COPD Microenvironment Study
Studying the airway microenvironment in patients undergoing surgical and bronchoscopic interventions for COPD.
Royal Brompton and Harefield NHS Foundation Trust (RB&HFT)
Duration of Study in the UK
3 years, 0 months, 1 days
The lining of the airways in the lungs of patients with chronic obstructive airways disease (COPD) is chronically inflamed. Acute exacerbations of the disease aggravate the inflammation and are believed to accelerate the decline in lung function. The mechanisms are not fully understood.
A role driving exacerbations has been suggested recently for ‘microvesicles’, minute fragments of the outer lining of cells shed into the blood in response to inflammation and known to be important in communication between cells. Elevated levels in the blood of patients with COPD, higher during acute exacerbations, are predictive of rapid decline of lung function. Little is known about these particles derived from the lining of the airways.
Surgical and bronchoscopic intervention in patients with severe COPD furnishes an opportunity to obtain samples and observe the responses to the procedures. Bronchoalveolar lavage (airway ‘wash’) and brushings are established sampling techniques to obtain material for respectively, measurement of inflammatory proteins and microvesicles, and for gene analysis. A novel technique sampling the airway lining employs a synthetic absorptive matrix (similar to a very small piece of litmus paper) which has been shown to have greater sensitivity to a standard bronchoalveolar lavage, eliminating the disadvantage of dilution.
This would be the first study to examine the airway environment before and after intervention and a predictive marker of the response and of future exacerbation risk may be identified.
London - Camden & Kings Cross Research Ethics Committee
Date of REC Opinion
25 Jan 2017