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Trial registered on ANZCTR
Registration number
ACTRN12611000945921
Ethics application status
Approved
Date submitted
13/03/2009
Date registered
2/09/2011
Date last updated
2/09/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Early lung disease in young infants and young children with cystic fibrosis
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Scientific title
The relationship between the lung clearance index, airway infection and inflammation and systemic inflammatory markers in infants and young children with cystic fibrosis
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Secondary ID [1]
262974
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Nil
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Universal Trial Number (UTN)
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Trial acronym
N/A
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cystic Fibrosis
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Early lung disease
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Condition category
Condition code
Respiratory
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0
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Other respiratory disorders / diseases
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Infection
4744
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0
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Other infectious diseases
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Human Genetics and Inherited Disorders
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0
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Cystic fibrosis
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Newborn screened infants with cystic fibrosis less than 3 years of age attending the Cystic Fibrosis clinic at Sydney Children's Hospital Randwick will be prospectively recruited for bronchoalveolar lavage, infant lung function testing, a chest xray and venepuncture.
A control group of similarly aged healthy infants undergoing sedated cardiac echo or a DMSA scan will also be recruited for infant lung function testing over the same period thus serving as the normative or reference population for infant lung function.
Healthy in fants and infants with CF will undergo sedated lung function on a single occasion over a duration of approximately one hour.
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Intervention code [1]
4215
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Not applicable
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Comparator / control treatment
Healthy infants and young children without previous respiratory, cardiac or neurologic imparirment attending Sydney Children's Hospital RANDWICK for a sedated cardiac echo or DMSA renal scan will be approached to undergo lung function as a follow on procedure whilst sedated for their primary investigation
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Control group
Active
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Outcomes
Primary outcome [1]
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Lung Clearance Index measured by a multiple-breath washout (MBW) method using a commercially available Infant Lung Function Testing System (Exhalyzer R)
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Assessment method [1]
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Timepoint [1]
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At baseline: One-off measurement in this cross-sectional case-control study
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Secondary outcome [1]
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Bronchoalveolar lavage markers of infection (measured by quantitative microbiologic culture) and inflammation (neutrophils, totol cell count , neutrophil elastase and interleukin-8, and the S100 proteins)
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Assessment method [1]
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Timepoint [1]
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At baseline: one off measurement
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Secondary outcome [2]
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Systemic markers of inflammation including the S100 proteins and C-reactive protein and blood neutrophils in additon to urinary desmosine
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Assessment method [2]
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Timepoint [2]
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All at baseline as a one off measurement
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Secondary outcome [3]
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Prevalence of an abnormal ph probe indicating gastro-oesophageal reflux (only in children with CF)
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Assessment method [3]
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Timepoint [3]
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All at baseline as a one off measurement only in subjects with CF
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Eligibility
Key inclusion criteria
Cystic fibrosis infants under age 3 years and healthy control children under 3 years of age will be recruited for sedated lung function testing. CF children up to 5 years of age will also undergo venepuncture and urine analysis for desmosine determination
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Minimum age
No limit
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Maximum age
5
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Chronic neonatal lung disease
Other respiratory disease
Cardiac disease
Neuurologic disease
Respiratory infection in the 3 weeks prior to infant lung function testing
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Case control
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2004
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
45
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
Individual
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Name
Dr Yvonne Belessis MBBS(Hons) FRACP MPH PhD
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Address
Sydney Children's Hospital
High Street
RANDWICK, NSW 2031
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
4208
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Other collaborator category [1]
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University
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Name [1]
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University of New South Wales
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Address [1]
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Randwick, NSW 2031
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Eastern Sydney and Illawarra Health Service- Eastern Section
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Ethics committee address [1]
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Hospital Research and Ethics Committee (HREC) Prince of Wales Hospital High Street Randwick NSW 2031
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
6698
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Approval date [1]
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01/01/2002
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Ethics approval number [1]
6698
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1/02/0098
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Summary
Brief summary
Although the lungs in children with cystic fibrosis (CF) are essentially normal at birth, airway infection and inflammation may begin within the first few weeks of life. As postnatal lung development, including significant alveolarisation continues during the first 2-3 years of life, this is a vulnerable period where undiagnosed infection and chronic inflammation may lead to irreversible tissue damage and lung disease. Identifying and treating infection (especially with Pseudomonas), in early childhood may prevent significant lung disease, reduce morbidity and improve survival. Early infection is often subclinical and conventional screening methods such as sputum microbiology, chest radiology and lung function, are either not possible or insensitive to detect disease in this age group. Upper airway cultures such as throat swabs or cough suction specimens correlate poorly with lower airway pathogens and the currently available systemic markers of inflammation lack sensitivity. Bronchoaclveolar lavage (BAL) is considered the gold standard for identifying airway infection and inflammation in young children with CF. The association between BAL markers of infection and inflammation and sensitive infant lung function testing such as the multiple breath washout test which determines the lung clearance index has not been studied. This study will investigate early CF lung disease by assessing the relationships between BAL markers of infection/inflammation, the lung clearance index, systemic markers of neutrophil inflammation (S100 proteins) and urinary desmosine. The study will also determine the prevalence of gastro-oesophageal reflux and the relationship between BAL pepsin and airway infection and inflammation.
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Trial website
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Trial related presentations / publications
Presentations: 1. Early detection of cystic fibrosis lung disease: LCI predicts BAL evidence of infection and inflammation. TSANZ 2009 2. BAL pepsin is associated with infection in infants and young children with cystic fibrosis and is suggestive of concurrent microaspiration in early CF lung disease. TSANZ 2008
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Yvonne Belessis
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Address
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Sydney Children's Hospital
High Street
RANDWICK, NSW 2031
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Country
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Australia
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Phone
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61 2 93821246
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Fax
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61 2 93821580
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Yvonne Belessis
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Address
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Sydney Children's Hospital
High Street
RANDWICK, NSW 2031
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Country
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Australia
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Phone
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61 2 93821246
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Fax
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61 2 93821580
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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