MedPath

Beta-Blocker Influences on Inflammatory and Neural Responses to Stress

Phase 4
Recruiting
Conditions
Cardiovascular Disease
Interventions
Drug: Placebo
Registration Number
NCT06263452
Lead Sponsor
University of North Carolina, Chapel Hill
Brief Summary

The purpose of this study is to map the neural and molecular mechanisms underlying psychological stress-induced changes in inflammation which could reveal new targets for intervention to reduce the risk of cardiovascular disease.

Detailed Description

The proposed work will conduct a mechanistic clinical trial utilizing the non-selective beta-adrenergic receptor blocker propranolol to examine the role of beta-adrenergic signaling in shaping neural and inflammatory responses to stress. The investigators will focus on beta-adrenergic signaling given seminal pre-clinical work showing that this molecular pathway is an important driver of stress-related increases in inflammation, and initial human neuroimaging work showing that beta-blockade leads to changes in neural responses to negative stimuli. Here, the investigators will bring these two previously disparate lines of work together to determine how experimentally blocking one critical stress-signaling pathway shapes neural activity and inflammatory responses to stress. In doing so, the investigators will be advancing knowledge by mapping mechanisms (i.e., beta-adrenergic signaling), offering methodological improvements (i.e., moving beyond correlation to using pharmacological manipulations to provide causal evidence), and identifying intervention targets (i.e., the neurocognitive systems that shift activity/connectivity in response to beta-blockade). In sum, the work proposed herein is significant because it will address the mechanisms by which one critical risk factor, psychological stress, may ultimately lead to cardiovascular disease via inflammation. The proposed study also offers significant methodological improvements over past work by using neuroimaging to identify neurocognitive pathways, and pharmacology to provide causal experimental evidence to move us beyond correlation. Finally, this project is significant because it could provide insight into novel targets for future interventions.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Ages 18-30 years
  • Right-handed
  • Fluent in English reading, writing, and speaking at least at a 10th grade level
  • Body mass index (BMI) less than or equal to 35 kg/m^2
Exclusion Criteria

Assessed as screening, reassessed at Session I:

  • Non-removeable metal devices/implants/objects in the body
  • Severe claustrophobia (assessed by self-report)
  • Currently pregnant
  • Left-handed
  • Body mass index (BMI) greater than 35 kg/m^2
  • History of fainting spells or any heart condition
  • History of or present low resting heart rate (< 60 BPM) and/or low blood pressure (systolic blood pressure < 80mmHg)
  • Self-reported physical illnesses: diabetes, cardiovascular diseases, high blood pressure, inflammatory bowel diseases, rheumatoid arthritis, asthma, autoimmune disease, Crohn's disease, ulcerative colitis, lupus
  • Any self-reported diagnosed mental illness
  • Current use of prescription medications
  • Current or recent regular nicotine/tobacco use (cigarettes, e-cigarettes, vape, chewing tobacco, nicotine gum)
  • Current regular (daily or almost daily) recreational drug use = 4 or more times per week

Instructed against during Session I, reassessed at Session II:

  • Received any vaccine within the past two weeks
  • Severe sleep disturbance (3-4 hours of sleep loss) the night before Session II
  • Vigorous physical activity on the day of Session II
  • Acute illness or allergy symptoms on the day of Session II
  • Usage of over-the-counter medications on the day of Session II
  • Usage of recreational drugs within 48 hours of Session II
  • Usage of alcohol on the day of Session II

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboEncapsulated placebo tablet
PropranololPropranololPropranolol tablet, 40mg, one-time, orally
Primary Outcome Measures
NameTimeMethod
Change in levels of pro-inflammatory cytokine interleukin-6 in response to social stressPost-drug baseline to 90-minutes post-stress task (T-90)

Blood plasma will be analyzed for levels of pro-inflammatory cytokine interleukin-6 (IL-6), from baseline, a baseline after drug administration, a sample 90-minutes after the stress task (T-90) measured in pg/mL. The timeline was determined on meta-analytic work showing changes in the inflammatory cytokine IL-6 are largest at 90 minutes post-stress.

Change in levels of inflammatory gene expression in response to social stressPost-drug baseline to 30-minutes post-stress task (T-30)

Whole blood samples will be collected in PaxGene tubes and analyzed for changes in inflammatory gene expression from baseline, a baseline after drug administration, and 30-minutes after the stress task (T-30), measured in gene transcript counts per million. The timeline is based on the Principal Investigator's work showing that changes in pro-inflammatory gene expression are observed 30-minutes post-stress.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Social Neuroscience and Health Laboratory

🇺🇸

Chapel Hill, North Carolina, United States

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