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In Vitro Evaluation of a Novel Drug on Airway Epithelial Cells Obtained From Participants With Severe Asthma

In Vitro Evaluation of a Novel Drug on Airway Epithelial Cells Obtained From Participants With Severe Asthma

Status
Completed
Phases
Early Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02740049
Enrollment
9
Registered
2016-04-15
Start date
2016-01-27
Completion date
2016-10-19
Last updated
2019-10-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Asthma

Keywords

Epithelial Cells

Brief summary

Asthma is a long term disease of the lungs. In asthma patients the sensitive airway tubes narrow in reaction to something that irritates the airways such as allergens or environmental pollutants. There is currently no cure for asthma and new medicines or combinations of medicines are needed that will be of benefit to patients particularly those with a more severe disease. Activation of certain signal molecules inside the lung cells may participate in the development of asthma and the response to allergens. Blocking these signal molecules specifically with medicines might therefore be beneficial in the treatment of asthma. In this study we want to test a new medicine that specifically targets a subset of signal molecules that are associated with the allergen response in the lung. In particular, we want to test this medicine on cells obtained from the lungs of asthma patients. Understanding the effects of this new medicine on these asthmatic lung cells will give vital information on how this new medicine works before we can test it in asthma patients.

Detailed description

Asthma and COPD are chronic inflammatory diseases of the airway although the precise cells and mediators involved are distinct. Both diseases are characterised by airway hyperresponsiveness (AHR) in response to exogenous stimuli such as allergens in asthma or environmental pollutants. There is currently no cure for asthma and new drugs or combinations of drugs are needed that will be of benefit to patients particularly those with more severe disease. Activation of JAK/STAT pathways may participate in the pathogenesis of asthma. STAT1 and STAT6 expression is elevated in animal models of asthma and in the lower airways of some but not all patients. STAT6 is activated by key cytokines involved in asthma such as IL-13 in primary human bronchial epithelial cells. In addition, baseline phospho-STAT1 and phospho-STAT6 levels are increased in systemic T cells from steroid naïve asthmatics and the Th2 cytokines IL-4, IL-13 and TSLP activate STAT1 and STAT6 in a number of airway cells. In animal models of allergen-induced AHR, airway inflammation including CXCL9 and CXCL10 involves STAT1. In addition, STAT6 knockout mice have no response to IL-4, do not develop Th2 cells in response to IL-4, and fail to produce IgE, bronchial hyperresponsiveness or BAL eosinophilia after allergen sensitization. The expression of CCL11, CCL17 and CCL22 also involves STAT6 in these models. Importantly, STAT1 is a critical signalling molecule involved in the production of type I IFNs (α/β), IFN-γ and for resistance to viral respiratory infections. JAK/STATs inhibitors have proved effective in clinical trials for rheumatoid arthritis and inflammatory bowel disease. Therefore, we propose to use the primary airway epithelial cell culture model grown at air:liquid interface (ALI culture) to evaluate the efficacy of a novel JAK/STAT inhibitor, VR588, against CP-690550 and fluticasone proprionate (FP) in suppressing inflammatory readouts induced by IL-13 and by TNF/IFN.

Interventions

DRUGVR588

Evaluation of the efficacy of a novel JAK/STAT inhibitor, VR588, in isolated epithelial cells from asthma patients

Sponsors

Vectura Limited
CollaboratorINDUSTRY
Imperial College London
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 79 Years
Healthy volunteers
No

Inclusion criteria

All patients must be able to give informed consent. The definition of severe asthma will be on the basis of: 1. Treatment: High dose of ICS ± OCS ≥ 1000mcg FP daily or equivalent plus one other controller medication. 2. Disease Control: Uncontrolled (GINA guidelines), three or more of the following present in any week in the preceding 4 weeks: 1. Daytime symptoms more than twice per week 2. Any limitation of activities 3. Nocturnal symptoms once or more per week 4. Need for reliever treatment more than twice per week 5. Prebronchodilator FEV1 \<80% predicted or personal best AND/OR Frequent severe exacerbations (≥2 per year requiring high dose OCS or doubling of maintenance dose for at least three days or requiring hospitalisation). 3. Asthma Diagnosis: Improvement in FEV1 ≥ 12% or 200ml predicted after inhalation of 400mcg salbutamol OR Diurnal variation in PEF: amplitude % mean of twice daily PEF \> 8% OR Decrease in FEV1 ≥ 12% and \>200ml within 4 weeks after tapering treatment with one or more of the following drugs: ICS, OCS, LABA, SABA PLUS A history of wheeze occurring spontaneously or on exertion.

