This will be a single center, open label study of allergic asthmatic and normal volunteers. The protocol will compare baseline characteristics of recovered sputum cells (collected on screening day) to those of cells recovered 6 hours after inhalational challenge with CCRE within each group as well as cross group comparisons between AA's and NV's. The following information indicates procedures to be performed at each visit as well as the anticipated duration of visits. Subsequent to this description are details regarding specific study procedures.
Visit 1: Baseline Visit (5 hours)
1. Consent will be obtained, review of subject's medical history, current medications and inclusion/exclusion criteria.
2. Vital sign measurements (temperature, pulse, respiratory rate, blood pressure), oxygen saturation, and symptom scoring
3. Urine pregnancy test for women of child bearing potential
4. Spirometry
5. Venipuncture for CBC with differential and baseline blood analyses
6. Physical exam of the ears, nose, throat and chest
7. Collection of exhaled breath for measurement of nitric oxide level
8. Xenon equilibrium gas scan and MCC
9. MCC scan
10. Sputum induction
11. After completion of the sputum induction, subjects will have brief MCC scan (\< 10 minutes)
Visit 2: 24 hours post baseline subjects will return for the following 1 hour visit:
1. Review any change in medical status over prior 24 hours, vital signs, O2 saturation and symptom score
2. Follow up MCC scan
Visit 3: 24-48 hours prior to challenge visit at least 2 days after the baseline visit (½ hour)
1. Review change in medical status since last visit; vital signs, oxygen saturation, \& symptom score
2. Urine pregnancy test
3. Spirometry
Visit 4: Endotoxin (CCRE) challenge day (8.5 to 9 hours)
1. Review any change in medical status since last visit
2. Vital signs, oxygen saturation, and symptom score
3. Spirometry
4. Physical exam of the ears, nose, throat and chest
5. If above measures are acceptable, CCRE challenge will be performed
6. Post-challenge monitoring including spirometry, vital signs, oxygen saturation, and symptom score at the following intervals post challenge: 30 and 60 minutes and then hourly for 5 additional hours.
7. Post challenge venipuncture (blood draw) for CBC with differential and post CCRE blood analyses
8. Collection of exhaled breath for measurement of nitric oxide level.
9. Four hours post challenge, subject will have MCC evaluated
10. After MCC is assessed, sputum induction will be performed.
11. After completion of the sputum induction, subjects will have brief MCC scan (\< 10 minutes)
12. Discharge home or, alternatively, to GCRC for overnight observation per study MD.
Visit 5: 24 hours post challenge visit (1 hour)
1. Subject returns to the CEMALB, vital signs, oxygen saturation, and symptom score
2. Collection of exhaled breath for measurement of nitric oxide level.
3. Spirometry
4. Follow-up MCC scan
5. Each volunteer will be given a symptom scoring sheet for each day up to 96 hours (4 days) after challenge (see accompanying symptom scoring sheet in Appendix 3).
Post Challenge Observations/Reporting (5 minutes)
1\. Subjects will be contacted for phone call follow-up 48-96 hours after challenge (see script Appendix 4 of accompanying protocol)
Study discontinuation visit within 10 days of the challenge dose: (15 minutes)
1. Vital signs, O2 saturation, symptom score, spirometry
2. If any findings are abnormal, medical evaluation as directed by the study physician will be undertaken Appendix 1 of the accompanying protocol provides a summary table regarding procedures performed at each subject study visit
