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Prenatal Aspirin and Postpartum Vascular Function

Primary Purpose

Preeclampsia, Microvascular Function

Status
Recruiting
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Acetylcholine
Endothelin-1
Sponsored by
Anna Stanhewicz, PhD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Preeclampsia

Eligibility Criteria

18 Years - 50 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion: 18 years or older, 12 weeks to 5 years postpartum and one of the following: women who had a normal pregnancy and did not use low does aspirin (LDA) during pregnancy, women who had a normal pregnancy and used LDA during pregnancy, women who had preeclampsia and did not use LDA during pregnancy, women who had preeclampsia and used LDA during pregnancy. Exclusion: current daily aspirin use, skin diseases, current tobacco use, diagnosed or suspected hepatic or metabolic disease including chronic kidney disease (CKD) defined as reduced eGFR < 60 mL/min/1.73m2, statin or other cholesterol-lowering medication, current antihypertensive medication, history of hypertension prior to pregnancy, history of gestational diabetes, current pregnancy, body mass index <18.5 kg/m2, allergy to materials used during the experiment.(e.g. latex), known allergies to study drugs.

Sites / Locations

  • University of IowaRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

assessment of microvascular function

Arm Description

The investigators use intradermal microdialysis to deliver acetylcholine, acetylcholine + L-NAME, endothelin-1, endothelin-1 + BQ-788, and endothelin-1 + BQ-123 to the cutaneous microvasculature.

Outcomes

Primary Outcome Measures

microvascular endothelial function
cutaneous vascular vasodilator response to exogenous acetylcholine perfusion; measured with laser-Doppler flowmetry coupled with intradermal microdialysis delivery of acetylcholine alone or co-infused with L-NAME
microvascular endothelin-1-mediated constriction
cutaneous vascular response to exogenous endothelin-1 perfusion; measured with laser-Doppler flowmetry coupled with intradermal microdialysis delivery of endothelin-1 alone or co-infused with BQ-788 or BQ-123

Secondary Outcome Measures

Full Information

First Posted
December 7, 2022
Last Updated
April 24, 2023
Sponsor
Anna Stanhewicz, PhD
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1. Study Identification

Unique Protocol Identification Number
NCT05653973
Brief Title
Prenatal Aspirin and Postpartum Vascular Function
Official Title
Protective Mechanisms of Prenatal Aspirin Therapy on Maternal Vascular Dysfunction Following Preeclampsia
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 3, 2023 (Actual)
Primary Completion Date
March 31, 2025 (Anticipated)
Study Completion Date
April 30, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Anna Stanhewicz, PhD

4. Oversight

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

5. Study Description

Brief Summary
Preeclampsia is a pregnancy disorder affecting ~5-10% of pregnancies in the United States. Women who develop preeclampsia during pregnancy are more likely to develop and die of cardiovascular disease later in life, even if they are otherwise healthy. The reason why this occurs is unclear but may be related to blood vessel damage and increased inflammation that occurs during the preeclamptic pregnancy and persists postpartum. Low dose aspirin (LDA; 75-150mg/daily) is currently the most effective and clinically accepted therapy for reducing preeclampsia prevalence in women at high risk for developing the syndrome. The purpose of this study is to interrogate the mechanisms by which LDA therapy mitigates persistent vascular dysfunction in postpartum women who have had preeclampsia. In this study, the investigators use the blood vessels in the skin as a representative vascular bed for examining mechanisms of microvascular dysfunction in humans. Using a minimally invasive technique (intradermal microdialysis for the local delivery of pharmaceutical agents) they examine the blood vessels in a dime-sized area of the skin in women who have had a history of preeclampsia. As a compliment to these measurements, they also draw blood from the subjects and isolate the inflammatory cells.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Preeclampsia, Microvascular Function

7. Study Design

Primary Purpose
Basic Science
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
assessment of microvascular function
Arm Type
Experimental
Arm Description
The investigators use intradermal microdialysis to deliver acetylcholine, acetylcholine + L-NAME, endothelin-1, endothelin-1 + BQ-788, and endothelin-1 + BQ-123 to the cutaneous microvasculature.
Intervention Type
Drug
Intervention Name(s)
Acetylcholine
Intervention Description
acetylcholine, and acetylcholine + L-NAME (Nitric oxide synthase inhibitor) are locally and acutely delivered to the cutaneous microvasculature to assess endothelium- and nitric oxide-dependent dilation
Intervention Type
Drug
Intervention Name(s)
Endothelin-1
Intervention Description
endothelin-1, endothelin-1 + BQ-788 (endothelin receptor type B-inhibitor), and endothelin-1 + BQ-123 (endothelin receptor type A-inhibitor) are locally and acutely delivered to the cutaneous microvasculature to assess endothelin-mediated constriction and the role of the receptor subtypes in this response.
Primary Outcome Measure Information:
Title
microvascular endothelial function
Description
cutaneous vascular vasodilator response to exogenous acetylcholine perfusion; measured with laser-Doppler flowmetry coupled with intradermal microdialysis delivery of acetylcholine alone or co-infused with L-NAME
Time Frame
at the study visit, an average of 4 hours
Title
microvascular endothelin-1-mediated constriction
Description
cutaneous vascular response to exogenous endothelin-1 perfusion; measured with laser-Doppler flowmetry coupled with intradermal microdialysis delivery of endothelin-1 alone or co-infused with BQ-788 or BQ-123
Time Frame
at the study visit, an average of 4 hours

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion: 18 years or older, 12 weeks to 5 years postpartum and one of the following: women who had a normal pregnancy and did not use low does aspirin (LDA) during pregnancy, women who had a normal pregnancy and used LDA during pregnancy, women who had preeclampsia and did not use LDA during pregnancy, women who had preeclampsia and used LDA during pregnancy. Exclusion: current daily aspirin use, skin diseases, current tobacco use, diagnosed or suspected hepatic or metabolic disease including chronic kidney disease (CKD) defined as reduced eGFR < 60 mL/min/1.73m2, statin or other cholesterol-lowering medication, current antihypertensive medication, history of hypertension prior to pregnancy, history of gestational diabetes, current pregnancy, body mass index <18.5 kg/m2, allergy to materials used during the experiment.(e.g. latex), known allergies to study drugs.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Anna Reid-Stanhewicz, PHD
Phone
319-467-1732
Email
anna-stanhewicz@uiowa.edu
Facility Information:
Facility Name
University of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anna Stanhewicz, PhD
Phone
319-467-1732
Email
anna-stanhewicz@uiowa.edu

12. IPD Sharing Statement

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Prenatal Aspirin and Postpartum Vascular Function

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