Novel vascular manifestations of COPD, part 3+ (NoVasC3+)
Research type
Research Study
Full title
Novel vascular manifestation of chronic obstructive pulmonary disease part 3+: a prospective clinical and imaging study to evaluate the acute and chronic effects of exacerbations of chronic obstructive pulmonary disease (COPD) on neuropathology.
IRAS ID
268523
Contact name
Daniel R Burrage
Contact email
Sponsor organisation
St George's University Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Aim.
To test whether symptom flare-up (exacerbations) of chronic obstructive pulmonary disease (COPD) increase brain white matter damage and whether this is related to changes in small blood vessels and inflammation in the body.Background.
COPD is a lung condition caused by inflammation of the airways and damage to the air sacs. The most common cause is cigarette smoking. COPD patients often have disturbances to other body systems including the heart, muscles and brain. Brain abnormalities appear to result from changes to the small blood vessels of the brain. The mechanisms leading to these changes are not understood but acute exacerbations of COPD are associated with cognitive impairment that does not recover over time. Our hypothesis is that systemic inflammation which worsens during an exacerbation is a key factor in causing brain damage.Design and methods.
This is a follow-up of our previous prospective observational cohort study (NoVasC3). It will use the same methodology but with fewer tests to provide an additional brain imaging follow-up timepoint, 2-3 years from the baseline visit for the original study. From the original cohort of 56 COPD patients we estimate that we will be able to re-recruit 35 who took part in the previous study. Brain magnetic resonance (MR) imaging data and minimal clinical measures will be acquired providing measures of brain structure and cerebral blood flow (from MR imaging), cognitive function, oxygen saturations, COPD disease status, psychological status, health status, comorbidities and exacerbation history. Data from this study will be combined with data from the previous study. We will perform statistical modelling of changes in brain structure and cerebral blood flow over time, taking into account the effect of exacerbations (treated as discrete events). We will also test the relationship between brain damage and cerebral vascular function and markers of baseline and exacerbation levels of systemic inflammation.REC name
London - Queen Square Research Ethics Committee
REC reference
20/LO/0747
Date of REC Opinion
15 May 2020
REC opinion
Favourable Opinion