Study to Improve Deployment Related Asthma by Using L-Citrulline Supplementation
Status:
Not yet recruiting
Trial end date:
2029-04-01
Target enrollment:
Participant gender:
Summary
Service men and women returning from deployment are significantly more likely to develop
asthma and severe respiratory symptoms from airway obstruction. Why this happens is not well
known, but exposure to diesel, burn pits, biomass smoke, and sandstorms are thought to play a
role. Ultimately, patients with deployment related asthma develop a complex airway disease
that does not respond well to standard asthma medications. Therefore, it is imperative that
we study safe and affordable treatments that could improve quality of life and symptoms.
We have previously shown that adult patients with poorly controlled asthma have an abnormal
regulation of an amino acid called L-arginine and airway nitric oxide (FeNO), a gaseous
molecule normally produced in the airways of healthy people. In healthy people, nitric oxide
is present in amounts that help keep the airways open. However, in some patients with asthma,
nitric oxide and L-arginine are often low. Our preliminary data in obese asthmatics show that
L-citrulline, which is an amino acid that can be metabolized into L-arginine, improved lung
function and asthma control, while increasing the levels of FeNO. This is potentially
shifting the paradigm in how we think of asthma management, as rising FeNO is often thought
of being a bad sign. Based on this, we hypothesize that an L-citrulline-based drug strategy
will normalize nitric oxide metabolism, suppress oxidative inflammatory responses and improve
airway function in obese patients with asthma. Our proposal presents a clinical trial
approach to treat deployment related asthma patients using L-citrulline as an add-on therapy
to improve asthma control. If we confirm our previous study results, we will be in route for
developing the only precision-based therapy available to treat this asthma phenotype. Our
results will potentially show that L-citrulline is a safe, tolerable medication that can make
a significant impact on the respiratory health of a large segment of our active and veteran
population at a reasonable cost.
Phase:
Phase 2
Details
Lead Sponsor:
University of Colorado, Denver
Collaborators:
National Jewish Health United States Department of Defense