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NGF, TrKA,p75NTR in Men With ED and Diabetes With or Without MS (ED)

Primary Purpose

Erectile Dysfunction

Status
Unknown status
Phase
Not Applicable
Locations
Italy
Study Type
Interventional
Intervention
A peripheral blood sample from the cubital vein
Sponsored by
University Of Perugia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Erectile Dysfunction focused on measuring Erectile Dysfunction, NGF, TrKA, p75NTR

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • men with DE and metabolic syndrome

Exclusion Criteria:

  • men with DE without metabolic syndrome

Sites / Locations

  • Elisabetta CostantiniRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Men with ED and diabetes

Arm Description

A peripheral blood sample from the cubital vein A collection of peripheral blood from the routinary cubital vein for hormone dosage and metabolic evaluation An introverted cavernous infiltration of Prostaglandin E1 to achieve erection (Aprostadil); A blood sample from both the corpus cavernosum and the cubital vein, once the erection is achieved Baseline interaction of prostaglandin E1 on the concentration of NGF released in the medium and on the expression of its receptors Evaluation of NGF and Cytokine levels Expression analysis of TrKA and p75NTR receptors and intracellular cytokines in PBMCs

Outcomes

Primary Outcome Measures

Baseline NGF
plasmatic concentration
intracavernous NGF
intracavernous concetration
plasmatic NGF
plasmatic concetration
Baseline TRka
plasmatic concetration
plasmatic TRka
plasmatic concetration
Intracavernous TRka
intracavernous concetration
Baseline p75NTR
plasmatic concentration
plasmatic p75NTR
plasmatic concentration
intracavernous p75NTR
intracavernous concentration

Secondary Outcome Measures

plasmatic concentration verus intracavernous concetration
to evaluate any differences between the data obtained from the systemic levy versus the intracavernous sampling.
clinical staging of ED and NGF,TrKa,p75NTR
is to evaluate if the levels of NGF and its receptors in the mononuclear cells can correlate with the clinical staging of ED.

Full Information

First Posted
February 14, 2019
Last Updated
March 2, 2019
Sponsor
University Of Perugia
Collaborators
Ester Illiano, MD, Mario Rende,Full Professor, Alessandra Psitilli, Researcher, Anna Stabile, Researcher
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1. Study Identification

Unique Protocol Identification Number
NCT03862547
Brief Title
NGF, TrKA,p75NTR in Men With ED and Diabetes With or Without MS
Acronym
ED
Official Title
Role and Clinical Relevance of Nerve Growth Factor (NGF) and Its Receptors (TrKA and p75NTR) in Patients With Erectile Dysfunction and Diabetes With or Wothout Metabolic Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Unknown status
Study Start Date
January 30, 2019 (Actual)
Primary Completion Date
December 30, 2019 (Anticipated)
Study Completion Date
January 30, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Of Perugia
Collaborators
Ester Illiano, MD, Mario Rende,Full Professor, Alessandra Psitilli, Researcher, Anna Stabile, Researcher

