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临床试验/NCT06263452
NCT06263452招募中4 期

Beta-Blocker Influences on Inflammatory and Neural Responses to Stress

University of North Carolina, Chapel Hill1 个研究点 分布在 1 个国家目标入组 120 人开始时间: 2024年5月1日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
4 期
状态
招募中
入组人数
120
试验地点
1
主要终点
Change in levels of pro-inflammatory cytokine interleukin-6 in response to social stress

研究概览

简要总结

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.

详细描述

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.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Basic Science
盲法
Triple (Participant, Care Provider, Investigator)

盲法说明

This is a double blind, randomized, placebo-controlled mechanistic clinical trial. The Investigational Drug Service will randomly assign patients to the experimental group (propranolol) or the placebo group. Research staff who have direct contact with the participant will be blind to their condition.

入排标准

年龄范围
18 Years 至 30 Years(Adult)
性别
All
接受健康志愿者

入选标准

  • 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

排除标准

  • 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 (except hormonal contraceptives)
  • 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

研究组 & 干预措施

Propranolol

Experimental

Propranolol tablet, 40mg, one-time, orally

干预措施: Propranolol (Drug)

Placebo

Placebo Comparator

Encapsulated placebo tablet

干预措施: Placebo (Drug)

结局指标

主要结局

Change in levels of pro-inflammatory cytokine interleukin-6 in response to social stress

时间窗: Post-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 stress

时间窗: Post-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.

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Sponsor

研究点 (1)

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