesion
The differences in stable adhered iEOS and rEOS quantity in the combined cell culture with airway smooth muscle (ASM) cells or pulmonary fibroblasts compared between the investigated groups.
iEOS and rEOS survival differences
Viable iEOS and rEOS number after an appropriate period of time in combined cell culture with ASM cells or pulmonary fibroblasts.
Quantity of iEOS and rEOS synthesized reactive oxygen species
Relative differences between iEOS and rEOS synthesized reactive oxygen species quantity after an appropriate period of incubation alone or with ASM cells or pulmonary fibroblasts.
Apoptotic iEOS and rEOS number
The number of apoptotic iEOS and rEOS after an appropriate period of time in combined cell culture with ASM cells or pulmonary fibroblasts.
Concentrations of iEOS and rEOS produced proteins in investigated subjects' body fluids.
Selected iEOS and rEOS proteins concentrations, measured in investigated subjects body fluids, expressed as the amount of protein in the respective amount of fluid sample.
iEOS and rEOS effect on airway smooth muscle cells or pulmonary fibroblasts proliferation
The quantity of ASM cells or pulmonary fibroblasts after several repeats of proliferation in the presence or absence of eosinophil subtypes.
iEOS and rEOS effect on apoptotic ASM cells and pulmonary fibroblasts number
The number of apoptotic ASM cells and pulmonary fibroblasts after an appropriate period of time in combined cell culture with iEOS and rEOS.
iEOS and rEOS effect on migration of ASM cells.
The migrated ASM cells number after an appropriate period of time in combined cell culture with iEOS and rEOS
iEOS and rEOS effect on migration of pulmonary fibroblasts
The migrated pulmonary fibroblasts number after an appropriate period of time in combined cell culture with iEOS and rEOS
iEOS and rEOS effect on ASM cells contractility
The relative efficiency of ASM cells' ability to contract collagen gel after an appropriate period of time in combined cell culture with iEOS and rEOS, expressed as reduced poured gel size in percentage, compared with control ASM cells without incubation with eosinophils.
iEOS and rEOS effect on pulmonary fibroblasts contractility
The relative efficiency of pulmonary fibroblasts ability to contract collagen gel after an appropriate period of time in combined cell culture with iEOS and rEOS. expressed as reduced poured gel size in percentage, compared with control pulmonary fibroblasts, without incubation with eosinophils.
iEOS and rEOS effect on fold changes of ASM cells and pulmonary fibroblasts proteins expression;
Altered selected ASM cells and pulmonary fibroblasts proteins expression, after incubation with iEOS and rEOS, expressed as fold changes in comparison with control cells, without incubation with eosinophils
iEOS and rEOS effect on fold changes of ASM cells and pulmonary fibroblasts proteins gene expression;
Altered selected ASM cells and pulmonary fibroblasts proteins gene expression, after incubation with iEOS and rEOS, expressed as fold changes in comparison with control cells, without incubation with eosinophils

Full Information

First Posted
August 25, 2020
Last Updated
September 7, 2020
Sponsor
Lithuanian University of Health Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT04542902
Brief Title
Non-coding RNAs Analysis of Eosinophil Subtypes in Asthma
Official Title
Non-coding RNAs Analysis of Eosinophil Subtypes in Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Unknown status
Study Start Date
October 1, 2020 (Anticipated)
Primary Completion Date
October 1, 2023 (Anticipated)
Study Completion Date
October 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Lithuanian University of Health Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Chronic airway inflammation rich in eosinophils is an important feature seen in asthma. Airway and blood eosinophilia is associated with increased rates of asthma exacerbations and more intense treatment. Recently, the existence of two distinct eosinophils subtypes was revealed-lung-resident eosinophils (rEOS), which maturate independently to interleukin (IL) 5, with the primary function to maintain tissue homeostasis, and inflammatory eosinophils (iEOS), which mature in IL-5-dependent manner and are mainly involved in immune responses. Eosinophils' effect on the airway remodeling in asthma depends not only on the activity but also by their viable number in the lungs. Blood iEOS infiltrate the airways mainly after the environmental stimulus like allergen and leave the airways with bronchial secretions. However, rEOS reside lung tissue for their entire lifetime regulating local immunity. Blood rEOS and iEOS ratio alters in asthma, compared with healthy controls. It is known that the predominant eosinophils subtype in allergic asthma are iEOS, while rEOS are basic subtype in severe eosinophilic asthma patients, moreover, they are different in adhesive properties and survivability as well. Distinct biological properties allows to speculate about their different functions in asthma, however, there are still little information. Data about differently expressed microRNA (miRNA) profiles in eosinophils in asthma suggests, that eosinophils subtypes can be distinct in non-coding RNA (ncRNA) - microRNA (miRNA), piwi-interacting RNA (piRNA) and long non-coding RNA (IncRNA) profiles that could describe their role in asthma pathogenesis and act as biomarkers to discern asthma phenotypes.
