Cognitive, Emotional, and Neural Responses to Acute Inflammation

Early Phase 1

Completed

• Conditions: Healthy
• Interventions: Biological: Typhoid Vi Polysaccharide Vaccine; Biological: Placebo

• Registration Number: NCT03294564
• Lead Sponsor: University of California, San Francisco

Brief Summary

This study is a pilot study to examine the effects of acute inflammation on cognition and emotion in healthy participants using a between-subjects, randomized, double-blind design.

Detailed Description

The inflammatory response of the immune system is responsive to stress and it impacts brain function. Animal studies have shown that inflammation appears to alter threat- and reward-related brain activity. Accumulating evidence points to inflammatory proteins, specifically cytokines, as key players in this relationship. Although cytokines are typically too large to pass through the blood brain barrier (BBB), they can influence brain function and structure by transmitting signals from peripheral systems to the brain.

The administration of endotoxin within the polysaccharide form of Salmonella typhi vaccination provides an ideal model for studying the causal effects of short-term inflammation on thinking patterns (i.e., cognition) and emotions in the brain. Endotoxin is a component of the cell walls of Gram-negative bacteria, which promotes the production of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) via toll-like receptor-4 (TLR-4) activation and nuclear factor- κB (NF-κB) signaling.

To examine the effects of acute inflammation on brain functioning, 24 healthy participants will be recruited. The investigators will will randomize participants to placebo or inflammatory challenge using polysaccharide typhoid vaccine (i.e., endotoxin) and will use validated behavioral tasks and questionnaires to assess threat and reward sensitivity. They will assess chronic resting levels of inflammation as well as the inflammatory response to Salmonella typhi vaccination.

Study Timeline

• Study First Submitted: 2017-09-22
• Study First Submitted QC: 2017-09-22
• Study First Posted: 2017-09-27
• Study Start: 2018-01-01
• Primary Completion: 2018-12-30
• Study Completion: 2018-12-30
• Status Verified: 2019-06
• Last Update Submitted: 2019-06-21
• Last Update Posted: 2019-06-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 24

Inclusion Criteria

• Healthy individuals (free of chronic illness or lifetime history of psychiatric disorder)
• Non-smokers

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Exclusion Criteria

• Lifetime history of an psychiatric disorder with psychotic features, bipolar disorder, obsessive-compulsive disorder, alcohol or substance dependence, or a history of alcohol or substance abuse within the past 2 years.
• Currently exposed to recurrent trauma or have been exposed to a traumatic event within the past 3 months, or has current diagnosis of PTSD.
• Diagnosis of sleep apnea, neurological disorder, systemic illness affective central nervous system function, and/or anemia.
• Any suicidal or homicidal ideation within the past year.
• Subjects currently receiving selective serotonin reuptake inhibitors (SSRIs), benzodiazepine receptor agonists, anticonvulsants, atypical antipsychotic medication, any antidepressant medication including trazodone, or any psychotropic medication.
• Termination of SSRIs, benzodiazepine or benzodiazepine receptor agonists, anticonvulsants, atypical antipsychotic medication, any antidepressant medication including trazodone in the last month, or plans to start these medications during the course of the study.
• Contraindications to fMRI, including severe claustrophobia and presence of ferromagnetic objects in the body that would interfere with magnetic resonance examination and/or cause a safety risk (e.g., pace makers, implanted stimulators, pumps, extensive dental work, upper body tattoos).
• Contraindications to typhoid vaccine, which include acute febrile illness within the past two weeks, disorders characterized by a deficiency to ability to mount a humoral or cell-mediated immune response, use of anti-malarial medications in the past six months, antibiotics in past three months, a history of hypersensitivity to typhoid vaccine or any other vaccine, pervious immunization with whole-cell typhoid or live, oral typhoid vaccines, vaccination with the polysaccharide version of the typhoid vaccine within the past 3 years.
• Conditions or use of substances that may be associated with inflammation, including drugs that affect the immune system.
• Any chronic medical illness.
• Having a body mass index (BMI) over 30.
• Individuals who work the night shift

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Typhoid Vi Polysaccharide Vaccine	Typhoid Vi Polysaccharide Vaccine	Patients will receive one intramuscular 0.5 mL injection of Typhoid Vi Polysaccharide Vaccine containing 0.025 mg purified Vi polysaccharide.
Placebo	Placebo	Patients will receive one intramuscular 0.5 mL injection of saline placebo.

Primary Outcome Measures

Name	Time	Method
Inflammatory markers elicited by the typhoid vaccine	5-7 hours	Participants will receive a vaccine or placebo and investigators will examine inflammation levels during three different time points via blood draws

Secondary Outcome Measures

Name	Time	Method
Threat sensitivity between groups	1-3 hours	Participants will complete questionnaires and perform computerized tasks designed to assess threat sensitivity
Reward sensitivity between groups	1-2 hours	Participants will complete questionnaires and perform computerized tasks designed to assess reward sensitivity

Trial Locations

Locations (2)

University of California, San Francisco; 🇺🇸 San Francisco, California, United States

San Francisco Veterans Affairs Medical Center; 🇺🇸 San Francisco, California, United States