Characterisation of Large Airway Collapse during Exercise (LACE)
Research type
Research Study
Full title
Characterisation of Large Airway Collapse during Exercise
IRAS ID
268188
Contact name
James Hull
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
The large central airways (i.e. trachea and bronchi) act as a conduit to enable lower airway (i.e. lungs) ventilation but also facilitate airway clearance (i.e. mucus) during dynamic manoeuvres, such as coughing. It is becoming increasingly well recognised however, that in a significant proportion of individuals with chronic airway disease (e.g. chronic obstructive pulmonary disease-COPD or chronic asthma) and in those with an elevated body weight, that the large airways may exhibit a tendency to excessive closure or narrowing. This large airway collapse (LAC) can be associated with exertional breathlessness and difficulty clearing airway secretions.
One clear limitation of the current approach to diagnosis is the fact that many of the ‘diagnostic’ tests employed, utilise static, supine measures +/- forced manoeuvres. These are somewhat physiologically flawed and differ markedly from the reality of the heightened state of airflow that develops during exertion. i.e. forced manoeuvres likely induce very different turbulent and thoracic pressure changes, in contrast to the real-life physical activity (i.e. walking or cycling). A current unanswered question is therefore, what happens to the large airway dynamic movement of healthy individuals (and ultimately patients) during real-life exercise and how does this compare with the measures taken during a forced manoeuvre, either during a bronchoscopy or during an imaging study such as MRI scan.
The key aim of this study is therefore to evaluate and characterise large airway movement in a cohort of healthy adults during a real-life exercise challenge and to compare this with findings from a dynamic expiratory MRI and MRI during exercise. In order to achieve this, we propose to develop and test the feasibility of an exercise-bronchoscopy protocol.
REC name
London - London Bridge Research Ethics Committee
REC reference
19/LO/1564
Date of REC Opinion
2 Dec 2019
REC opinion
Further Information Favourable Opinion