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Inflammation and the Metabolic Syndrome in Humans (LPS)

Primary Purpose

Metabolic Syndrome X

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Endotoxin (LPS)
Sponsored by
University of Pennsylvania
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Metabolic Syndrome X

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Men and non-pregnant/lactating women between the ages of 18 and 40
  2. Subjects must be able to give written informed consent and willing to comply with all study-related procedures.
  3. BMI >18 and < 24 and BIA < 15% fat for men, < 25% fat for women, and do not have diagnosis of NCEP metabolic syndrome as defined below, OR
  4. BMI > 26 but < 30 and BIA > 15% fat for men, > 25% fat for women, do not have diagnosis of NCEP metabolic syndrome, OR
  5. BMI >18 and < 30 and have metabolic syndrome abnormalities as defined below. The modified NCEP Metabolic Syndrome criteria are as follows

    • abdominal obesity, waist circumference: men >= 37 in (94 cm), women >= 31 in (80 cm)
    • fasting triglycerides > 150 mg/dL
    • HDL cholesterol < 40 mg/dL for men; HDL cholesterol < 50 mg/dL for women
    • Blood pressure > 130/ >85 mmHg in untreated patients
    • Fasting glucose > 100 mg/dL, but less than 126 mg/dL
  6. For inclusion in "metabolic syndrome" group, the following additional criteria must be fulfilled:

    • Three or more of the NCEP criteria defined above. OR
    • Two or more of the NCEP criteria AND TG/HDL ratio > 3.0.

Exclusion Criteria:

  1. Known atherosclerotic cardiovascular disease, including coronary disease, cerebrovascular disease, or peripheral vascular disease.
  2. History of diabetes mellitus.
  3. A plasma glucose greater than 200 mg/dL at the 2 hour blood draw of the oral glucose tolerance test.
  4. History of a non-skin malignancy within the previous 5 years.
  5. Renal insufficiency as defined by creatinine >= 1.5 mg/dl at visit 1 (grade 1 of NIH's Common Toxicity Criteria (CTC), version 2.0, 4/30/99).
  6. History of liver disease or ALT, AST, ALK Phosphatase or Gamma GT above normal limits as defined by HUP William Pepper Clinical Laboratory at visit 1.
  7. Elevated (> 1.5x ULN; grade 1, CTC, 4/30/99) Total Bilirubin or LDH at visit 1.
  8. Men who consume > 14 alcoholic drinks per week or > 4 alcoholic drinks per occasion (AMA/NIAAA criteria for "at risk" usage levels).
  9. Women who consume > 7 alcoholic drinks per week or > 3 alcoholic drinks per occasion (AMA/NIAAA criteria for "at risk" usage levels).
  10. Total white blood cell count below normal limits as defined at HUP William Pepper Clinical Laboratory prior to the baseline visit.
  11. Hemoglobin below normal limits (gender specific) as defined at HUP William Pepper Clinical Laboratory prior to the baseline visit.
  12. Any medical condition or abnormal laboratory value that is judged clinically significant by an investigator.
  13. Any major active rheumatologic, pulmonary, or dermatologic disease or inflammatory condition or minor active infection.
  14. History of HIV positive.
  15. First degree family history of premature cardiovascular disease event (father or brother if diagnosed at before 55 years of age; mother or sister if diagnosed before 65 years of age).
  16. Patients who have undergone any organ transplant.
  17. Individuals who currently use tobacco products or have done so in the previous 30 days.
  18. Treatment with aspirin, NSAIDs, COX-2 inhibitors, steroids or other immunomodulatory therapy 2 weeks prior to the screening visit
  19. Treatment with statins, fibrates or niacin 4 weeks prior to the screening visit.
  20. Current daily use of Vitamin C > 1000 mg, Beta carotene > 1000 IU, vitamin A > 5000 IU, vitamin E > 400 IU, and selenium > 200 mcg.
  21. Positive urine pregnancy at the screening visit.
  22. Participation in another clinical trial within the previous 6 weeks prior to the screening visit.
  23. Poorly controlled blood pressure (BP > 160/100) or on any anti-hypertensive medications.
  24. For subjects in non-metabolic syndrome groups; a diagnosis of metabolic syndrome using NCEP ATPIII criteria.
  25. For subjects in "metabolic syndrome" group; an abnormal Bruce protocol cardiac exercise stress test.

Sites / Locations

  • Clinical and Translational Research Center, Hospital of the University of Pennsylvania

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Endotoxin (LPS)

Arm Description

Single administration low-dose (3 ng/kg) endotoxin (LPS).

Outcomes

Primary Outcome Measures

The Primary Outcome Measure is Plasma Levels of TNF Alpha.