Exclusion criteria

1. Patients with a FEV1 \< 1L 2. Any other active lung condition 3. Subjects unable to give consent

Design outcomes

Primary

MeasureTime frameDescription
Concentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.21 daysMeasurement of cytokine levels in cell supernatant after stimulation of isolated epithelial cells. For this study epithelial cells from severe asthma patients (n = 9) were cultured and stimulated with either IFN/TNF or IL-13 to induce inflammation. Cells are then treated with VR588 (2 concentration) or with Fluticasone Propionate (FP) or with CP690553 (CP; Tofacitinib). The concentrations of drugs are listed in the title (e.g. 10-9M).
Percentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.21 daysMeasurement of cell viability after stimulation of isolated epithelial cells. For this study epithelial cells from severe asthma patients (n = 9) were cultured and stimulated with either IFN/TNF or IL-13 to induce inflammation. Cells are then treated with VR588 (2 concentration) or with Fluticasone Propionate (FP) or with CP690553 (CP; Tofacitinib). The concentrations of drugs are listed in the title (e.g. 10-9M).
Relative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.21 daysMeasurement of activation of phospho-STAT1 member of the JAK/STAT signaltransduction pathway in cell lysates. For this study epithelial cells from severe asthma patients (n = 9) were cultured and stimulated with either IFN/TNF or IL-13 to induce inflammation. Cells are then treated with VR588 (2 concentration) or with Fluticasone Propionate (FP) or with CP690553 (CP; Tofacitinib). The concentrations of drugs are listed in the title (e.g. 10-9M).

Countries

United Kingdom

Participant flow

Recruitment details

Participant diagnosed with severe asthma were recruited from clinics at the Royal Brompton hospital between January 2016 and September 2016.

Participants by arm

ArmCount
Astma Patients
Participant undergoes a bronchoscopy to isolate epithelial cells VR588: Evaluation of the efficacy of a novel JAK/STAT inhibitor, VR588, in isolated epithelial cells from asthma patients
9
Total9

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyIsolated cells did not grow sufficiently1

Baseline characteristics

CharacteristicAstma Patients
Age, Customized
Participants
51.9 years
STANDARD_DEVIATION 15.5
Race/Ethnicity, Customized
Indian
1 Participants
Race/Ethnicity, Customized
White
8 Participants
Region of Enrollment
United Kingdom
9 participants
Sex: Female, Male
Female
5 Participants
Sex: Female, Male
Male
4 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 9
other
Total, other adverse events
0 / 9
serious
Total, serious adverse events
0 / 9

Outcome results

Primary

Concentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.

Measurement of cytokine levels in cell supernatant after stimulation of isolated epithelial cells. For this study epithelial cells from severe asthma patients (n = 9) were cultured and stimulated with either IFN/TNF or IL-13 to induce inflammation. Cells are then treated with VR588 (2 concentration) or with Fluticasone Propionate (FP) or with CP690553 (CP; Tofacitinib). The concentrations of drugs are listed in the title (e.g. 10-9M).

Time frame: 21 days

Population: 1 participant's cell did not grow

ArmMeasureGroupValue (MEAN)Dispersion
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated Control2090.0 pg/mlStandard Deviation 319.7
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated VR588 10-8M1835.2 pg/mlStandard Deviation 818.1
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated VR588 10-7M1863.7 pg/mlStandard Deviation 310.9
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated CP 10-7M1815.1 pg/mlStandard Deviation 605.1
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated FP 10-8M1635.1 pg/mlStandard Deviation 530.1
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF7000.5 pg/mlStandard Deviation 1047.4
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF VR588 10-9M5402.1 pg/mlStandard Deviation 1427.5
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF VR588 10-7M3996.4 pg/mlStandard Deviation 988.5
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF CP 10-7M3050.4 pg/mlStandard Deviation 924.1
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF FP 10-8M2558.6 pg/mlStandard Deviation 895.5
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-138686.3 pg/mlStandard Deviation 2024.3
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 VR588 10-9M6188.6 pg/mlStandard Deviation 734.3
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 VR588 10-7M4555.2 pg/mlStandard Deviation 1467.9
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 CP 10-7M4599.8 pg/mlStandard Deviation 1649.7
Astma PatientsConcentration (pg/ml) of CXCL8 Cytokine in Cell Supernatant After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 FP 10-8M4639.0 pg/mlStandard Deviation 905.9
Comparison: Statistical differences is determined using the Kruskal-Wallis test followed by Dunn's multiple comparison test or a Wilcoxon signed rank test as appropriate.p-value: 0.0002Wilcoxon (Mann-Whitney)
Primary

Percentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.

