Clinical trial NCT03541239: Immune Modulation by Ischemic Pre-conditioning in Healthy Individuals: Intracellular Signalling in Regulatory Cells
Official title: Immune Modulation by Ischemic Pre-conditioning in Healthy Individuals: Intracellular Signalling in Regulatory Cells
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Ischemia Reperfusion Injury
Ischaemia Reperfusion Injury
Lead sponsor: University of Aarhus
Sponsor class: OTHER
Collaborators: name: Fonden til Lægevidenskabens Fremme
name: Erasmus Medical Center
First posted: 2018-05-30
Enrollment: 19
Sex: MALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: BASIC_SCIENCE

Brief summary: The aim of the study is to investigate how phosphorylation of STAT3, p38 mitogen-activated protein kinase (MAPK), extracellular signal-regulated kinase (ERK) and protein kinase B (AKT) reacts to remote ischemic conditioning (rIC) in healthy humans, which could point to mechanisms by which rIC may protect against ischemia-reperfusion injury (IRI), and if rIC affects immune reactivity.

Detailed description: In rIC brief episodes of non-lethal ischemia and reperfusion in one vascular bed, tissue or organ, has shown to have protective effects against IRI in various organs. The protective effect of rIC seems convincing, but to date it is not clear which mechanisms give rIC its effects, and why effects are absent in some situations. Effects of rIC on the immune system are also not clear, but important if rIC is used in transplantation and autoimmunity settings, and also in regards to infection risk. Patients studied have often been given medical treatment and/or have comorbidities affecting the results.

This project will measure how intracellular phosphorylation of STAT3, p38 MAPK, ERK and AKT, inflammatory cell patterns and cytokine production react to rIC in healthy humans, and potentially give a better understanding of the mechanisms that mediate the protective effects of rIC. The intracellular mediators studied are involved in the initiation of cytokine production and regulate apoptosis and activation of the inflammatory cells. An altered balance between leucocytes and their mediators could be of importance for rIC effects, particularly in transplantation and autoimmunity, and this will be elucidated in our study.

As a secondary end point the investigators will measure the effect of rIC on pulse variability and blood pressure using a non-invasive device, since evidence regarding these aspects is sparse, although documented positive effects of rIC have primarily been on the heart and vascular system.

Eligibility criteria: Inclusion Criteria:

* Healthy and well

Exclusion Criteria:

* Smoker.
* Taking regular medication.
* Any acute, chronic or systemic disease
* No hard physical exercise 72 hours prior to study participation.
* No alcohol or caffein-containing drinks 24 hours prior to study participation.
* Fasted for at least 6 hours prior to study participation.

Primary outcomes:
measure: Changes in the amount of immune cells in the peripheral blood
timeFrame: Baseline before any intervention, 0 minutes and 85 minutes after IRI and 24 hours after IRI
measure: Changes in inflammatory cytokines in the peripheral blood
timeFrame: Baseline before any intervention, 85 minutes after IRI and 24 hours after IRI
measure: Changes in intracellular activation markers in T-cells
timeFrame: Baseline before any intervention, 0 minutes and 85 mins after IRI and 24 hours after IRI
measure: Changes in intracellular activation markers in monocytes
timeFrame: Baseline before any intervention, 0 minutes and 85 minutes after IRI and 24 hours after IRI
Secondary outcomes:
measure: Measure pulse variability.
timeFrame: Baseline before any intervention and until 85 minutes after IRI and 24 hours.
measure: Measure blood pressure.
timeFrame: Baseline before any intervention and until 85 minutes after IRI and 24 hours.
Other outcomes:
Locations:
city: Aarhus N
country: Denmark
facility: C-Laboratorium, Skejby Sygehus
Study officials:
affiliation: Dept. of Renal Diseases, SKS, DK
name: Bente Jespersen, Professor
role: PRINCIPAL_INVESTIGATOR
affiliation: Dept. of Clinical Immunology, SKS, DK
name: Bjarne Kuno Møller, MD
role: STUDY_CHAIR
affiliation: Erasmus Medical Center
name: Carla Baan, Professor
role: STUDY_CHAIR
References: