MUcociliary Clearance IN Stroke
试验速览
- 阶段
- 不适用
- 入组人数
- 24
- 试验地点
- 1
- 主要终点
- Mucociliary Clearance
研究概览
简要总结
Stroke patients frequently suffer from stroke associated pneumonia. Pathophysiologically speaking, dysphagia and central nervous system (CNS)-injury induced immunosuppression largely contribute to the risk for pneumonia. In mouse models for stroke, the self-cleaning mechanisms of the lung are also affected by stroke, possibly further contributing to this risk.
The investigators designed a pilot-study to examine the structural and functional integrity of the self-cleaning mechanisms of the lung in stroke patients.
详细描述
Survival and functional outcome of stroke is strongly depending on the occurence of pneumonia (stroke-associated pneumonia, SAP). Early diagnose and treatment of SAP is paramount in the treatment of stroke patients. While dysphagia strongly contributes to its pathogenesis, recent years have also shown a strong risk-modulation by CNS injury induced immunosuppression, making stroke patients more susceptible to SAP. Additionally, murine models of stroke showed changes in mucociliary clearance as possible contributors to SAP. It remains unclear, whether structural integrity and mucociliary clearance of the respiratory epithel change in stroke patients, and whether these changes might contribute to the occurence of SAP.
Therefore, the investigators designed this exploratory observational pilot-study to examine the structural and functional integrity of respiratory epithel in severely affected stroke patients and correlate these findings to immune phenotyping and occurence of SAP. The investigators will conduct bronchoscopy in severely affected stroke patients to collect histological samples in order to evaluate multiple tissue predictors, as well as perform optical coherence tomography to examine ciliary kinetics in-vivo. The investigators will furthermore perform serum and plasma immune phenotyping, record occuring pneumonias and correlate these data in order to identify possible predictors of pneumonia.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥18 years
- •Informed consent signed by patient or legal representatives
- •Acute ischemic stroke within the past 2 weeks (except the control group)
- •Indication for diagnostic or therapeutic bronchoscopy
排除标准
- •Confirmed lung malignancies or specific inflammations of the lungs
- •Pneumonia (only control group)
- •Autoimmune diseases of respiratory system (only control group)
- •Chronic inflammatory diseases of respiratory system (only control group)
- •chronic obstructive pulmonary disease (COPD) and spastic diseases of respiratory system (only control group)
- •Patients being committed to psychiatric institutions or prisons
结局指标
主要结局
Mucociliary Clearance
时间窗: at time of bronchoscopy (within 2 weeks after acute ischemic stroke)
- activity of cilia given as frequency (in-vivo optical coherence tomography)
次要结局
- Structural changes in respiratory tissue (nasal, tracheal and bronchial) - Autophagy(at time of bronchoscopy (within 2 weeks after acute ischemic stroke))
- Activity of autonomous nervous system(at time of bronchoscopy (within 2 weeks after acute ischemic stroke))
- Structural changes in respiratory tissue (nasal, tracheal and bronchial) - Apoptosis(at time of bronchoscopy (within 2 weeks after acute ischemic stroke))
- Structural changes in respiratory tissue (nasal, tracheal and bronchial) - Increase of secretory cells(at time of bronchoscopy (within 2 weeks after acute ischemic stroke))
- Activity of immune System - Expression of HLA-DR(at time of bronchoscopy (within 2 weeks after acute ischemic stroke))
- Occurence of stroke-associated pneumonia(7 days after stroke)
- Activity of immune System - Concentration of cytokines(at time of bronchoscopy (within 2 weeks after acute ischemic stroke))
- Activity of immune System - Concentration of inflammatory markers(at time of bronchoscopy (within 2 weeks after acute ischemic stroke))
研究者
Andreas Meisel
Prof. Dr. med.
Charite University, Berlin, Germany