Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing (GESTALT)
- Conditions
- Healthy VolunteersNon-Healthy/Non-FrailFrail
- Registration Number
- NCT02339012
- Lead Sponsor
- National Institute on Aging (NIA)
- Brief Summary
Background:
- Biomarkers are substances in people s blood and tissues. They help researchers understand diseases and signs of aging. Scientists want to do more research on biomarkers to find ways to improve quality of life in old age.
Objective:
- To learn more about biomarkers and their relationship to aging.
Eligibility:
- Adults at least 20 years old who weigh at least 110 pounds and have a body mass index below 30. They must agree that their genetic samples can be collected, studied, and stored.
Design:
* Participants will be screened with medical history, physical exam, and blood and urine tests. They will have heart tests and nurse will assess their veins. They will fill out a questionnaire.
* Participants will have a 2-day baseline visit. Then they will return every 2 years for up to 10 years. These follow-up visits will repeat the baseline visit:
* Repeat of screening procedures.
* Physical performance tests like balance and walking tests.
* Leg and grip strength tests.
* Health and mental state questions.
* Memory and problem solving tests.
* Cytapheresis. Blood will be removed through a needle in the vein of one arm and run through a machine. The blood will be returned through a needle in a vein of the other arm.
* Visits may also include:
* Magnetic resonance imaging scans. Participants will lie on a table that slides in and out of a machine that takes pictures.
* Diabetes test. After fasting, participants will drink a sweet drink and give blood.
* Breathing and walking tests.
* Wearing a device that record physical activity.
* Scan of the abdomen and the right leg.
* A small amount of muscle tissue and/or skin removed.
- Detailed Description
Under the assumption that aging is caused by dysfunction of specific biological mechanisms, it is reasonable to hypothesize that slowing aging should delay the onset of chronic diseases that typically affect older persons and improve their longevity and quality of life. Indeed, there is emerging evidence that factors associated with premature mortality are also involved in multiple pathologic conditions typical of aging. There is evidence that the study of aging and longevity requires a more comprehensive analysis of biological, environmental and phenotypic changes that occur with aging and how they are reflected by circulating and tissue biomarkers. A major limitation in this approach to date is that most studies of biomarkers rely on blood specimens, which may not recapitulate the biology of other tissues. In addition, although all cell types from the same person have exactly the same genetic code; information on epigenetic modifications, RNAm, and protein expression likely differ across cell types and at different points in time. Thus, global measures of these biomarkers in specific cell types can be affected by percentages of these cell types in the blood, and it is well known that such percentages change with aging and chronic diseases. More recently single cell biomarker assessment overcome such limitation and will be introduced in GESTALT in parallel with the measures already obtained.
In GESTALT, we will use cytapheresis to collect large number of PBMCs in the H group and we will draw blood to collect PBMCs in the NHF and F individuals dispersed over a wide age- range. The collection of large number of PBMCs is essential to obtain enough cells for each cell type to support measurements of the biomarkers of interest.
The information collected will be used to identify biomarkers that change with aging in healthy, non-healthy-or-frail and frail individuals, independent of changes in specific PBMCs cell types. We will also develop a statistical model that can be used by other studies of biomarkers to adjust their analysis for PBMCs cell type composition without having to perform complex and expensive measures, such as flow cytometry. The data collected in PBMCs will be compared to similar biomarker data obtained from muscle/fat and skin biopsies to understand to what extent biomarkers measured in the blood recapitulate similar changes that occur in different human tissues. Finally, once methodological limitations of measuring biomarkers in the blood have been addressed, we plan to assess the relationship of biomarkers assessed in specific circulating cell types, in the whole blood, bone marrow aspirate and in muscle/fat and skin biopsies to physiological measures that typically change with aging, including measures of body composition (anthropometrics, CT scan and MRI), energetics (spirometry at rest and during different degrees of exercise intensity), homeostatic equilibrium (hormones and inflammatory markers), neurological function (neurocognitive testing, brain MRI, nerve conduction studies). At even visits, we will focus on in depth characterization of phenotypes that are relevant for aging. Additionally, a modified schedule of testing will occur starting at Year 8. Year 8 Visit 4.5, which is between visits 4 and 5 and Year 18 Visit 8.5, which is between visits 8 and 9 and every 10 years thereafter. This strategy reduces the burden to participants but still allows delineating trajectories of essential variables and relate them longitudinally. The final goal is to develop new hypotheses about the biological nature of the aging process and how aging is associated with decline of physical and cognitive function.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 900
Not provided
These criteria pertain to the Screening and Baseline Visits. If conditions considered as exclusion criteria for study entry develop any time after the Baseline evaluation, the participant remains in the study.
Exclusion Criteria:
- HIV virus infection (all groups).
- Hepatitis B or C (all groups).
- Active syphilis, gonorrhea or TB requiring treatment (all groups).
- WBC <3,000 or > 12,000/k/microL (only Healthy group).
- Platelets < 100,000 or >600,000 k/ microL (only Healthy group).
- Hemoglobin < 11.0 gm/dL in women and < 12.0 gm/dL in men (only Healthy Group).
- GFR <50 mL/min/1.73 m^2 (only Healthy group)
- GFR <= to 30 (only non-Healthy-or-Frail group or Frail group)
- Bilirubin > 1.5 mg/dl (unless higher levels can be ascribed to Gilbert s disease (only Healthy Group).
- ALT, AST, or alkaline phosphatase twice the normal serum concentration (only Healthy Group).
- Corrected calcium < 8.5 or > 10.7 mg/dl (all groups).
- Albumin < 3.1 g/dl (only Healthy Group).
- Cholesterol, LDL and/or Triglycerides >1.5x normal (only Healthy group).
- Positive Urine Drug Screen (unless taking prescribed medication and at the discretion of the PI) (all groups).
- Currently pregnant or a nursing mother (all groups).
Furthermore, if the participant is found eligible at Screening and Baseline but fails a urine drug screen (unless taking a prescribed medication and at the discretion of the PI) at any of the subsequent visits, the participant will be asked to return to repeat the test and if positive, will no longer be eligible to participate in the study.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Development of state-of-theart expression/methylation /protein PBMC atlas in aging Ongoing measurement of epigenetic, gene expression, and protein biomarkers
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
National Institute of Aging, Clinical Research Unit
🇺🇸Baltimore, Maryland, United States