Immune Modulation by Misoprostol
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Early Phase 1
Contacts and Locations
Study Locations
-
-
Tennessee
-
Nashville, Tennessee, United States, 37232
- Vanderbilt University Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Healthy women 18-45 years of age
- Negative result of urine pregnancy test at screening and prior to each administration of study drug
- Normal, regularly occurring menses (being 25-35 day cycles)
Exclusion Criteria:
- Use of hormonal contraception (current or past 3 months)
- Use of non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin within two weeks prior to enrollment or planned use of these medications during the study period
- Allergy to prostaglandins
- Previous cervical cancer
- Partial or complete cervical excision
- Previous hysterectomy
- Immunosuppression: either pharmacological or due to comorbidities
- Diabetes mellitus
- Auto-immune disease
- History of lymphoma or leukemia
- Sexually transmitted infection (by self-report) over previous 1 year
- Bacterial Vaginosis or Candidiasis (current or past 3 months)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Misoprostol administration - buccal then vaginal
Vaginal or buccal administration
|
buccal administration
Other Names:
vaginal administration
Other Names:
|
|
Experimental: Misoprostol administration - vaginal then buccal
Vaginal or buccal administration
|
buccal administration
Other Names:
vaginal administration
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Comparison of misoprostol drug levels in patients after vaginal and buccal administration
Time Frame: Peripheral blood collected at Days 0, 1, 28, and 29
|
Peripheral blood collected at Days 0, 1, 28, and 29
|
Peripheral blood collected at Days 0, 1, 28, and 29
|
|
Comparison of cytokine and chemokine levels in patients after vaginal and buccal administration
Time Frame: Peripheral blood collected at Days 0, 1, 28, and 29
|
Peripheral blood collected at Days 0, 1, 28, and 29
|
Peripheral blood collected at Days 0, 1, 28, and 29
|
|
Determination of immune cell activation state after vaginal and buccal administration
Time Frame: Peripheral blood collected at Days 0, 1, 28, and 29
|
Peripheral blood collected at Days 0, 1, 28, and 29
|
Peripheral blood collected at Days 0, 1, 28, and 29
|
|
Comparison of misoprostol drug levels in patients after vaginal and buccal administration
Time Frame: Cervicovaginal lavage at Days 0, 1, 28, and 29
|
Cervicovaginal lavage at Days 0, 1, 28, and 29
|
Cervicovaginal lavage at Days 0, 1, 28, and 29
|
|
Comparison of cytokine and chemokine levels in patients after vaginal and buccal administration
Time Frame: Cervicovaginal lavage at Days 0, 1, 28, and 29
|
Cervicovaginal lavage at Days 0, 1, 28, and 29
|
Cervicovaginal lavage at Days 0, 1, 28, and 29
|
|
Determination of immune cell activation state after vaginal and buccal administration
Time Frame: Cervical cytobrush at Days 0, 1, 28, and 29
|
Cervical cytobrush at Days 0, 1, 28, and 29
|
Cervical cytobrush at Days 0, 1, 28, and 29
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Sequencing of 16S rRNA gene for microbial ecology studies after vaginal and buccal administration
Time Frame: Vaginal swab at Days 0, 1, 28, and 29
|
Vaginal swab at Days 0, 1, 28, and 29
|
Vaginal swab at Days 0, 1, 28, and 29
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: David M. Aronoff, MD, Vanderbilt University
Publications and helpful links
General Publications
- Fjerstad M, Trussell J, Sivin I, Lichtenberg ES, Cullins V. Rates of serious infection after changes in regimens for medical abortion. N Engl J Med. 2009 Jul 9;361(2):145-51. doi: 10.1056/NEJMoa0809146.
- Herting RL, Clay GA. Overview of clinical safety with misoprostol. Dig Dis Sci. 1985 Nov;30(11 Suppl):185S-193S. doi: 10.1007/BF01309407.
- Middleton T, Schaff E, Fielding SL, Scahill M, Shannon C, Westheimer E, Wilkinson T, Winikoff B. Randomized trial of mifepristone and buccal or vaginal misoprostol for abortion through 56 days of last menstrual period. Contraception. 2005 Nov;72(5):328-32. doi: 10.1016/j.contraception.2005.05.017. Epub 2005 Aug 9.
