Emphysema

Researchers are evaluating the effects of inhaled nitroglycerin on improving respiratory function in patients with late-stage Chronic Obstructive Pulmonary Disease COPD, especially those experiencing respiratory failure and pulmonary hypertension. The study aims to investigate how this treatment may help by dilating pulmonary arteries to reduce ventilationperfusion mismatch and improve antibiotic delivery to the lungs. This trial is sponsored by Beni-Suef University and includes patients admitted to adult intensive care units. Participants will be randomly assigned to one of two groups. One group will receive the standard treatment for COPD exacerbation, including antibiotics, corticosteroids, and bronchodilators. The other group will receive inhaled nitroglycerin in addition to the standard treatment. The study is designed as a phase 2 and phase 3 trial, with no blinding, and will monitor the effects over several days. During the study, participants will be closely monitored for changes in pulmonary function five days after starting the inhaled nitroglycerin. Researchers will also track the number of days on mechanical ventilation, the dose of vasopressor therapy, reduction in white blood cell count, and mortality rate up to ten days after treatment begins. The study aims to understand the treatments impact on respiratory failure in COPD patients and will continue until December 2025.

Researchers are evaluating how a 12-week daily inhaler therapy combining fluticasone furoate, umeclidinium, and vilanterol affects adults aged 50 to 85 with moderate to severe COPD. The study includes equal numbers of males and females with persistent symptoms and compares those at low and high risk of COPD flare-ups. It aims to understand if this triple therapy improves lung ventilation as measured by 129-Xenon MRI and how this relates to lung function tests. Participants will use a single Ellipta inhaler containing the three medications once daily for 12 weeks, with an optional additional 48 weeks of treatment. They will attend two main visits at baseline and after 12 weeks, with an optional third visit at 48 weeks to assess longer-term effects. The study observes participants responses during and after therapy. During visits, participants undergo various lung function tests including spirometry, plethysmography, oscillometry, and exhaled nitric oxide measurement. They will have 129-Xe MRI scans and chest CT scans before and after bronchodilator use. Questionnaires assessing respiratory symptoms, health status, and exertion are completed, along with a blood draw for inflammatory markers. Researchers measure ventilation defect percentage and lung function changes to evaluate therapy effects over time.

This NIH-sponsored study aims to characterize three biomarkers derived from 129Xe gas exchange MRI and understand how they change in response to interventions. The study focuses on markers derived from the interaction of 129Xe with pulmonary capillary red blood cells RBCs, specifically RBC transfer MRI, cardiogenic oscillations in 129Xe-RBC signal amplitude, and the 129Xe-RBC chemical shift. The study population includes healthy volunteers, patients scheduled to undergo transfusion or phlebotomy, patients with dyspnea, interstitial lung disease ILD, idiopathic pulmonary fibrosis IPF, non-specific interstitial pneumonias NSIP, chronic hypersensitivity pneumonitis cHP, sarcoid, chronic thromboembolic pulmonary hypertension CTEPH, and acute pulmonary embolism.

Researchers are studying how blood flow to muscles is controlled and how this changes with age and certain diseases such as chronic obstructive pulmonary disease COPD, sepsis, pulmonary hypertension, and cardiovascular disease. The study focuses on four key pathways that affect blood vessel constriction and dilation Angiotensin-II, Endothelin-1, Nitric Oxide, and oxidative stress. The goal is to better understand how these pathways contribute to reduced blood flow during exercise and whether these changes can be improved. Participants will receive various treatments including exercise tests and drugs that affect blood vessel function, such as Nitric Oxide blockers, antioxidants, receptor antagonists, and other vasoactive agents. These treatments will be given through catheter placements for measurements and infusions. Different groups include healthy young adults, older adults, and patients with conditions like COPD, pulmonary arterial hypertension, heart failure, and hypertension. The study will also evaluate effects before and after exercise training. During the study, participants will undergo tests such as maximum exercise capacity, measurements of blood flow, blood pressure, muscle metabolism, and muscle fatigue using advanced imaging techniques like Nuclear Magnetic Resonance NMR. Researchers will monitor changes in limb blood flow and other outcomes at baseline and one hour after treatments. The study aims to provide detailed insight into how vascular function changes with age and disease and how it responds to various interventions over time.

Researchers are investigating the effects of inhaled nitric oxide iNO on exercise capacity and safety in people with moderate-to-severe chronic obstructive pulmonary disease COPD. The study evaluates two doses of iNO, 10 parts per million ppm and 40 ppm, each administered for at least 2 hours daily over one week. This research aims to find safe and effective treatment methods for COPD, focusing on lung function and exercise performance. Participants are randomly assigned to one of three groups inhaled nitric oxide at 10 ppm, inhaled nitric oxide at 40 ppm, or a placebo treatment using air. Each treatment is inhaled for at least 2 hours per day for 7 consecutive days. The iNO is delivered through a specialized system that ensures a constant concentration during inhalation. The placebo group inhales air with 21% oxygen, mimicking the treatment process without active nitric oxide. During the study, participants undergo cardiopulmonary exercise tests measuring oxygen uptake, ventilation efficiency, and breathlessness scores at the start and end of the 7-day treatment period. Lung function tests, symptom questionnaires, a six-minute walk test, and safety monitoring for adverse events are also performed. The study tracks changes from baseline to day 7 to assess the impact of the treatments on exercise capacity and respiratory health.

