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The Effect of Vitamin A on Atherosclerosis

Phase 4
Conditions
Atherosclerosis
Interventions
Drug: placebo
Registration Number
NCT01414972
Lead Sponsor
Tehran University of Medical Sciences
Brief Summary

The aim of this study is the comparison between the effects of supplementation with 25000 IU preformed vitamin A (retinyl palmitate) or placebo for 4 months on gene expression of T CD4+ lymphocyte in atherosclerotic patients(documented with angiography).

Detailed Description

Atherosclerosis, the leading cause of death and disability in the world, is considered an inflammatory disease with a complex etiology. The immune system has a prominent role in the formation, development and destabilization of atherosclerotic plaques. A whole range of identified cytokines have been shown to play a part in atherogenesis, some with proatherogenic properties while others having antiatherogenic properties. With increasing evidence for the significant role of inflammation and the cytokines involved together with the Th1/Th2 imbalance in atherosclerosis and its progression to Coronary artery diseases (CADs), the control of cytokine production may become potential therapeutic targets and modulation of the Th1/Th2 balance may provide a new pharmacological tool to treat this disease. Vitamin A (VA) or VA-like analogs known as retinoids, are potent hormonal modifiers of type 1 or type 2 responses but a definitive description of their mechanism(s) of action is lacking. high level dietary vitamin A enhances Th2 cytokine production and IgA responses, and is likely to decrease Th1 cytokine production. Retinoic acid inhibits IL 12 production in activated macrophages, and RA pretreatment of macrophages reduces IFNγ production and increases IL4 production in antigen primed CD4 T cells. Supplemental treatment with vitamin A or retinoic acid (RA) decreases IFNγ and increases IL5, IL10, and IL4 production. Thus, vitamin A deficiency biases the immune response in a Th1 direction, whereas high level dietary vitamin A may bias the response in a Th2 direction.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
45
Inclusion Criteria

• The criteria for enrollment of the patients and control subjects is consecutive patients of both sexes referred to the Division of Cardiology of the one of the Hospitals of Tehran University of Medical Sciences for coronary angiography for investigation of chest pain and/or suspected CAD.

Exclusion Criteria
  • Patients who have diseases which affect on Th1/Th2 balance such as asthma, active viral infections, and autoimmune diseases, OR
  • Patients who have allergy to vitamin A compounds, OR
  • Patients who have used vitamin supplements in last 3 months.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
patients with atherosclerosis/ vitamin AVitamin Apatients with angiographically confirmed CAD (defined as luminal stenosis ≥50% in at least one major coronary artery branch)who receive 25000 IU/day vitamin A
patients with atherosclerosis/ placeboplacebopatients with angiographically confirmed CAD (defined as luminal stenosis ≥50% in at least one major coronary artery branch)who receive placebo
people without athrosclerosis/ vitamin aVitamin Apeople in whom significant (e.g. stenosis ≥ 50%) CAD is ruled out by coronary angiography, who receive 2500 Iu/day vitamin A
Primary Outcome Measures
NameTimeMethod
serum Total cholesterolChange from baseline at 4 months
serum HDL cholesterolChange from baseline at 4 months
serum triglycerides levelChange from baseline at 4 months
RBP/ TTR ratioChange from baseline at 4 months
PBMC's proliferation (BrdU colorimetric)Change from baseline at 4 months
complete blood count (CBC)Change from baseline at 4 months
SGOTChange from baseline at 4 months
SGPTChange from baseline at 4 months
Secondary Outcome Measures
NameTimeMethod
gene expression of T-bet, INF-gamma, IL-4, GATA3, IL-17, RORc, IL-10, FOXP3 (Relative quantification)Change from baseline at 4 months

Trial Locations

Locations (1)

Tehran University of Medical Sciences, School of Public Health

🇮🇷

Tehran, Iran, Islamic Republic of

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