- Moran M, Mozes MF, Maddux MS, Veremis S, Bartkus C, Ketel B, Pollak R, Wallemark C, Jonasson O. Prevention of acute graft rejection by the prostaglandin E1 analogue misoprostol in renal-transplant recipients treated with cyclosporine and prednisone. N Engl J Med. 1990 Apr 26;322(17):1183-8. doi: 10.1056/NEJM199004263221703.
- Pouteil-Noble C, Chapuis F, Berra N, Hadj-Aissa A, Lacavalerie B, Lefrancois N, Martin X, Touraine JL. Misoprostol in renal transplant recipients: a prospective, randomized, controlled study on the prevention of acute rejection episodes and cyclosporin A nephrotoxicity. Nephrol Dial Transplant. 1994;9(5):552-5. doi: 10.1093/ndt/9.5.552.
- Zieman M, Fong SK, Benowitz NL, Banskter D, Darney PD. Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol. 1997 Jul;90(1):88-92. doi: 10.1016/S0029-7844(97)00111-7.
- Waiser J, Bohler T, Stoll J, Schumann B, Budde K, Neumayer HH. The immunosuppressive potential of misoprostol--efficacy and variability. Clin Immunol. 2003 Dec;109(3):288-94. doi: 10.1016/j.clim.2003.08.009.
- Tang OS, Ho PC. The pharmacokinetics and different regimens of misoprostol in early first-trimester medical abortion. Contraception. 2006 Jul;74(1):26-30. doi: 10.1016/j.contraception.2006.03.005. Epub 2006 Apr 27.
- el-Refaey H, Rajasekar D, Abdalla M, Calder L, Templeton A. Induction of abortion with mifepristone (RU 486) and oral or vaginal misoprostol. N Engl J Med. 1995 Apr 13;332(15):983-7. doi: 10.1056/NEJM199504133321502.
- Ho PC, Ngai SW, Liu KL, Wong GC, Lee SW. Vaginal misoprostol compared with oral misoprostol in termination of second-trimester pregnancy. Obstet Gynecol. 1997 Nov;90(5):735-8. doi: 10.1016/S0029-7844(97)00419-5.
- Silverstein FE, Graham DY, Senior JR, Davies HW, Struthers BJ, Bittman RM, Geis GS. Misoprostol reduces serious gastrointestinal complications in patients with rheumatoid arthritis receiving nonsteroidal anti-inflammatory drugs. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1995 Aug 15;123(4):241-9. doi: 10.7326/0003-4819-123-4-199508150-00001.
- Wildeman RA. Focus on misoprostol: review of worldwide safety data. Clin Invest Med. 1987 May;10(3):243-5.
- Rostom A, Dube C, Wells G, Tugwell P, Welch V, Jolicoeur E, McGowan J. Prevention of NSAID-induced gastroduodenal ulcers. Cochrane Database Syst Rev. 2002;(4):CD002296. doi: 10.1002/14651858.CD002296.
- Chong E, Tsereteli T, Nguyen NN, Winikoff B. A randomized controlled trial of different buccal misoprostol doses in mifepristone medical abortion. Contraception. 2012 Sep;86(3):251-6. doi: 10.1016/j.contraception.2011.12.012. Epub 2012 Feb 2.
- Raymond EG, Shannon C, Weaver MA, Winikoff B. First-trimester medical abortion with mifepristone 200 mg and misoprostol: a systematic review. Contraception. 2013 Jan;87(1):26-37. doi: 10.1016/j.contraception.2012.06.011. Epub 2012 Aug 13.
- Kotsonis FN, Dodd DC, Regnier B, Kohn FE. Preclinical toxicology profile of misoprostol. Dig Dis Sci. 1985 Nov;30(11 Suppl):142S-146S. doi: 10.1007/BF01309401.
- Zane S, Guarner J. Gynecologic clostridial toxic shock in women of reproductive age. Curr Infect Dis Rep. 2011 Dec;13(6):561-70. doi: 10.1007/s11908-011-0207-7.
- Hemmerling A. The safety of misoprostol. Int J Gynaecol Obstet. 2006 Nov;94 Suppl 2:S149-S150. doi: 10.1016/S0020-7292(06)60019-2.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 140667
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