October 3 , 2005
of studies examines asthma triggers, treatments
By Tia McCollors
An Emory pulmonology researcher is recruiting patients
for a pair of national, asthma-related studies: one to analyze how
ozone levels in the environment affect a person’s innate nasal
defenses and their ability to protect healthy lung function, and
the other to determine whether treating acid reflux improves asthma
“We know that high ozone levels can make asthma worse,” said principal
investigator Sumita Khatri, assistant professor of pulmonary and critical care
medicine, of the former. “We’re specifically looking to see whether
the mechanism of this is due to decreased antioxidant defenses in the noses of
asthmatics that render the asthmatics more susceptible to pulmonary symptoms
than other individuals.”
Researchers are enrolling 44 asthmatics and 20 non-asthmatics
years old to participate in the Serial Nasal Oxidant-Defense Testing (SNOT)
in Asthma study. The study will evaluate their lung functions, as
well as how nasal
antioxidant activity may act as a biochemical filter for pollutants such as
ozone, thereby decreasing airway inflammation.
Each participant will make two three-hour visits to
Crawford Long Hospital’s
Clinical Research Center, one during high ozone season (May to September) and
one during low ozone season (October to April). Participants’ involvement
in the study will include symptom questionnaires, medical and medication history,
blood work, urine samples, breathing tests and nasal washing. Those who qualify
and complete the study will receive $50 per visit for participation.
All participants must be non-smokers, cannot be pregnant,
have emphysema, be on prednisone for asthma, or take daily vitamins
C or E supplements
more than a multivitamin. Non-smoking asthmatics must currently have stable
asthma symptoms, no lung disease, no family history of asthma or chronic sinus
problems, and no history of seasonal or significant allergies.
“If we determine that asthmatics do worse during high ozone season due
to depleted antioxidants, antioxidant supplements such as vitamin C and E given
orally or even nasally may be a protective treatment,” Khatri said.
The acid reflux/asthma study is part of a national
clinical trial; Emory is one of 20 sites in the American Lung Association-Asthma
(ACRC) network participating in the Study of Acid Reflux and Asthma (SARA).
SARA trial is designed to determine whether asthma is worsened by gastroesophageal
reflux disease (GERD, or severe heartburn) and whether treatment of this
condition using proton pump inhibitors improves asthma symptoms.
“It’s not well known why there appears to be more GERD in asthmatics
than in the general population, or whether the presence of GERD actually worsens
asthma,” Khatri said. “There are links experimentally between acid
reflux and bronchial spasms related to asthma. In addition, bronchial spasms
may increase reflux by altering pressures in the chest that may allow more acid
to reflux into the esophagus. Asthma medications may also contribute to worsening
Khatri is principal investigator of the SARA trial
for the Emory site and co-principal investigator for the studies
the ACRC, for
which Emory pediatric
pulmonologist Gerald Teague is the main principal investigator.
Patients with asthma who express some degree of continued
asthma symptoms, and who also show signs of GERD, are being sought
either the Emory Children’s Center or Crawford Long Hospital over
a six-month period are required.
The national SARA trial will enroll 400 non-smoking
asthmatics, ages 18–60,
who have poor asthma control on inhaled steroids, defined on the basis
of excessive bronchodilator use, nocturnal awakenings or frequent
Participants will be randomly assigned for treatment
with either a proton pump inhibitor or matching placebo. The presence,
relationship of GERD to asthma symptoms will be documented with a 24-hour
ambulatory esophageal pH probe test of the participant’s esophagus
to determine whether gastric acid washes back into the esophagus and causes
symptoms. Interested participants who qualify and complete the study
will receive between
$600 and $650 for their time and effort.
For more information about either study, contact research
coordinator Jeannie Peabody at Crawford Long at 404-686-1956. For
requirements and exclusion factors for the SARA trial, interested participants
may also contact Rachna Patel at the Children’s Center at