Airway Temperature

A total of eight participants will be enrolled into this study. We will take direct measurements of bronchial mucosa temperature. This can only be tested accurately in asthma participants because anesthesia is known to lower the body temperature. The proposed study using and experimental procedure called a segmental bronchoprovocation challenge with allergen in asthmatic patients offers a unique approach to test our hypothesis.

Individuals enrolled into this study will participate for eight weeks and will take part in four visits each estimated to last 2 and 8 hours. Participants will also participant in one follow-up phone call following Test day 2.

Patients with asthma and healthy participants will be recruited to participate in this study through advertisement postings in the Kentucky Clinic and/or the University of Kentucky Hospital as well as on main campus. The study will also be added to a website using the same posting.

Patients with asthma who have been prescribed for a diagnostic or therapeutic bronchoscopy procedure at the UK Pulmonary Clinic will be identified and recruited by qualified physicians in that clinic. The medical history and records of the patients will be made available which includes data form a complete spirometry test and other clinical tests, physical examination, smoking history, symptoms, current medication use, drug allergies, laboratory and imaging data.

After eligible patients are identified and meet proper inclusion criteria, informed consent will be obtained.

Participants will receive an explanation of the research project including any potential risks. In addition, the participant will be shown the actual size of the temperature probe to be used in this procedure. The participation of these individuals in the study will in no way affect their current treatment. No bias will be held against the individual by any clinical staff if they elect not to participate in the study. Informed consent will be obtained after the potential participant is fully informed via verbal/written information of the procedures and nature of the research, the risks involved, and their rights as a research subject.

The experimental procedure will be carried out in the University of Kentucky A.B. Chandler Hospital.

Direct measurements of the airway mucosal temperature will be performed before and at ten minutes after the SBP-Ag challenge. This miniature probe will be positioned in the airway lumen using an Olympus fiberoptic bronchoscope (model MP160F), and connected via a cable to a battery-operated thermometer (model FLL) manufactured also by Physitemp Instrument Inc. The probe (outside diameter of 0.4 mm) will be passed through the instrument channel (inner diameter: 2.0 mm) of the bronchoscope. By maneuvering the control knob of the bronchoscope, the blunted tip of the probe will be gently pressed against the airway mucosa at 5-6 different positions in segmental and sub-segmental bronchi, each for five to ten seconds. The entire protocol of the temperature measurement will require no more than 5 minutes to complete. The contact of the temperature probe on the airway mucosa should not cause any tissue damage, and is relatively non-invasive compared to other procedures involved in the routine bronchoscopy such as biopsy, cytology brushing, etc

Physical Examination: It will include assessment of subject's general condition, head and neck, chest and respiratory auscultation, cardiac auscultation, and limited abdominal, extremity and neurological exams.

Vital signs: Heart rate, blood pressure, body temperature and arterial oxygen saturation.

Screening Visits 1 and 2: Following procedures will occur on the screening visit after obtaining written informed consent.

• Collection of demographic information (Demographic data to be collected on screening visit will include name, initials, address, social security number, coded study number, medical record number, height, weight, age, race, ethnicity, gender, telephone number and email address.)
• Collection of medical and medication history
• Urine pregnancy test
• Vital signs
• Skin prick test
• Spirometry
• Limited physical examination
• Study eligibility review
• Whole lung allergen inhalation challenge
• Adverse Event assessment
• Concomitant medication

Visit 3 (Test Day 1)

• Review eligibility criteria
• Vital signs
• Spirometry
• Urine pregnancy test
• Physical examination
• Bronchoscopy with lavage
• Segmental allergen challenge
• Adverse Event assessment
• Concomitant medication

Visit 4 (Test Day 2)

• Review eligibility criteria
• Vital signs
• Spirometry
• Physical examination
• Bronchoscopy with lavage
• Adverse Event assessment
• Concomitant medication

Follow-up Phone Call. A follow-up phone call will take place 1 day following the last study visit. During this phone call the participant will be asked questions regarding any adverse events they may have experienced since the last visit along with the use of any concomitant medications.