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MitoQ Treatment of Claudication: Myofiber and Micro-vessel Pathology

Not Applicable
Recruiting
Conditions
Peripheral Arterial Disease
Interventions
Diagnostic Test: Walking assessment
Other: QOL Survey
Diagnostic Test: Ankle pressure at rest and after stress
Diagnostic Test: Muscle Oxygen
Diagnostic Test: Serum MitoQ Level
Procedure: Needle Biopsy
Registration Number
NCT06409949
Lead Sponsor
University of Nebraska
Brief Summary

In our research, we are delving into whether taking MitoQ for six months can improve the symptoms and function of people diagnosed with peripheral artery disease, especially those who suffer from leg pain while walking, known as intermittent claudication. We will be checking if MitoQ helps people with claudication walk better, be more active every day, feel better about their lives, and if it enhances the health of their leg muscles.

Detailed Description

This study will investigate whether taking MitoQ for six months can improve the walking ability, daily activity levels, and quality of life of people with claudication (leg pain) caused by peripheral artery disease (PAD). We'll also look at how MitoQ affects their calf muscles.

Here's what we'll be checking:

Muscle health: We'll examine muscle tissue samples under a microscope to see if MitoQ improves muscle health and function.

Body chemistry: We'll check blood tests to see if MitoQ affects overall health markers.

Mitochondrial health: We'll see if MitoQ reduces damage to mitochondria (the cell's powerhouses) and helps the body get rid of damaged ones. We'll also see if it improves how well mitochondria function.

Blood flow: We'll measure blood flow in the legs and see if MitoQ improves the function of tiny blood vessels in the calf muscles.

In short, we want to see if MitoQ can improve various aspects of health in people with claudication and PAD, and if these improvements are linked to better functioning mitochondria in their muscles.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  1. a positive history of chronic claudication
  2. exercise-limiting claudication established by history and direct observation during a screening walking test administered by the evaluating vascular surgeon
  3. documented lower extremity arterial occlusive disease based on ankle/brachial index measurements and/or arterial imaging
  4. stable blood pressure, lipid and diabetes regimens and risk factor control for 6 weeks.
Exclusion Criteria
  1. rest pain or tissue loss due to PAD (Fontaine stage III and IV)
  2. acute lower extremity ischemic event
  3. walking capacity significantly and primarily limited by conditions other than claudication including leg (joint/musculoskeletal, neurologic) and systemic (heart, lung disease) pathology.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MitoQMuscle OxygenParticipants will be placed on a 24-week regimen of oral dosing with MitoQ. The patients will take two 20 mg caps of MitoQ on empty stomach, each morning
MitoQNeedle BiopsyParticipants will be placed on a 24-week regimen of oral dosing with MitoQ. The patients will take two 20 mg caps of MitoQ on empty stomach, each morning
PlaceboMuscle OxygenThe patients will take two identical caps of matched placebo on empty stomach, each morning
PlaceboSerum MitoQ LevelThe patients will take two identical caps of matched placebo on empty stomach, each morning
MitoQSerum MitoQ LevelParticipants will be placed on a 24-week regimen of oral dosing with MitoQ. The patients will take two 20 mg caps of MitoQ on empty stomach, each morning
PlaceboQOL SurveyThe patients will take two identical caps of matched placebo on empty stomach, each morning
PlaceboAnkle pressure at rest and after stressThe patients will take two identical caps of matched placebo on empty stomach, each morning
MitoQWalking assessmentParticipants will be placed on a 24-week regimen of oral dosing with MitoQ. The patients will take two 20 mg caps of MitoQ on empty stomach, each morning
MitoQQOL SurveyParticipants will be placed on a 24-week regimen of oral dosing with MitoQ. The patients will take two 20 mg caps of MitoQ on empty stomach, each morning
MitoQAnkle pressure at rest and after stressParticipants will be placed on a 24-week regimen of oral dosing with MitoQ. The patients will take two 20 mg caps of MitoQ on empty stomach, each morning
PlaceboWalking assessmentThe patients will take two identical caps of matched placebo on empty stomach, each morning
PlaceboNeedle BiopsyThe patients will take two identical caps of matched placebo on empty stomach, each morning
Primary Outcome Measures
NameTimeMethod
Walking Impairment: maximum treadmill distanceBefore and After 6 months of treatment with MitoQ or placebo

Evaluation of maximum walking distance on treadmill until participant chooses to stop due to pain in his legs.

