Bronchoscopy studies in patients with asthma, chronic obstructive pulmonary disease, interstitial lung disease and healthy controls; identification of new therapeutic targets
Chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease (ILD)
Participants will undergo the following assessments for suitability for bronchoscopy: spirometry, DLCO (ILD patients only), physical examination, oxygen saturations via a pulse oximeter, blood sampling for safety (e.g. Full Blood Count (FBC) and coagulation). Suitable participants may undergo bronchoscopy. For bronchoscopy, a sedative agent is given via intravenous (IV) cannula. A bronchoscope is passed through the nose or mouth to visualise the airways. Topical anaesthesia is used as required to anaesthetise the nasal passage, vocal cords, trachea and bronchial tree. The following samples may be collected from the lung: Bronchial mucosal biopsies, bronchoalveolar lavage, bronchial brushings and bronchial absorption. A venous blood sample may also be collected for laboratory research. A subset of participants may attend an additional visit for nasal biopsy. Local anaesthesia will be used. Nasal washings and brushings may also be performed.
1. Must be aged over 18 years, be competent to understand and give informed consent 2. Participants with asthma, COPD and ILD must have stable disease with no exacerbations or infections for at least 6 weeks prior to bronchoscopy Participants with asthma must have: 1. Clinically diagnosed asthma 2. Forced Expiratory Volume in 1 Second (FEV1) >30% predicted 3. FEV1 > 1.0 litre; participants with FEV1 >30% predicted but <1 litre may undergo a restricted procedure with only one lung undergoing lavage as judged by the investigator 4. Oxygen saturation above 90% on room air Participants with COPD must have: 1. Clinically diagnosed COPD 2. FEV1 >30% predicted 3. FEV1 >1.0 L; participants with FEV1 >30% predicted but <1 litre may undergo a restricted procedure with only one lung undergoing lavage as judged by the investigator 4. Smoking history of at least 10 pack years 5. Oxygen saturation above 90% on room air Participants with ILD must have: 1. Diffusing Capacity for Carbon Monoxide (DLCO) >35% predicted 2. Forced Vital Capacity (FVC) >45% predicted 3. Oxygen saturation above 90% on room air Healthy participants must have: 1. No history of a chronic respiratory disorder 2. No history of acute respiratory disease within 6 weeks prior to bronchoscopy 3. No other significant medical disorder that may affect the respiratory system or that causes significant disability Healthy participants who are smokers must: 1. Be current or ex-cigarette smokers with a smoking history of at least 10 pack-years 2. Have FEV1 >90% predicted Healthy participants who are non-smokers must have: No significant smoking history as judged by the investigator
All participants: 1. History of any other inflammatory lung condition or carcinoma of the lung 2. Participants who are taking warfarin or have any bleeding disorders 3. Women who are pregnant or breastfeeding Participants with respiratory conditions: 1. Exacerbation of disease requiring hospitalisation within previous 6 months 2. History of ITU admission secondary to asthma, COPD or ILD 3. Use of home oxygen for COPD or ILD