The Physiological Effects of hERG Blockade on Metabolism
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 44
- 试验地点
- 1
- 主要终点
- Insulin and GLP-1
研究概览
简要总结
The human ether-a-go-go-related gene HERG (encoding Kv11.1 potassium channels) is expressed in different parts of the body including the heart, pancreas and intestines. In the heart, Kv11.1 channels play a role in ending depolarization by causing repolarization. Loss-of-function mutations of HERG cause long QT syndrome, a condition of elongated QT interval that can lead to ventricular tachycardia, syncope and sudden death. Kv11.1 channels are also found in pancreatic α- and β-cells and intestinal L-cells, where they seem to play a role in the secretion of insulin, glucagon and Glucagon-Like Peptide-1 (GLP-1). Carriers of loss-of-function mutations in the HERG gene have showed increased insulin and incretin responses after glucose ingestion and decreased fasting levels of glucagon compared to matched control persons. Blockade of Kv11.1 has shown to augment glucose dependent insulin secretion and decrease low-glucose stimulated glucagon secretion in isolated α- and β- cells. The investigators of this study hypothesize that a blockade of Kv11.1 channels will increase incretin and β cell function and decrease α cell function and thus lead to lower glucose levels in humans after glucose intake. To investigate this, The investigators of this study will perform a randomized, cross sectional study of up to 40 healthy study participants who will serve as their own controls. The study participants will undergo two 6-hours oral glucose tolerance tests, one after intake of a known Kv11.1 blocker (moxifloxacin) and one control oral glucose tolerance test after intake of placebo. Prior to both tests the study participants will wear a continuous glucose monitor and on the day of the tests they will fill out a glucose questionnaire. Investigation of the physiological role of HERG in metabolism may provide a better insight on metabolic regulation.
详细描述
Background and significance:
The human ether-a-go-go-related gene (HERG) encodes Kv11.1 voltage-gated potassium channels throughout different parts of the human body including the heart, pancreas and intestine. Potassium channels are important for ending the depolarization by causing repolarization in cells.
Hence, various mutations in HERG have effects on cardiac and metabolic functions. One known example in the case of loss-of-function mutations in HERG is a reduced outward flow of potassium during repolarization of the heart, leading to an elongated QT interval that can lead to ventricular tachycardia, cardiac syncope and sudden death - known as the long-QT syndrome (LQTS) (1, 2). LQTS caused by HERG mutations is the second most common type of LQTS (1).
With regards to metabolism, blockade of Kv11.1 has shown to augment glucose dependent insulin secretion (3-5) and decrease low-glucose stimulated glucagon secretion (4) in isolated β and α cells and to augment insulin secretion and reduce blood glucose in living mice(3).
A study of 11 patients with LQTS caused by HERG mutations showed that during a 6-hour OGTT, the mutation carriers experienced increased levels of insulin, GLP-1 and Gastric Inhibitory Polypeptide (GIP), decreased levels of glucose and lower fasting levels of glucagon compared to matched control persons(6).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Basic Science
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 20 Years 至 40 Years(Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Healthy men and women
- •Age ≥20 and ≤40 years
- •BMI ≥18,5 and ≤27,5
排除标准
- •Chronic diseases (cardiac, metabolic, liver) including a family history of congenital Long QT syndrome.
- •QTc values >440 ms (men) and >450 ms (women)
- •Clinical important and/or symptomatic bradycardia
- •Regular medication (contraceptive pills allowed)
- •Pregnancy and breastfeeding
研究组 & 干预措施
Moxifloxacin
Per os, 800 mg, once daily for 4 days
干预措施: Moxifloxacin (Drug)
Placebo
Per os, 800 mg, once daily for 4 days
干预措施: Placebo (Drug)
结局指标
主要结局
Insulin and GLP-1
时间窗: First and second test day
Change in serum insulin response (AUC/30 min) and GLP-1(AUC/30 min) to a 75 g oral glucose tolerance test between OGTT with and without Kv11.1 blocker (moxifloxacin).
次要结局
- Glucose, Glucagon and GIP(First and second test day)
- Continuous Glucose Monitor(First and second test day)
研究者
Signe Torekov
Associate Professor
University of Copenhagen
