Bronchiesctasis Longitudinal Observational Cohort Study (BLOCS)

• Research type

  Research Study

• Full title

  Bronchiesctasis Longitudinal Observational Cohort Study.(BLOCS). Cross sectional and longitudinal anaylsis of imflammatory markers in bronchiesctasis.

• IRAS ID

  143510

• Contact name

  Anthony De Soyza

• Contact email

  anthony.desoyza@nuth.nhs.uk

• Research summary

  Bronchiectasis is an abnormal dilation of the bronchi and bronchioles that results in chronic cough, sputum production and recurrent bronchial infections. Bronchiectasis can lead to progressive loss of lung function, resulting in chronic morbidity and premature mortality.(1) Bronchiectasis not due to cystic fibrosis (non-cystic fibrosis bronchiectasis; NCFBr) has diverse causes, though post-infectious and idiopathic bronchiectasis are the most common.(2) (3)
  Bronchiectasis has been identified as a cause of increasing morbidity in the U.S. and mortality in the U.K.(4) As the condition is increasingly encountered (or recognised), more patients may need to be considered for lung transplantation. Lung transplantation is an intensive therapeutic intervention that can be performed for the treatment of end-stage NCFBr.(5, 6) However the British Thoracic Society (BTS) national guidelines specifically note scarce data on the results of lung transplantation for bronchiectasis.(3) This knowledge gap results in uncertainty for clinicians in managing patients with more severe bronchiectasis. Increasingly there is recognition of a complex polymicrobial community in the airways of normal volunteers that is disrupted in other chronic lung conditions. Recent data from our lab and that from others note that bronchiectasis is an exemplar of chronic polymicrobial infection with a variable bacterial community in the lower airway. It is unclear however what drives flare ups of NCFbr. Two potential mechanisms exist- firstly a change in bacterial community (eg incoming species) or secondly a change in virulence (community stale but behavioural change within the community)

  We propose to study the following parameters on a cross sectional and longitudinal basis in patients with NCFBR. We will study sputum microbiology cultures, non culture based pyrosequencing of bacterial communities, sputum and serum inflammatory markers, lung function and exhaled and nasal nitric oxide plus quality of life measures. The study aims to identify markers of associated with different pathogens, aetiologies and provide pilot data on the effect of exacerbations on clinical and patient reported outcomes and
  This is an exploratory study and we aim to recruit 160 patients with NCFBr bronchiectasis. NO change in therapy is required for patients to enter this study nor will change sin therapy preclude continuance in the study

• REC name

  North East - Tyne & Wear South Research Ethics Committee

• REC reference

  13/NE/0369

• Date of REC Opinion

  23 Dec 2013

• REC opinion

  Favourable Opinion