PRONOVAEffects of a Prescription Omega-3 Fatty Acid Concentrate in a Placebo-controlled Trial of Human Endotoxemia
Placebo
+ 4 g prescription omega-3 concentrate
Pathologic Processes
+ Pathological Conditions, Signs and Symptoms
+ Inflammation
Basic Science Study
Summary
Study start date: May 1, 2014
Actual date on which the first participant was enrolled.Controlled endotoxin infusion has been used widely as a model system to evaluate anti-inflammatory mediators and therapies in a controlled, in vivo setting. It is well established that infusion of bacterial endotoxin (also known as lipopolysaccharide or LPS) in humans results in a marked increase in inflammatory cytokines, most notably TNF-α, IL-1, IL-6 and IL-8, CRP, granulocyte colony stimulating factor (GCSF); eicosanoids, such as prostaglandin (PG) E2 and other mediators. Administration of endotoxin, even at a low dose (0.6 ng/kg) elevates circulating concentrations of inflammatory cytokines, and mimics the inflammatory effects of chronic diseases. This model has been used for decades and has proved to be safe and informative for evaluating anti-inflammatory therapeutic interventions on human inflammation and downstream consequences. Prolonged or chronic inflammation is involved in the etiology of several diseases such as cardiovascular disease (CVD), diabetes, rheumatoid arthritis, cancer, and neurodegenerative diseases such as Alzheimer's disease. The evidence base clearly demonstrates benefits of diet in ameliorating inflammation and reducing the burden of chronic disease. With respect to marine-derived omega-3 fatty acids and various markers of inflammation related to cardiovascular disease (CVD), both population studies and randomized controlled supplementation trials have yielded mixed results. It is well established that these omega-3 fatty acids are precursors of series-3 prostanoids, thromboxanes, 5-series leukotrienes, and novel lipid mediators such as resolvins and protectins that have anti-inflammatory effects. We hypothesize that supplementation of omega-3 fatty acids will blunt the response to an inflammatory stimulus and/or enhance the resolution phase. We propose to test this hypothesis using an in vivo endotoxin challenge with a pharmacological dose of omega-3 fatty acid ethyl esters (P-OM3, 3.4 g/d EPA + DHA) in healthy volunteers. Our proposed approach is novel in that we will provoke an in vivo inflammatory response by infusing human subjects with a low dose (0.6 ng/kg body weight) of sterile endotoxin (lipopolysaccharide [LPS]) in contrast to studies that have attempted to reverse established inflammatory pathology. Results from our proposed research will advance our understanding of the effect of omega-3 fatty acids on prevention/attenuation of an inflammatory response.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.21 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Basic Science Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Male
Biological sex of participants that are eligible to enroll.From 20 to 45 Years
Range of ages for which participants are eligible to join.Healthy volunteers allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
Inclusion Criteria: Men between the ages of 20 and 45. BMI ≥20 and ≤30 Participants who are able to give written informed consent and willing to comply with all study-related procedures. Any race or ethnic background is acceptable Non-smoking The specific exclusion criteria are: Previous history of vasovagal reactions or unprovoked fainting (I.e. fainting as a result of prolonged standing, exercise) Resting heart rate < 55 bpm History of atherosclerotic cardiovascular disease, including coronary disease, cerebrovascular disease, or peripheral vascular disease History of diabetes mellitus (and/or a fasting glucose >126 mg/dL at screening) Chronic anti-inflammatory medication use or treatment with aspirin, NSAIDs, COX-2 inhibitors; steroids or any immunomodulatory therapy 2 weeks prior to the screening visit Self-reported history of allergy to fish History of a non-skin malignancy within the previous 5 years Renal insufficiency as defined by creatinine outside of lab defined normal range at Screening Visit History of liver disease or abnormal LFTs (AST, ALT, Alk. Phos., GGT > 1.5x ULN; bilirubin > 2x ULN) at Screening Visit Total white blood cell count less than or equal to 3.0 THO/uL Hemoglobin less than 11.0 g/dL Any major active rheumatologic, pulmonary, or dermatologic disease or inflammatory condition or minor active infection Self-reported history of HIV positive Participants who have undergone any organ transplant Individuals who currently use tobacco products or have done so in the previous 30 days. Participants who are unwilling to discontinue use of nutritional supplements, herbs or vitamins unless approved by study staff. Participants who are unwilling to eliminate omega-3 fatty acid (EPA + DHA) supplements and/or fortified food, or have a usual intake of high omega-3 fish (tuna and other non-fried fish) > 2 servings per week Elevated blood pressure (BP > 159/99) or use of any anti-hypertensive medications. Latex allergy Unwillingness to refrain from blood donation for 2 months prior to and following endotoxin administration Any medical condition or abnormal laboratory value that is judged clinically significant by an investigator Inability to take study capsules History of severe, repeated headaches History of migraine Medical condition that causes severe nausea or vomiting Low resting blood pressure (SBP < 90 mmHg) History of atrial fibrillation/flutter Abnormal coagulation parameters (platelet count, prothrombin time with INR), documented coagulation abnormality, or use of anticoagulant medication High LDL-C (> or = 160 mg/dL)
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.2 intervention groups are designated in this study
50% chance of being blinded to the placebo group
Treatment Groups
Group I
PlaceboGroup II
ExperimentalStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 1 location