Detailed Description
Asthma is not cured, and only well-balanced treatment can control the course and severity of the disease. Most clinical symptoms rise from aberrant chronic airway inflammation mostly eosinophilic. Eosinophils are terminally differentiated granulocytes that actively contribute to innate and adaptive inflammatory cascades through the production and release of diverse chemokines, cytokines, lipid mediators and other growth factors. IL-5 plays a fundamental role in eosinophils maturation in the bone marrow, their recruitment, and activation at sites of inflammation. Historically eosinophils were described as a critical player in host defense, including parasites, viruses, fungi, or bacteria, giving them a destructive inflammatory cell label. However, it became clear that steady-state eosinophils can contribute to the immunoregulation and tissue homeostasis as well. Studies revealed that there are distinct eosinophils subtypes - immunoregulatory lung-resident eosinophils (rEOS) and inflammatory eosinophils (iEOS), involved in immune responses. Distinct eosinophils subtypes with different functions determines the separate treatment. There are still only a few studies describing distinct eosinophils subtypes in the lungs or blood. It is the beginning of a new promising research area for better individualized eosinophilic asthma treatment, moreover, other eosinophilic diseases as well. Peripheral blood eosinophils studies are sufficiently relevant to the tissue eosinophils studies, as blood eosinophils are released into the bloodstream in a fully maturated form. Moreover, peripheral blood study could give additional information with possibilities to prevent eosinophils effects in the early stage, before migration to the airways. Furthermore, the existence of tissue-resident eosinophils in peripheral blood is confirmed and primary research for eosinophil subtypes surface markers was made according to the data of human blood eosinophils. Data about differently differently expressed microRNA (miRNA) profiles in eosinophils in asthma suggests, that eosinophils subtypes can be distinct in non-coding RNA (ncRNA) - microRNA (miRNA), piwi-interacting RNA (piRNA) and long non-coding RNA (IncRNA) profiles that could describe their role in asthma pathogenesis and act as biomarkers to discern asthma phenotypes. Researchers have plan to expand research by analyzing non-coding RNA (ncRNA) - miRNA, piRNA and lncRNA profiles of rEOS and iEOS as well as selected ncRNA signatures in blood plasma estimating their diagnostic value. Moreover, additional investigation of ncRNA in eosinophil-derived exosomes will provide important data about possible effect of eosinophils subtypes on airway remodeling via secreted ncRNA. ncRNAs are key regulators for gene transcription. However, there is evidence about their dysregulation in eosinophils during asthma. It will give important information about molecular signaling pathways that regulate the activity of distinct eosinophil subtypes during health and asthma, and provide the essential information about possible new therapeutic targets for their control. Additionally researchers will investigate the biological differences between rEOS and iEOS, including surface integrins and eosinophilopoietins receptors expression, adhesive properties, survivability, synthesized reactive oxygen species and apoptosis, as well as their effect on pulmonary structural cells physiological activity as proliferation, apoptosis, migration, contractility and proteins production, and will relate it with molecular signaling pathways, regulated by distinct expressed ncRNAs. ncRNAs can be stored in eosinophils exosomes and expressed to the surrounding environment. Information about ncRNAs in eosinophils-derived exosomes will demonstrate their function by affecting the other cells, especially after migration to airways. Moreover, ncRNAs are stable and resistant to blood RNases and differentially expressed in several pathologies. Researchers suppose that altered blood levels of ncRNAs could act as a possible new diagnostic biomarker in asthma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Allergic Asthma, Severe Eosinophilic Asthma
Keywords
Eosinophils subtypes, Non-coding RNA, Exosome

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
80 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Allergic asthma patients
Arm Type
Experimental
Arm Description
Allergic asthma patients and sensitization to house dust mites (D. pteronyssinus) allergen.
