Mechanisms of Ozone-Induced Alterations in Efferocytosis and Phagocytosis

Sponsor
Robert Tighe, MD (Other)
Overall Status
Recruiting
CT.gov ID
NCT03646877
Collaborator
National Institutes of Health (NIH) (NIH), Ohio State University (Other)
70
1
2
58.4
1.2

Study Details

Study Description

Brief Summary

The purpose of this research study to understand how environmental and genetic factors may be involved in lung function. Healthy Study participants will undergo a 1-day screening that includes a blood draw and breathing testing, return for a two-day series of testing to include blood draw, and brief breathing test before and after an inhaled challenge with either filtered air (FA) or ozone (O3). Participants return the next day for a brief breathing test, a blood draw and a procedure called bronchoscopy performed under conscious sedation to evaluate the lung after the challenge.

Participants then return 18 - 20 days later to repeat the two-day series of testing to be challenged with the exposure not received on the first series, (FA or O3). Each visit will take about 3 - 3.5 hours. Follow-up phone calls from the study team will occur at 24 hours after each 2-day test series. Total study duration is about one to one-and a half months.

Condition or Disease Intervention/Treatment Phase
Phase 1

Detailed Description

In brief, at V1 subjects will be assessed for baseline spirometry and venous blood analysis prior to exposure. The venous blood will be used to obtain PMNs for apoptosis assays, and serum for CFH and sCD163 levels. Additionally, this will be used to measure cytokines and growth factors. At each visit, if the subject is female, there will be a urine pregnancy test performed. Following this initial assessment, subjects will be challenged with FA or O3 and then spirometry will be performed, and venous blood will be obtained immediately following the exposure (V2). The subjects will then return 20 hours ±4h later for follow up studies (V3). There will be spirometry, a venous blood draw and urine pregnancy testing (if female) followed by bronchoscopy. At bronchoscopy, vital signs will be determined, including O2 sat. Patient then undergo an 18-20 day washout period before they are brought back in for V4 for the alternate challenge. This will follow the same protocol as outline above in the initial exposure and use the same series of analysis as the first set of visits. Therefore, we will fully characterize the biological response to ozone and filtered air in these same subjects.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
70 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Masking:
Single (Participant)
Primary Purpose:
Other
Official Title:
Mechanisms of Ozone-Induced Alterations in Efferocytosis and Phagocytosis
Actual Study Start Date :
Mar 19, 2019
Anticipated Primary Completion Date :
Jan 31, 2024
Anticipated Study Completion Date :
Jan 31, 2024

Arms and Interventions

Arm Intervention/Treatment
Experimental: Ozone (O3)

The O3 level during the exposures will be 200 ppb, which has previously been used in human exposure studies without short or long term, untoward side effects (and comparable to peak levels attained during the summer in the Raleigh-Durham area of North Carolina) (REF - Bromberg review).

Drug: Ozone
Subjects will perform alternating 15 minutes rest with 15 minutes treadmill walk exercise periods for 135 minutes in while breathing Ozone (O3).
Other Names:
  • O3
  • Placebo Comparator: Filtered Air (FA)

    Control will be treadmill walk with filtered room air in chamber.

    Other: Filtered Air
    Subjects will perform alternating 15 minutes rest with 15 minutes treadmill walk exercise periods for 135 minutes in while breathing filtered air.

    Outcome Measures

    Primary Outcome Measures

    1. change in ozone induced efferocytosis of lung macrophages (ability to clear dead or dying cells) [Baseline, 21 days]

      Efferocytosis is defined by determining the number of apoptotic PMNs phagocytized by alveolar macrophages (BAL cytospins) versus the total number of macrophages ('efferocytic index')

    2. Change in ozone induced phagocytosis of lung macrophages (ability to clear debris or bacteria) [Baseline, 21 days]

      Bronchoalveolar macrophages are incubated with pHrodo™ dye-labeled particles. Macrophage phagocytosis will be defined by determining the number of macrophages that contain fluorescent particles versus the total macrophages Cell free hemoglobin and soluble CD163 - both are measured by commercial ELISA kit

    Secondary Outcome Measures

    1. Change in ozone induced increase in cell free hemoglobin in bronchoalveolar lavage fluid and serum [Baseline, 21 days]

      Measured by enzyme-linked immunosorbent assay (ELISA)

    2. Change in ozone induced increase in soluble CD163 in bronchoalveolar lavage fluid and serum [Baseline, 21 days]

      Measured by enzyme-linked immunosorbent assay (ELISA)

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 35 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    Yes

    Inclusion Criteria

    • Individuals between 18-35 yrs. of age (No subject will be excluded from the study on the basis of gender or ethnicity)

    Exclusion Criteria

    • Current smokers of tobacco products including e-cigarettes or those with previous smoking history within the prior 5 years

    • Pregnant women and women who are presently lactating.

    • Subjects that have received antibiotic administration or an upper respiratory infection within the previous 4 weeks

    • College and graduate students or employees who are under direct supervision by any of the investigators in this protocol

    • Alcohol or illicit substance abuse

    • Chronic cardio/pulmonary respiratory disorders or other medical conditions as determined by the investigator

    • Increased airway hyperresponsiveness at baseline as measured by a positive methacholine challenge response (methacholine PC20 FEV1 < 8 mg/ml)

    • Subjects will be requested to refrain from antihistamines, nonsteroidal anti-inflammatory agents, antioxidants (e.g. beta-carotene, selenium, and lutein) and supplemental vitamins (e.g. C and E), for 1 week prior to, and during testing.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Duke University Medical Center Durham North Carolina United States 27710

    Sponsors and Collaborators

    • Robert Tighe, MD
    • National Institutes of Health (NIH)
    • Ohio State University

    Investigators

    • Principal Investigator: Robert Tighe, MD, Duke University

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Robert Tighe, MD, Associate Professor of Medicine, Duke University
    ClinicalTrials.gov Identifier:
    NCT03646877
    Other Study ID Numbers:
    • PRO00100375
    First Posted:
    Aug 24, 2018
    Last Update Posted:
    Jul 27, 2022
    Last Verified:
    Jul 1, 2022
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No

    Study Results

    No Results Posted as of Jul 27, 2022