Analysis of Bronchial Tissue and Fluid in Patients With Wegener’s Granulomatosis

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Brief Title

Analysis of Bronchial Tissue and Fluid in Patients With Wegener's Granulomatosis

Official Title

Analysis of Bronchial and Bronchoalveolar Lavage Fluid and Bronchial Mucosal Biopsies in Patients With Wegener's Granulomatosis

Brief Summary

      This study will collect fluid and tissue samples from the bronchi (air passages to the lungs)
      of patients with Wegener's granulomatosis for laboratory examination. Wegener's
      granulomatosis is a type of vasculitis (blood vessel inflammation) that can affect many parts
      of the body, including the brain, nerves, eyes, skin, sinuses, kidneys, intestinal tract,
      joints, heart, lungs and other sites. About 85 percent of patients have lung involvement. The
      lining of the bronchi (bronchial mucosa) is composed of cells that produce mucus,
      inflammatory cells, and inflammatory mediators (chemicals produced in response to
      inflammation). Analysis of these various substances may provide insight into what causes
      different types of lung problems in Wegener's granulomatosis.

      Patients between 18 and 75 years of age with Wegener's granulomatosis who require
      bronchoscopy to evaluate the cause of their lung problem may be eligible for this study.

      Participants will undergo a bronchoscopy in the hospital intensive care unit (ICU). For this
      procedure, the mouth and throat are numbed with lidocaine jelly and spray. If needed, a
      sedative is given for comfort. A small plastic tube (intravenous catheter) is placed in a
      vein to give medications. A pencil-thin tube is then placed through the nose or mouth into
      the lung airways to examine the airways carefully.

      At the time of the bronchoscopy, patients in this study will undergo the following additional
      procedures:

        -  Bronchoalveolar lavage - Saline (salt water) is injected through the bronchoscope into
           the air passage, acting as a rinse. A sample of the fluid is then withdrawn and examined
           for infection, inflammatory cells and inflammatory chemicals. (This may be done as part
           of the standard medical care procedure.)

        -  Bronchial lavage - This procedure is similar to bronchoalveolar lavage, but less fluid
           is used to rinse larger airways.

        -  Bronchial mucosal biopsies - A small wire is inserted through the bronchoscope next to
           the bronchial lining. Forceps at the end of the wire pinch off a small piece of tissue
           for withdrawal and examination.

      The patient's heart rhythm and rate and oxygen levels are monitored during the procedure.
      When the procedures are finished, the patient is monitored in the ICU until the numbing
      effect of the anesthetic has worn off and then moves to a regular hospital bed for overnight.

      Patients whose test results show an isolated infection or isolated Wegener's lung tissue
      involvement and who are being treated or are eligible for treatment under another NIH
      protocol will be followed by X-ray for improvement of their infection or other lung
      involvement with treatment. Patients whose infection or lung tissue involvement improves may
      be asked to undergo a second bronchoscopy as described above, but for research purposes only.
    

Detailed Description

      Wegener's granulomatosis is a systemic vasculitis in which parenchymal and/or endobronchial
      inflammation frequently occur. The purpose of this investigation is to analyze bronchial and
      bronchoalveolar lavage fluid in patients with Wegener's granulomatosis for the presence of
      immunoregulatory mediators and pro-inflammatory cytokines. We will also be examining mucosal
      biopsies in these patients to define the histologic changes, the phenotype of infiltrating
      leukocytes, and the pattern of adhesion molecule expression that may be present. Such studies
      could lead to an improved understanding of the pathophysiology of this disease and of its
      pulmonary manifestations and provide potential directions for future therapy.
    


Study Type

Observational




Condition

Inflammation



Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information



Estimated Enrollment

25

Start Date

April 1996

Completion Date

January 2003


Eligibility Criteria

        INCLUSION CRITERIA:

        Diagnosis of Wegener's granulomatosis based on clinical and histological characteristics.

        Age between 18-75 years.

        Bronchoscopy is required as part of their standard medical care.

        FEV1 is greater than 55 percent of FVC.

        O2 saturation is greater than 90 percent.

        EXCLUSION CRITERIA:

        FEV1 is less than 55% of FVC.

        O2 saturation is less than 90%.

        Abnormal PT, PTT, or platelet count less than 50.

        History of adverse reaction to lidocaine or other local anesthetics.

        Pregnancy.
      

Gender

All

Ages

N/A - N/A

Accepts Healthy Volunteers

No

Contacts

, , 

Location Countries

United States

Location Countries

United States

Administrative Informations


NCT ID

NCT00001541

Organization ID

960065

Secondary IDs

96-I-0065


Study Sponsor

National Institute of Allergy and Infectious Diseases (NIAID)


Study Sponsor

, , 


Verification Date

January 2003