Arm Title
Severe eosinophilic asthma patients
Arm Type
Experimental
Arm Title
Healthy subjects as a control group
Arm Type
Active Comparator
Arm Description
Healthy subjects without allergic and other chronic respiratory diseases (control group).
Intervention Type
Biological
Intervention Name(s)
Dermatophagoides pteronyssinus allergen
Intervention Description
Dermatophagoides pteronyssinus allergen is required to perform allergen bronchial challenge test.
Intervention Type
Procedure
Intervention Name(s)
Blood sampling
Intervention Description
An amount of a person's blood taken from their body for use in medical.
Intervention Type
Procedure
Intervention Name(s)
Bronchial challenge with allergen
Intervention Description
Bronchial challenge is performed with D. pteronyssinus allergen. Measurements of differences in eosinophils activity after allergen challenge.
Primary Outcome Measure Information:
Title
Fold changes of ncRNA expression between eosinophils subtypes
Description
Validated ncRNA expression of rEOS and iEOS in severe and non-severe eosinophilic asthma patients and healthy subjects.
Time Frame
From 6 to 12 months
Title
ncRNA levels in rEOS- and iEOS-derived exosomes
Description
Qualitative and quantitative selected ncRNA levels in rEOS- and iEOS-derived exosomes of all investigated groups.
Time Frame
From 12 to 18 months
Secondary Outcome Measure Information:
Title
Fold changes of ncRNA profiles of distinct eosinophil subtypes
Description
Non-validated whole ncRNA profiles of distinct eosinophil subtypes in severe and non-severe eosinophilic asthma patients and healthy subjects.
Time Frame
From 6 to 12 months
Title
The fold changes of rEOS and iEOS surface integrins expression
Description
The gene expression of selected outer-membrane integrins in eosinophil subtypes.
Time Frame
From 6 to 12 months
Title
The fold changes of rEOS and iEOS eosinophilopoietins receptors expression
Description
The gene expression of interleukin (IL)-5, IL-3, and granulocyte-macrophage colony-stimulating factor in eosinophil subtypes.
Time Frame
From 6 to 12 months
Title
The efficiency of iEOS and rEOS adhesion
Description
The differences in stable adhered iEOS and rEOS quantity in the combined cell culture with airway smooth muscle (ASM) cells or pulmonary fibroblasts compared between the investigated groups.
Time Frame
From 6 to 12 months
Title
iEOS and rEOS survival differences
Description
Viable iEOS and rEOS number after an appropriate period of time in combined cell culture with ASM cells or pulmonary fibroblasts.
Time Frame
From 6 to 12 months
Title
Quantity of iEOS and rEOS synthesized reactive oxygen species
Description
Relative differences between iEOS and rEOS synthesized reactive oxygen species quantity after an appropriate period of incubation alone or with ASM cells or pulmonary fibroblasts.
Time Frame
From 6 to 12 months
Title
Apoptotic iEOS and rEOS number
Description
The number of apoptotic iEOS and rEOS after an appropriate period of time in combined cell culture with ASM cells or pulmonary fibroblasts.
Time Frame
From 6 to 12 months
Title
Concentrations of iEOS and rEOS produced proteins in investigated subjects' body fluids.
Description
Selected iEOS and rEOS proteins concentrations, measured in investigated subjects body fluids, expressed as the amount of protein in the respective amount of fluid sample.
Time Frame
From 6 to 12 months
Title
iEOS and rEOS effect on airway smooth muscle cells or pulmonary fibroblasts proliferation
Description
The quantity of ASM cells or pulmonary fibroblasts after several repeats of proliferation in the presence or absence of eosinophil subtypes.