Secondary Outcome Measures

Full Information

First Posted
August 5, 2009
Last Updated
March 28, 2017
Sponsor
University of Pennsylvania
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
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1. Study Identification

Unique Protocol Identification Number
NCT00954824
Brief Title
Inflammation and the Metabolic Syndrome in Humans
Acronym
LPS
Official Title
Inflammation and the Metabolic Syndrome in Humans
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
August 2003 (undefined)
Primary Completion Date
November 2007 (Actual)
Study Completion Date
November 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Pennsylvania
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
People who are overweight are at increased risk of heart disease. Being overweight and having heart disease are linked in that both involve inflammation. Inflammation refers to the body's first line of defense against infection and injury. Metabolic changes in cholesterol, triglycerides (fat in the blood) and sugar in the blood caused by inflammation are similar to that in some people who are overweight. The investigators wish to examine the effects of inflammation on these metabolic changes that may lead to heart disease.
Detailed Description
This study is a single site, open-label, "baseline-controlled" (pre LPS saline period) study examining the pro-atherosclerotic metabolic responses and safety responses to a single administration low-dose (3 ng/kg) endotoxin (LPS) in 20 additional non-metabolic syndrome participants: 10 healthy overweight and 10 healthy lean counterparts (20 non-metabolic syndrome participants were studies in first phase), and 40 subjects with the metabolic syndrome. We are continuing to use an approach whereby "metabolic syndrome" subjects will be recruited to have key metabolic syndrome abnormalities that are sensitive to insulin resistance compared to the non-metabolic syndrome groups, although all of these "metabolic syndrome" subjects may not fulfill traditional NCEP criteria for the syndrome.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metabolic Syndrome X

