Lung Macrophage Populations and Functions in Chronic Obstructive Pulmonary Disease (COPD)-Susceptible Smokers
University of California, San Francisco
Summary
Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous disease that affects only a fraction of those who smoke tobacco. The origin of this variability in susceptibility to develop COPD is unclear, but understanding its underlying biology has important implications for our ability to design suitable preventative and therapeutic strategies for its management. This Department of Defense (DOD) discovery research proposes to develop methodologies and generate preliminary data needed to lay the foundation for a large study that would investigate the underlying biological susceptibility of those who smoke tobacco to develop COPD.
Description
This is a pilot observational study of 20 subjects ≥40 years of age with smoking history of at least 20 pack-years (former or current) who have preserved spirometry, as defined by normal Forced Expiratory Volume (FEV1) / Forced Vital Capacity (FVC). Of the 20 subjects, 10 with and 10 without air trapping as determined by high and abnormal versus low and normal Residual Volume (RV) / Total Lung Capacity (TLC) measured by plethysmography. The cohort will undergo extensive clinical characterization including full Pulmonary Function Testing (PFT) and medical, symptom, activity, and quality of life…
Eligibility
- Age range
- 40–75 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Ages between 40 to 75 years old. * History of at least 20 pack-years of smoking. * No diagnosis of COPD or asthma. * No spirometric evidence of airflow obstruction as determined by FEV1/FVC ratio ≥0.7. * FEV1 and FVC \>lower limit of normal. * Less than 1 pack-year history of tobacco smoking and no tobacco use within the past 12 months. * Subjects will be divided into two groups by their RV/TLC: Normal RV/TLC Group: • Plethysmographic RV/TLC equal or less than lower limit of normal. Abnormal RV/TLC Group: • Plethysmographic RV/TLC higher than lower limit of normal.…
Interventions
- ProcedureBronchoscopy with Bronchoalveolar Lavage (BAL)
1. Bronchoscopy w/ (BAL): The bronchoscope will be introduced through mouth and directed into the right middle lobe bronchus for bronchial lavage. The BAL will be performed with two 60-mL aliquots (total of 120 ml) of saline in each of medial and lateral segments of Right Middle Lobe (RML) (total 240 ml lavage). 2. Albuterol Administration: The subjects will inhale 2 puffs of respiratory medication albuterol, then repeat the breathing test. 3. Peak Flow Measurement: Subjects will breathe in fully then out forcefully into the handheld device. 4. Pulmonary Function Test w/ Spirometry: will be used for determination of COPD and its severity. The PFT measures breathing capacity and lung function with different types of breathing maneuvers including flow-volume curve, single breath CO diffusing capacity, and total lung capacity. 5. Blood draw 6. Medical Health and Symptom Questionnaires 7. Physical Exam by study doctor to determine suitability and safety for participation.
Locations (3)
- Zuckerberg San Francisco General Hospital and Trauma CenterSan Francisco, California
- San Francisco VA Medical CenterSan Francisco, California
- University of California, San FranciscoSan Francisco, California