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
To evaluate the level of NGF,TrKA and p75NTR in patientd with erectile dysfunction and diabetes with or without metabolic syndrome
Detailed Description
Penile erection is a complex phenomenon which implies a delicate and co-ordinated equilibrium among the neurological, vascular and the smooth muscle compartment. It includes arterial dilation, trabecular smooth muscle relaxation and activation of the corporeal veno-occlusive mechanism. Erectile Dysfunction (ED) is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. Erectile Dysfunction may affect physical and psychosocial health and may have a significant impact on the quality of life (QoL) of sufferers and their partner's . There is increasing evidence that ED can be an early manifestation of coronary artery and peripheral vascular disease. Erectile Dysfunction should not be regarded only as a QoL issue, but also as a potential warning sign of cardiovascular disease (CVD) .The most important organic causes of ED are vascular, metabolic, neurogenic, hormonal and pharmacological. 35-90% of diabetic patients suffer from ED In the latter metabolic disease, Dai et al. have identified as a possible etiology of ED a lack of interaction between nerve growth factor (NGF) and its TrKA receptor, resulting in a noticeable increase in NGF levels in the corpora cavernosa11. Furthermore, Hou et al. have shown that the activation of the NGF / TrKA system in the corpora cavernosa (increased expression of NGF and TrKA mRNA and upregulation of c-raf, ERK1 / 2 and CREB1) improves erectile function in mice with ED and diabetes mellitus. The objectives of this study are: The primary outcome is to evaluate the systemic plasma concentration and the concentration in cavernous bodies of penis of NGF in patients with ED and diabetes with or without metabolic syndrome (a); (b) the expression of its TrKA and p75NTR receptors in the mononuclear cells taken from peripheral blood and in cavernous bodies of penis. The secondary outcome is to evaluate whether the levels of NGF and its receptors in the mononuclear cells can correlate with the clinical staging of ED. Prospective pilot study. 12 patients diagnosed with ED with diabetes with or without metabolic syndrome( Mets )aged between 18 and 65 will be recruited. Each patient will undergo an initial evaluation that includes: the pathological and pharmacological anamnesis, the local objective examination and the compilation of the validated questionnaire International Index of Erectile Function Questionnaire short form (IIEF5). Based on the IIEF5 score, patients will be divided into 4 groups (each of 10 patients): mild ED (score 17-21) mild to moderate ED (score 12-16) Moderate ED (score 8-11) Severe ED (score 5-7) In vivo study: Each patient will then be submitted in succession to: A collection of peripheral blood from the routinary cubital vein for hormone dosage Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), TESTOSTERONE FREE AND TOTAL, ESTRADIOL, PROLACTIN) and metabolic evaluation (total HDL cholesterol, LDH, glycemia, lipidemic framework); and an aliquot will be used for in vitro study An introverted cavernous infiltration of Prostaglandin E1 to achieve erection (Aprostadil); A blood sample from both the corpus cavernosum and the cubital vein, once the erection is achieved Vitro study To verify a possible baseline interaction of prostaglandin E1 on the concentration of NGF released in the medium and on the expression of its receptors, an in vitro study will be performed using mononuclear cells isolated from peripheral blood (PBMC) obtained from buffy coat treated with prostaglandin E1 Evaluation of NGF and Cytokine levels A portion of each blood sample and medium conditioned by PBMC will be used for the enzyme immunoassay of NGF and pro and anti-inflammatory cytokine levels (TNF alfa and IL-10). Expression analysis of TrKA and p75NTR receptors and intracellular cytokines in PBMCs. The remaining part of each blood sample and PBMC of the in vitro experiment will be used for the cytofluorimetric evaluation of the expression of TrKA, p75NTR and the pro and anti-inflammatory cytokines and reactive oxygen species Evaluation of the levels of NGF and its receptors in the different degrees of severity of the EDThe levels of NGF and its receptors will be stratified into the 4 groups of clinical severity of the ED In vitro study An in vitro study will be performed using PBMC obtained from buffy coat of healthy subjects treated with prostaglandin E1. Statistical analysis of the results The data obtained during the study will be treated with appropriate statistical tests. The results will be expressed in terms of mean ± standard error and compared by appropriate statistical tests (ANOVA or non-parametric where appropriate). Expected results From the present study we expect to obtain more information on the impact and relevance of the NGF / TrKA / p75NTR pathway on DE in patients with Mets. Furthermore, we expect a correlation between the plasma levels of NGF and its receptors in relation to the clinical severity of the ED.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Erectile Dysfunction
Keywords
Erectile Dysfunction, NGF, TrKA, p75NTR

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Men with ED and diabetes
Arm Type
Experimental
Arm Description
A peripheral blood sample from the cubital vein A collection of peripheral blood from the routinary cubital vein for hormone dosage and metabolic evaluation An introverted cavernous infiltration of Prostaglandin E1 to achieve erection (Aprostadil); A blood sample from both the corpus cavernosum and the cubital vein, once the erection is achieved Baseline interaction of prostaglandin E1 on the concentration of NGF released in the medium and on the expression of its receptors Evaluation of NGF and Cytokine levels Expression analysis of TrKA and p75NTR receptors and intracellular cytokines in PBMCs
Intervention Type
Diagnostic Test
Intervention Name(s)
A peripheral blood sample from the cubital vein
Other Intervention Name(s)
cavernous infiltration of PGE1
Intervention Description
Evaluation of NGF and Cytokine levels A portion of each blood sample and medium conditioned by PBMC will be used for the enzyme immunoassay of NGF and pro and anti-inflammatory cytokine levels (TNF alfa and IL-10). Expression analysis of TrKA and p75NTR receptors and intracellular cytokines in PBMCs The remaining part of each blood sample and PBMC of the in vitro experiment will be used for the cytofluorimetric evaluation of the expression of TrKA, p75NTR and the pro and anti-inflammatory cytokines and reactive oxygen species.
Primary Outcome Measure Information:
Title
Baseline NGF
Description
plasmatic concentration
Time Frame
baseline
Title
intracavernous NGF
Description
intracavernous concetration
Time Frame
15 minutes
Title
plasmatic NGF
Description
plasmatic concetration
Time Frame
15 minutes
Title
Baseline TRka
Description
plasmatic concetration
Time Frame
baseline
Title
plasmatic TRka
Description
plasmatic concetration
Time Frame
15 minutes
Title
Intracavernous TRka
Description
intracavernous concetration
Time Frame
15 minutes
Title
Baseline p75NTR
Description
plasmatic concentration
Time Frame
baseline
Title
plasmatic p75NTR
Description
plasmatic concentration
Time Frame
15 minutes
Title
intracavernous p75NTR
Description
intracavernous concentration
Time Frame
15 minutes
Secondary Outcome Measure Information:
Title
plasmatic concentration verus intracavernous concetration
Description
to evaluate any differences between the data obtained from the systemic levy versus the intracavernous sampling.
Time Frame
15 minutes
Title
clinical staging of ED and NGF,TrKa,p75NTR
Description
is to evaluate if the levels of NGF and its receptors in the mononuclear cells can correlate with the clinical staging of ED.
Time Frame
15 minutes