Researchers are evaluating inhaled nitric oxide to understand its effects on exercise tolerance and safety in people with moderate-to-severe Chronic Obstructive Pulmonary Disease COPD. This study aims to help develop better treatment options for managing COPD symptoms and improving patient outcomes. The trial is sponsored by Novlead Inc. and does not involve a specific drug phase classification. Participants will be randomly assigned to receive inhaled nitric oxide at either 10 parts per million ppm or 40 ppm. Each participant will inhale the gas for at least 2 hours each day over a period of 7 consecutive days. The nitric oxide is delivered using a specialized device that controls the concentration of gas inhaled through the breathing apparatus. During the study, participants will be closely monitored with various tests and assessments. These include measuring changes in oxygen uptake, breathing efficiency, perceived exertion, lung function, walking distance, and COPD symptom scores, all recorded at the beginning and end of the 7-day treatment period. Safety and treatment effects will be assessed throughout, with the total participation lasting just over one week.

Researchers are evaluating the safety, tolerability, and how the body processes TQC3302 inhalation spray in healthy adults between 18 and 55 years old. This Phase 1 clinical study uses both a single-center, open-label design and a randomized three-sequence, three-period crossover design for different groups. The study focuses on measuring adverse events and drug levels in the body after single and multiple inhalations of TQC3302 and comparator inhalation sprays in healthy participants. Participants receive single doses or multiple doses of TQC3302 inhalation spray alone or combined with other inhaled drugs like Tiotropium bromide and olodaterol hydrochloride inhalation spray or Budesonide Powder for Inhalation. Different dosing schedules cover single doses during days 1 to 7 and two doses during this period. The study groups are randomized to receive these treatments in various sequences to compare safety and pharmacokinetic profiles. During the study, participants undergo detailed safety assessments including monitoring for side effects up to day 14 after dosing. Blood samples are collected at multiple time points to measure drug concentrations and pharmacokinetic parameters like peak concentration, clearance, and half-life. The study also includes physical exams, lung function tests, laboratory tests, chest X-rays, and ultrasound evaluations during screening. The total participation spans from screening through follow-up visits up to 14 days after the last dose.

Researchers are studying ways to improve treatment decisions for smokers who find it hard to quit using medications. This trial compares different approaches including nicotine replacement therapies patches and lozenges, varenicline, and harm reduction products like e-cigarettes. The goal is to find better strategies to help smokers quit by adjusting treatments based on early response. Participants will receive free treatment products for 12 weeks. Initially, they will be randomized to either varenicline or combination nicotine replacement therapy. After 4 weeks, based on their success in quitting, they may continue the same medication or switch to the other option. At 8 weeks, those still not successful may either continue their current medication or switch to e-cigarettes. No products are provided after 12 weeks. The study includes an additional survey at 6 months after the first phone call. All visits and assessments are done remotely, with a total of 8 surveys completed over the 6-month study period. Researchers will measure quitting success at 8 weeks as the primary outcome and assess dependence and longest quit attempt duration at 12 weeks. Participants are monitored through surveys without in-person visits, making participation convenient and accessible.

The PALMIRE project is a prospective, monocentric study conducted at the University Hospital of Reims, France, involving patients diagnosed with chronic inflammatory pulmonary diseases including asthma, chronic obstructive pulmonary disease COPD, bronchiectasis, cystic fibrosis CF, primary ciliary dyskinesia PCD, and interstitial lung diseases ILD. These diseases are characterized by lung inflammation and remodelling, with highly variable clinical, functional, microbiological, biological, pathological, and prognostic features. The study aims to analyze phenotypic characteristics, including clinical, demographic, biological, morphological, pathological, and microbiological features, together with respiratory exposures and underlying mechanisms involving airway epithelium and inflammation processes. It also considers shared phenotypic traits between different diseases and the coexistence of components of several diagnoses in the same patient, which may suggest shared underlying mechanisms and possible therapeutic targets beyond the initial medical diagnosis.

Researchers are evaluating a digital health intervention using a mobile application called Pust Deg Bedre PDB to support self-management in patients with Chronic Obstructive Pulmonary Disease COPD. COPD patients often experience symptoms like dyspnea, cough, and chronic mucus hypersecretion, which increase infection risks and exacerbate the disease. This study aims to explore the feasibility, patient and physiotherapist experiences, and implementation of the PDB app in managing these symptoms. The intervention involves physiotherapists providing patients with training on how to use the PDB app, which offers tailored breathing and airway clearance techniques based on clinical assessment. Patients will engage with the apps treatment plan over an 8-week period, with follow-up at 6 months. Adjustments to the treatment plan may be made during the intervention. The study includes qualitative interviews and video-recorded physiotherapy sessions to gain deeper insights into the interactions and experiences of patients and physiotherapists. Participants will be assessed through questionnaires and interviews at the end of the 8-week treatment and at the 6-month follow-up. Researchers will collect both quantitative and qualitative data, including health-related outcomes, adherence, adverse events, and patient satisfaction. Physiotherapists will also be followed up to explore the impact of participation on their clinical practice. The total study duration includes the initial intervention and a long-term follow-up, aiming to gather comprehensive information on the apps usefulness and acceptability.