Measurement of cell viability after stimulation of isolated epithelial cells. For this study epithelial cells from severe asthma patients (n = 9) were cultured and stimulated with either IFN/TNF or IL-13 to induce inflammation. Cells are then treated with VR588 (2 concentration) or with Fluticasone Propionate (FP) or with CP690553 (CP; Tofacitinib). The concentrations of drugs are listed in the title (e.g. 10-9M).

Time frame: 21 days

Population: 1 participant's cell did not grow

ArmMeasureGroupValue (MEAN)Dispersion
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated Control100.0 percentage against baselineStandard Deviation 30.1
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated VR588 10-9M98.4 percentage against baselineStandard Deviation 23.1
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated VR588 10-7M95.4 percentage against baselineStandard Deviation 23.2
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated CP 10-7M98.4 percentage against baselineStandard Deviation 14.1
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated FP 10-8M102.9 percentage against baselineStandard Deviation 27.1
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF87.1 percentage against baselineStandard Deviation 10.5
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF VR588 10-9M92.0 percentage against baselineStandard Deviation 15
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF VR588 10-7M93.3 percentage against baselineStandard Deviation 14.5
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF CP 10-7M96.6 percentage against baselineStandard Deviation 10.5
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF FP 10-8M82.2 percentage against baselineStandard Deviation 11.2
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-1391.4 percentage against baselineStandard Deviation 12.4
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 VR588 10-9M86.9 percentage against baselineStandard Deviation 14.2
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 VR588 10-7M90.0 percentage against baselineStandard Deviation 10.7
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 CP 10-7M89.0 percentage against baselineStandard Deviation 11.7
Astma PatientsPercentage of Viable Cells Compared to Baseline After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 FP 10-8M92.7 percentage against baselineStandard Deviation 12.4
Comparison: Statistical differences is determined using the Kruskal-Wallis test followed by Dunn's multiple comparison test or Wilcoxon signed rank test as appropriate.p-value: 0.3994Wilcoxon (Mann-Whitney)
Primary

Relative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.

Measurement of activation of phospho-STAT1 member of the JAK/STAT signaltransduction pathway in cell lysates. For this study epithelial cells from severe asthma patients (n = 9) were cultured and stimulated with either IFN/TNF or IL-13 to induce inflammation. Cells are then treated with VR588 (2 concentration) or with Fluticasone Propionate (FP) or with CP690553 (CP; Tofacitinib). The concentrations of drugs are listed in the title (e.g. 10-9M).

Time frame: 21 days

Population: 1 participant's cell did not grow

ArmMeasureGroupValue (MEAN)Dispersion
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated Control0.80 Relative Fluorescence UnitsStandard Deviation 0.11
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated VR588 10-9M0.82 Relative Fluorescence UnitsStandard Deviation 0.13
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated VR588 10-7M0.74 Relative Fluorescence UnitsStandard Deviation 0.2
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated CP 10-7M0.64 Relative Fluorescence UnitsStandard Deviation 0.22
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.Non-treated FP 10-8M0.60 Relative Fluorescence UnitsStandard Deviation 0.28
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF6.94 Relative Fluorescence UnitsStandard Deviation 1.75
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF VR588 10-9M4.99 Relative Fluorescence UnitsStandard Deviation 1.82
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF VR588 10-7M4.15 Relative Fluorescence UnitsStandard Deviation 1.55
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF CP 10-7M1.56 Relative Fluorescence UnitsStandard Deviation 0.96
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IFN/TNF FP 10-8M3.20 Relative Fluorescence UnitsStandard Deviation 1.36
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-134.24 Relative Fluorescence UnitsStandard Deviation 1.72
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 VR588 10-9M1.97 Relative Fluorescence UnitsStandard Deviation 1.37
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 VR588 10-7M1.38 Relative Fluorescence UnitsStandard Deviation 0.71
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 CP 10-7M0.89 Relative Fluorescence UnitsStandard Deviation 0.36
Astma PatientsRelative Fluorescence Units of STAT1 Protein Phosphorylation After Stimulation (IFN/TNF or IL13) and Treatment (VR588, FP or CP) Conditions in ALI Cultured Epithelial Cells.IL-13 FP 10-8M0.96 Relative Fluorescence UnitsStandard Deviation 0.37
Comparison: Statistical difference is determined using the Kruskal-Wallis test followed by Dunn's multiple comparison test or a Wilcoxon signed rank test as appropriate.p-value: 0.0104Wilcoxon (Mann-Whitney)

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026