Time Frame
From 6 to 12 months
Title
iEOS and rEOS effect on apoptotic ASM cells and pulmonary fibroblasts number
Description
The number of apoptotic ASM cells and pulmonary fibroblasts after an appropriate period of time in combined cell culture with iEOS and rEOS.
Time Frame
From 6 to 12 months
Title
iEOS and rEOS effect on migration of ASM cells.
Description
The migrated ASM cells number after an appropriate period of time in combined cell culture with iEOS and rEOS
Time Frame
From 6 to 12 months
Title
iEOS and rEOS effect on migration of pulmonary fibroblasts
Description
The migrated pulmonary fibroblasts number after an appropriate period of time in combined cell culture with iEOS and rEOS
Time Frame
From 6 to 12 months
Title
iEOS and rEOS effect on ASM cells contractility
Description
The relative efficiency of ASM cells' ability to contract collagen gel after an appropriate period of time in combined cell culture with iEOS and rEOS, expressed as reduced poured gel size in percentage, compared with control ASM cells without incubation with eosinophils.
Time Frame
From 6 to 12 months
Title
iEOS and rEOS effect on pulmonary fibroblasts contractility
Description
The relative efficiency of pulmonary fibroblasts ability to contract collagen gel after an appropriate period of time in combined cell culture with iEOS and rEOS. expressed as reduced poured gel size in percentage, compared with control pulmonary fibroblasts, without incubation with eosinophils.
Time Frame
From 6 to 12 months
Title
iEOS and rEOS effect on fold changes of ASM cells and pulmonary fibroblasts proteins expression;
Description
Altered selected ASM cells and pulmonary fibroblasts proteins expression, after incubation with iEOS and rEOS, expressed as fold changes in comparison with control cells, without incubation with eosinophils
Time Frame
From 6 to 12 months
Title
iEOS and rEOS effect on fold changes of ASM cells and pulmonary fibroblasts proteins gene expression;
Description
Altered selected ASM cells and pulmonary fibroblasts proteins gene expression, after incubation with iEOS and rEOS, expressed as fold changes in comparison with control cells, without incubation with eosinophils
Time Frame
From 6 to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Men and women between the ages of 18-70 years; Allergic asthma and sensitization to house dust mites (D. pteronyssinus) allergen, approved with: 1) medical history and symptoms more than one year; 2) skin prick test positive for D. pteronyssinus (positive wheals are those exceeding 3 mm in diameter greater than the negative control); 3) positive bronchial challenge with methacholine or documented reversible bronchial obstruction; Severe eosinophilic asthma; Premenopausal women if pregnancy test is negative; Healthy subjects without allergic and other chronic respiratory diseases (control group); Participants who gave his/her informed written consent. Exclusion Criteria: Asthma exacerbation 1 month prior to study; Clinically significant permanent allergy symptoms (ex. cat or dog dander induced allergy); Contraindications to perform an allergy skin test and/or bronchial provocation test: 1) active airway infection 1 month prior the study; 2) used medicaments: inhaled glucocorticoids intake 1 month prior the study, antihistamines intake 7 days prior the study; 3) short acting β2 agonists 12 hours prior the study; 4) long acting β2 agonists 2 days prior the study; 5) leukotriene receptor antagonists prior 14 days; Contraindications for epinephrine; Other significant mental and / or internal diseases and conditions, which could be as exclusion criteria due to the opinion of the researcher; Alcohol or narcotic abuse; Pregnancy; Breast-feeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Kestutis Prof. Dr. Malakauskas
Phone
+37037326737
Email
kestutis.malakauskas@lsmuni.lt
First Name & Middle Initial & Last Name or Official Title & Degree
Jolita Palacionyte
Phone
+37062591727
Email
jolita.palacionyte@lsmuni.lt
Facility Information:
Facility Name
Lithuanian University of Health Sciences, Pulmonology Department
City
Kaunas
ZIP/Postal Code
LT-50009
Country
Lithuania
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kęstutis Malakauskas, Prof., Dr.
Phone
+37037326737
Email
kestutis.malakauskas@lsmuni.lt

12. IPD Sharing Statement

Plan to Share IPD
No
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Non-coding RNAs Analysis of Eosinophil Subtypes in Asthma

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