10. Eligibility

Sex
Male
Gender Based
Yes
Gender Eligibility Description
men with erectile dysfunction and metabolic syndrome
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: men with DE and metabolic syndrome Exclusion Criteria: men with DE without metabolic syndrome
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Elisabetta Costantini, Professor
Phone
3283620614
Email
elisabetta.costantini@unipg.it
First Name & Middle Initial & Last Name or Official Title & Degree
Ester Illiano, MD
Phone
3283620614
Email
ester.illiano@inwind.it
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ester Illiano, MD
Organizational Affiliation
University Of Perugia
Official's Role
Study Director
Facility Information:
Facility Name
Elisabetta Costantini
City
Terni
ZIP/Postal Code
05100
Country
Italy
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elisabetta Costantini, Professor
Phone
3283620614
Email
elisabetta.costantini@unipg.it
First Name & Middle Initial & Last Name & Degree
Ester Illiano, MD
Phone
3283620614
Email
ester.illiano@inwind.it
First Name & Middle Initial & Last Name & Degree
Ester Illiano, MD
First Name & Middle Initial & Last Name & Degree
Elisabetta Costantini, Professor
First Name & Middle Initial & Last Name & Degree
Mario Rende, Professor
First Name & Middle Initial & Last Name & Degree
Alessandra Pistilli, Researcher
First Name & Middle Initial & Last Name & Degree
Anna Stabile, Researcher

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
14704852
Citation
Teng KK, Hempstead BL. Neurotrophins and their receptors: signaling trios in complex biological systems. Cell Mol Life Sci. 2004 Jan;61(1):35-48. doi: 10.1007/s00018-003-3099-3.
Results Reference
background
PubMed Identifier
29407470
Citation
Arcidiacono P, Stabile AM, Ragonese F, Pistilli A, Calvieri S, Bottoni U, Crisanti A, Spaccapelo R, Rende M. Anticarcinogenic activities of sulforaphane are influenced by Nerve Growth Factor in human melanoma A375 cells. Food Chem Toxicol. 2018 Mar;113:154-161. doi: 10.1016/j.fct.2018.01.051. Epub 2018 Jan 31.
Results Reference
background
PubMed Identifier
26653825
Citation
Pistilli A, Rende M, Crispoltoni L, Montagnoli C, Stabile AM. LY294002 induces in vitro apoptosis and overexpression of p75NTR in human uterine leiomyosarcoma HTB 114 cells. Growth Factors. 2015;33(5-6):376-83. doi: 10.3109/08977194.2015.1118096. Epub 2015 Dec 10.
Results Reference
background
PubMed Identifier
23872911
Citation
Pula G, Pistilli A, Montagnoli C, Stabile AM, Rambotti MG, Rende M. The tricyclic antidepressant amitriptyline is cytotoxic to HTB114 human leiomyosarcoma and induces p75(NTR)-dependent apoptosis. Anticancer Drugs. 2013 Oct;24(9):899-910. doi: 10.1097/CAD.0b013e328364312f.
Results Reference
background
PubMed Identifier
16940803
Citation
Rende M, Pistilli A, Stabile AM, Terenzi A, Cattaneo A, Ugolini G, Sanna P. Role of nerve growth factor and its receptors in non-nervous cancer growth: efficacy of a tyrosine kinase inhibitor (AG879) and neutralizing antibodies antityrosine kinase receptor A and antinerve growth factor: an in-vitro and in-vivo study. Anticancer Drugs. 2006 Sep;17(8):929-41. doi: 10.1097/01.cad.0000224459.13651.fd.
Results Reference
background
PubMed Identifier
17179929
Citation
Rask-Madsen C, King GL. Mechanisms of Disease: endothelial dysfunction in insulin resistance and diabetes. Nat Clin Pract Endocrinol Metab. 2007 Jan;3(1):46-56. doi: 10.1038/ncpendmet0366.
Results Reference
background
PubMed Identifier
18042325
Citation
Jackson G. The importance of risk factor reduction in erectile dysfunction. Curr Urol Rep. 2007 Nov;8(6):463-6. doi: 10.1007/s11934-007-0049-x.
Results Reference
background
PubMed Identifier
25675988
Citation
Kaya E, Sikka SC, Gur S. A comprehensive review of metabolic syndrome affecting erectile dysfunction. J Sex Med. 2015 Apr;12(4):856-75. doi: 10.1111/jsm.12828. Epub 2015 Feb 11.
Results Reference
background
PubMed Identifier
16281507
Citation
Dai YT, Chen Y, Yao LS, Yang R, Sun ZY, Wen DG. [Expression of nerve growth factor in cavernous tissue and its effects on the treatment of rats with diabetic erectile dysfunction]. Zhonghua Nan Ke Xue. 2005 Oct;11(10):748-51, 754. Chinese.
Results Reference
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NGF, TrKA,p75NTR in Men With ED and Diabetes With or Without MS

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