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Role of Adrenaline in in the Inflammatory Response in Diabetes

Not Applicable
Completed
Conditions
Inflammatory Response
Diabetes Type1
Hypoglycemia
Interventions
Registration Number
NCT05990933
Lead Sponsor
Cees Tack
Brief Summary

The primary aim of the present study is to study the effect of adrenaline administration on inflammatory parameters (e.g. leukocyte phenotype, cytokines, inflammatory proteins). Secondary objectives consist of the effect of adrenaline on atherogenic parameters.

* All participants will receive intravenous infusion of adrenaline for an hour

* We will draw blood at 7 time points, not including screening

* Participants will be asked to return for a total of 4 times

Researchers will compare 2 groups, healthy individuals versus people with diabetes type 1 to see if the inflammatory reaction to adrenaline differs between these two groups.

Detailed Description

Objective: The aim of the present study is to study the effect of increased adrenaline levels on the inflammatory response (e.g. leukocyte phenotype, cytokines, inflammatory proteins) by administering exogenous adrenaline in participants with type 1 diabetes and healthy participants.

Potentially eligible adult ( 16 - 75 years) participants will be recruited from the diabetes clinic at the department of internal medicine from the Radboud University Medical Center. Healthy participants will be recruited through social media and other advertisements. We will recruit a total of 30 individuals, i.e. 15 healthy participants and 15 people with type 1 diabetes. Participants with type 1 diabetes will be equipped with a blinded continuous glucose monitoring device (CGM) during the test, which will measure interstitial glucose levels for a total of 10 days.

Intervention: All participants will receive intravenous infusion of adrenaline at a rate of 0.04ug/kg/min for 1 hour. We will draw blood at baseline, 30 minutes, 60 minutes, 180 minutes, 24 hours 72 hours and a week after start of infusion. The blood samples will be used for phenotyping of the innate immune system and measuring inflammatory and atherogenic parameters. Throughout the infusion, vital parameters will be monitored.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria

Not provided

Exclusion Criteria
  • Any event of cardiovascular disease in the past 5 years (e.g. myocardial infarction, stroke, heart failure, symptomatic peripheral arterial disease)
  • Pregnancy or breastfeeding or unwillingness to undertake measures for birth control
  • Epilepsy
  • Current treatment with Alpha or beta blockers ( doxazosin, propranolol)
  • History of panic disorders
  • History of Arrhythmias
  • Use of immune-modifying drugs or antibiotics
  • Use of tricyclic antidepressants or MAO inhibitors
  • Use of statins (e.g. stop statins >2 weeks before performing blood sampling.
  • Any infection with systemic symptoms in past 2 weeks
  • Previous vaccination in the past 2 weeks
  • Proliferative retinopathy
  • Nephropathy with an estimated glomerular filtration rate (by MDRD) ˂60ml/min/1.73m2

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
People with type 1 diabetesAdrenalineThe participants with type 1 diabetes will receive an intravenous infusion of adrenaline at a rate of 0.04ug/kg/min for 1 hour.
Healthy individualsAdrenalineThe participants without type 1 diabetes will receive an intravenous infusion of adrenaline at a rate of 0.04ug/kg/min for 1 hour.
Primary Outcome Measures
NameTimeMethod
Monocyte countChange from baseline compared to after 1 hour

The amount of monocytes following 60 minutes of adrenaline infusion compared to baseline to asses the adrenaline effect on the inflammatory response.

Secondary Outcome Measures
NameTimeMethod
Leukocyte countChange from baseline at day 30, 60 and 180 minutes 1, day 3 and day 7 after adrenaline infusion

Measurement of the amount of leukocytes

Glucose variability2 weeks

Glucose variability measured by the blinded continuous glucose monitor including but not limited to, measuring time within range, amount of hypoglycaemic events, amount of hyperglycaemic events.

Inflammation plasma parametersChange from baseline at 30, 60 and 180 minutes day 1, day 3 and day 7 after adrenaline infusion

Inflammatory plasma protein using ELISA, ( e.g high sensitive-crp)

InsulinChange from baseline at, 60 and 180 minutes

Plasma levels of insulin

Ex vivo cytokinesChange from baseline at 30, 60 and 180 minutes, day 1, day 3 and day 7 after adrenaline infusion

Ex vivo production of pro- and anti-inflammatory cytokines and chemokines after ex vivo stimulation of isolated monocytes, including TNF-α, IL-6, IL-10 and IL-1β.

NoradrenalineChange from baseline at 30, 60 and 180 minutes

Plasma levels of noradrenaline

Atherogenic parametersChange from baseline at 30, 60 and 180 minutes day 1, day 3 and day 7 after adrenaline infusion

Atherogenic parameters using ELISA method including but not limited to, VCAM-1, ICAM-1, E-Selectin, P-selectin, PAI-1, Plasma Endothelin

Leukocyte phenotypeChange from baseline at day 30, 60 and 180 minutes 1, day 3 and day 7 after adrenaline infusion

Measuring several phenotypes by using a pre-defined panel of interest with flow-cytometry ( e.g. NK-cells, granulocytes)

Pro-inflammatory proteinsChange from baseline at day 30, 60 and 180 minutes 1, day 3 and day 7 after adrenaline infusion

Pro-inflammatory proteins using Olink Proteomics AB inflammation panel with 92 circulating inflammatory proteins ( e.g. EN-rage, FIT3L)

AdrenalineChange from baseline at 30, 60 and 180 minutes

Plasma levels of adrenaline

Distribution of monocyte subsetChange from baseline at 30, 60 and 180 minutes, day 1, day 3 and day 7 after adrenaline infusion

Distribution of pro- and anti-inflammatory monocyte subsets using FACS (Fluorescence-activated Cell Sorting)

Trial Locations

Locations (1)

Radboud UMC

🇳🇱

Nijmegen, Gelderland, Netherlands

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