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Endotoxin (LPS)
Arm Type
Experimental
Arm Description
Single administration low-dose (3 ng/kg) endotoxin (LPS).
Intervention Type
Biological
Intervention Name(s)
Endotoxin (LPS)
Other Intervention Name(s)
LPS
Intervention Description
Single administration low-dose (3 ng/kg) endotoxin (LPS).
Primary Outcome Measure Information:
Title
The Primary Outcome Measure is Plasma Levels of TNF Alpha.
Time Frame
24 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Men and non-pregnant/lactating women between the ages of 18 and 40 Subjects must be able to give written informed consent and willing to comply with all study-related procedures. BMI >18 and < 24 and BIA < 15% fat for men, < 25% fat for women, and do not have diagnosis of NCEP metabolic syndrome as defined below, OR BMI > 26 but < 30 and BIA > 15% fat for men, > 25% fat for women, do not have diagnosis of NCEP metabolic syndrome, OR BMI >18 and < 30 and have metabolic syndrome abnormalities as defined below. The modified NCEP Metabolic Syndrome criteria are as follows abdominal obesity, waist circumference: men >= 37 in (94 cm), women >= 31 in (80 cm) fasting triglycerides > 150 mg/dL HDL cholesterol < 40 mg/dL for men; HDL cholesterol < 50 mg/dL for women Blood pressure > 130/ >85 mmHg in untreated patients Fasting glucose > 100 mg/dL, but less than 126 mg/dL For inclusion in "metabolic syndrome" group, the following additional criteria must be fulfilled: Three or more of the NCEP criteria defined above. OR Two or more of the NCEP criteria AND TG/HDL ratio > 3.0. Exclusion Criteria: Known atherosclerotic cardiovascular disease, including coronary disease, cerebrovascular disease, or peripheral vascular disease. History of diabetes mellitus. A plasma glucose greater than 200 mg/dL at the 2 hour blood draw of the oral glucose tolerance test. History of a non-skin malignancy within the previous 5 years. Renal insufficiency as defined by creatinine >= 1.5 mg/dl at visit 1 (grade 1 of NIH's Common Toxicity Criteria (CTC), version 2.0, 4/30/99). History of liver disease or ALT, AST, ALK Phosphatase or Gamma GT above normal limits as defined by HUP William Pepper Clinical Laboratory at visit 1. Elevated (> 1.5x ULN; grade 1, CTC, 4/30/99) Total Bilirubin or LDH at visit 1. Men who consume > 14 alcoholic drinks per week or > 4 alcoholic drinks per occasion (AMA/NIAAA criteria for "at risk" usage levels). Women who consume > 7 alcoholic drinks per week or > 3 alcoholic drinks per occasion (AMA/NIAAA criteria for "at risk" usage levels). Total white blood cell count below normal limits as defined at HUP William Pepper Clinical Laboratory prior to the baseline visit. Hemoglobin below normal limits (gender specific) as defined at HUP William Pepper Clinical Laboratory prior to the baseline visit. Any medical condition or abnormal laboratory value that is judged clinically significant by an investigator. Any major active rheumatologic, pulmonary, or dermatologic disease or inflammatory condition or minor active infection. History of HIV positive. First degree family history of premature cardiovascular disease event (father or brother if diagnosed at before 55 years of age; mother or sister if diagnosed before 65 years of age). Patients who have undergone any organ transplant. Individuals who currently use tobacco products or have done so in the previous 30 days. Treatment with aspirin, NSAIDs, COX-2 inhibitors, steroids or other immunomodulatory therapy 2 weeks prior to the screening visit Treatment with statins, fibrates or niacin 4 weeks prior to the screening visit. Current daily use of Vitamin C > 1000 mg, Beta carotene > 1000 IU, vitamin A > 5000 IU, vitamin E > 400 IU, and selenium > 200 mcg. Positive urine pregnancy at the screening visit. Participation in another clinical trial within the previous 6 weeks prior to the screening visit. Poorly controlled blood pressure (BP > 160/100) or on any anti-hypertensive medications. For subjects in non-metabolic syndrome groups; a diagnosis of metabolic syndrome using NCEP ATPIII criteria. For subjects in "metabolic syndrome" group; an abnormal Bruce protocol cardiac exercise stress test.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Muredach P. Reilly, MB, MSCE
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clinical and Translational Research Center, Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17374708
Citation
Anderson PD, Mehta NN, Wolfe ML, Hinkle CC, Pruscino L, Comiskey LL, Tabita-Martinez J, Sellers KF, Rickels MR, Ahima RS, Reilly MP. Innate immunity modulates adipokines in humans. J Clin Endocrinol Metab. 2007 Jun;92(6):2272-9. doi: 10.1210/jc.2006-2545. Epub 2007 Mar 20.
Results Reference
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PubMed Identifier
19631267
Citation
Heffron SP, Parastatidis I, Cuchel M, Wolfe ML, Tadesse MG, Mohler ER 3rd, Ischiropoulos H, Rader DJ, Reilly MP. Inflammation induces fibrinogen nitration in experimental human endotoxemia. Free Radic Biol Med. 2009 Oct 15;47(8):1140-6. doi: 10.1016/j.freeradbiomed.2009.07.025. Epub 2009 Jul 22.
Results Reference
background
PubMed Identifier
19581417
Citation
Shah R, Lu Y, Hinkle CC, McGillicuddy FC, Kim R, Hannenhalli S, Cappola TP, Heffron S, Wang X, Mehta NN, Putt M, Reilly MP. Gene profiling of human adipose tissue during evoked inflammation in vivo. Diabetes. 2009 Oct;58(10):2211-9. doi: 10.2337/db09-0256. Epub 2009 Jul 6.
Results Reference
background
PubMed Identifier
19221221
Citation
McGillicuddy FC, de la Llera Moya M, Hinkle CC, Joshi MR, Chiquoine EH, Billheimer JT, Rothblat GH, Reilly MP. Inflammation impairs reverse cholesterol transport in vivo. Circulation. 2009 Mar 3;119(8):1135-45. doi: 10.1161/CIRCULATIONAHA.108.810721. Epub 2009 Feb 16.
Results Reference
background
PubMed Identifier
18212282
Citation
Badellino KO, Wolfe ML, Reilly MP, Rader DJ. Endothelial lipase is increased in vivo by inflammation in humans. Circulation. 2008 Feb 5;117(5):678-85. doi: 10.1161/CIRCULATIONAHA.107.707349. Epub 2008 Jan 22.
Results Reference
background
PubMed Identifier
17993463
Citation
Song WL, Wang M, Ricciotti E, Fries S, Yu Y, Grosser T, Reilly M, Lawson JA, FitzGerald GA. Tetranor PGDM, an abundant urinary metabolite reflects biosynthesis of prostaglandin D2 in mice and humans. J Biol Chem. 2008 Jan 11;283(2):1179-88. doi: 10.1074/jbc.M706839200. Epub 2007 Nov 8.
Results Reference
background
PubMed Identifier
17258089
Citation
Lehrke M, Millington SC, Lefterova M, Cumaranatunge RG, Szapary P, Wilensky R, Rader DJ, Lazar MA, Reilly MP. CXCL16 is a marker of inflammation, atherosclerosis, and acute coronary syndromes in humans. J Am Coll Cardiol. 2007 Jan 30;49(4):442-9. doi: 10.1016/j.jacc.2006.09.034. Epub 2007 Jan 12.
Results Reference
background
PubMed Identifier
15710760
Citation
Reilly MP, Lehrke M, Wolfe ML, Rohatgi A, Lazar MA, Rader DJ. Resistin is an inflammatory marker of atherosclerosis in humans. Circulation. 2005 Feb 22;111(7):932-9. doi: 10.1161/01.CIR.0000155620.10387.43. Epub 2005 Feb 14.
Results Reference
background
PubMed Identifier
15578112
Citation
Lehrke M, Reilly MP, Millington SC, Iqbal N, Rader DJ, Lazar MA. An inflammatory cascade leading to hyperresistinemia in humans. PLoS Med. 2004 Nov;1(2):e45. doi: 10.1371/journal.pmed.0010045. Epub 2004 Nov 30.
Results Reference
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Inflammation and the Metabolic Syndrome in Humans

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