Secondary Outcome Measures
NameTimeMethod
Walking Impairment: initial claudication treadmill distanceBefore and after 6 months of treatment with MitoQ or placebo

Evaluation of walking distance on treadmill until participant starts experiencing claudication pain in his legs.

Walking Impairment: 6 minute distanceBefore and after 6 months of treatment with MitoQ or placebo

Evaluation of maximum walking distance the participant can walk over 6 minutes in hallway.

Walking Impairment: daily physical activityBefore and after 6 months of treatment with MitoQ or placebo

Measurement of average steps taken daily using a pedometer

Leg hemodynamics ankle/brachial index at rest and after stressBefore and after 6 months of treatment with MitoQ or placebo

Evaluation of ankle/brachial index at rest and after stress. The ankle-brachial index test compares the blood pressure measured at the ankle with the blood pressure measured at the arm. A care provider measures your blood pressure in both arms and both ankles. This is done using an inflatable cuff and a hand-held ultrasound device. The device uses sound waves to detect blood flow and allows the pulse in the ankle arteries to be heard after the cuff is deflated.

The test will be done first with you resting and then under stress. The stress will be produced by a blood pressure cuff placed around the lower thigh and the cuff being inflated to block blood flow to your calf and foot for five minutes.The cuff is then deflated, allowing blood to flow back into the leg.

Walking Impairment Short Form-36Before and after 6 months of treatment with MitoQ or placebo

Walking Impairment Short Form-36 - (The Short Form 36 Health Survey Questionnaire) has 8 scale (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health) that measures quality of life. The SF-36 scoring ranges from 0-100. Higher scores indicate better health; lower scores indicate more disability.

Leg hemodynamics muscle heme-oxygen (StO2)Before and after 6 months of treatment with MitoQ or placebo

Evaluation of the level of oxygen in your calf muscle at rest and during during exercise. StO2 is measured with a wireless, probe placed on the skin of your calf.

Calf muscle cell damageBefore and after 6 months of treatment with MitoQ or placebo

In the small tissue sample (biopsy) from your calf muscle we will look at the damage of the muscle cells by oxidative stress and the way the shape and size of the cells changes. This will be measured with quantitative widefield fluorescence microscopy.

Calf muscle inflammationBefore and after 6 months of treatment with MitoQ or placebo

In the small tissue sample (biopsy) from your calf muscle we will measure the inflammation present in the muscle.This will be measured with quantitative widefield fluorescence microscopy and enzyme-linked immunosorbent assay.

Level of MitoQ in the blood and the muscleAfter 6 months of treatment with MitoQ or placebo

In the blood sample and the muscle sample we will collect from you we will check the level of MitoQ. This will be measured with mass spectrometry.

Calf muscle fibrosisBefore and after 6 months of treatment with MitoQ or placebo

In the small tissue sample (biopsy) from your calf muscle we will look at the amount of scarring (fibrosis) and measure if there is there any scar tissue buildup in the muscle.This will be measured with high-resolution respirometry, quantitative widefield fluorescence microscopy and with multiSpectral wide-field microscopy.

Calf muscle blood vessel healthBefore and after 6 months of treatment with MitoQ or placebo

In the small tissue sample (biopsy) from your calf muscle we will check how well the tiny blood vessels inside your muscle are working and if they are damaged and how much.This will be measured with videomicroscopy of calf muscle micro-vessel vasomotor function, high-resolution respirometry and quantitative widefield fluorescence microscopy.

Walking Impairment QuestionnaireBefore and after 6 months of treatment with MitoQ or placebo

Walking Impairment Questionnaire: There are 14 questions across three categories of walking distance, walking speed and stair climbing.

The WIQ is graded on a scale of 0-4; 0 represents no difficulty; 4 represents inability to walk. 0 score represents no difficulty, 1 score is slight difficulty, 2 score is some difficulty, 3 score is much difficulty, 4 score is unable to complete the task in question.

Calf muscle mitochondria function and damageBefore and after 6 months of treatment with MitoQ or placebo

In the small tissue sample (biopsy) from your calf muscle we will look at the function and possible damage of the mitochondria in your muscle cells. Mitochondria are the powerhouses of your cells. We'll see if they're working properly or damaged.This will be measured with high-resolution respirometry, quantitative widefield fluorescence microscopy, 2-dimensional gel electrophoresis and mass spectrometry.

Trial Locations

Locations (1)

VA Medical Center

🇺🇸

Omaha, Nebraska, United States

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