Role of Oxidative Stress and Inflammation in Type 1 Gaucher Disease (GD1)
Role of Oxidative Stress and Inflammation in Type 1 Gaucher Disease (GD1): Potential Use of Antioxidant/Anti-inflammatory Medications
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Reena V. Kartha, Ph.D.
- Phone Number: 612-626-2436
- Email: rvkartha@umn.edu
Study Locations
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-
Minnesota
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Minneapolis, Minnesota, United States, 55455
- University of Minnesota
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New York
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New York, New York, United States, 10016
- New York University
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All participants must be 18 years or older.
- All participants must understand and cooperate with requirements of the study in the opinion of the investigators and must be able to provide written informed consent.
- Individuals with GD1 who are medically stable for participation in the study in the opinion of the investigator.
- GD1 patients must be on a stable, specific ERT and/or SRT therapy at a specific dose (e.g. on a units/kg basis) for at least 2 years.
- GD1 patients who have had a change in therapy, i.e. a change in dose or switch from one drug to another, can be enrolled after at least 6 months have elapsed since the change and is considered stable in the opinion of the clinician providing care to the patient.
- Healthy subjects who will be frequency-matched for age.
- All participants must not have taken antioxidants coenzyme Q-10, vitamin C, or vitamin E for 3 weeks prior to the study and during the course of the study.
Exclusion Criteria:
- Medically unstable conditions in any group as determined by the investigators.
- Concurrent disease; medical condition; or an extenuating circumstance that, in the opinion of the investigator, might compromise subject safety, study compliance, completion of the study, or the integrity of the data collected for the study.
- Women who are pregnant or lactating or of child-bearing age who are not using acceptable forms of contraception.
- History of asthma that is presently being treated.
- Patients enrolled in another interventional study.
- Allergy to N-acetylcysteine.
- Patients who cannot or are unwilling to have blood drawn.
- Inability to undergo MRI scanning, including but not limited to: unable to remain still in an MRI scanner for more than 30 minutes, claustrophobia, presence of paramagnetic substances or pacemakers in body, weight over 300 lbs.
- Unable to adhere to study protocol for whatever reason.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: N-acetylcysteine
The first 10 GD1 subjects will take 1800mg NAC twice daily (3600mg/day) orally for approximately 90 days.
An interim analysis will be performed to determine if this dose produces changes in systemic redox status and brain glutathione (GSH) levels.
If no signal of a significant change is observed, the remaining 20 subjects will receive up to 3600 mg NAC orally twice a day (7200 mg/day).
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1800mg NAC twice daily (3600mg/day) orally for approximately 90 days.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in subjects with Gaucher disease type 1, in concentration of glutathione in brain (μmol/g)
Time Frame: At 90 days and at 180 days
|
The investigators will measure the concentration of glutathione (GSH) in the brains of subjects with Gaucher disease type 1 at 90 days after enrollment, which is the baseline measure.
It will again be measured at 180 days after enrollment.
These measures will be obtained using NMR spectroscopy (often referred to by the acronym "MRS").
The MRS study will take place over approximately 1.0 hour and will generate measurements of GSH levels from 2-3 brain regions.
Scanning may be done in multiple sessions if needed, but will not exceed 1.5 total scanning hours.
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At 90 days and at 180 days
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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In healthy volunteers, determination of level of glutathione in brain (μmol/g)
Time Frame: 90 Days After Enrollment
|
The investigators will measure the glutathione (GSH) level in the brains of healthy volunteers at 90 days after enrollment.
This measure will be obtained using MRS.
The MRS study will take place over approximately 1.0 hour and will generate measurements of GSH levels from 2-3 brain regions.
Scanning may be done in multiple sessions if needed, but will not exceed 1.5 total scanning hours.
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90 Days After Enrollment
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Change in subjects with Gaucher disease type 1, in concentration of glutathione in blood (μmol/g)
Time Frame: Baseline, 45 days, 90 days, 120 days, 150 days, 180 days, and 270 days
|
Investigators will measure the glutathione concentration in the blood of subjects with Gaucher disease type 1, at baseline (enrollment), 45 days, 90 days, 120 days, 150 days, 180 days, and 270 days.
Blood samples will be drawn and analyzed using liquid chromatography-tandem mass spectrometry ("LC-MS").
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Baseline, 45 days, 90 days, 120 days, 150 days, 180 days, and 270 days
|
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Change in healthy volunteers, in concentration of glutathione in blood (μmol/g)
Time Frame: Baseline, 45 days, and 90 days
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Investigators will measure the concentration of glutathione in the blood of healthy volunteers at baseline, at 45 days, and at 90 days.
Blood samples will be drawn and analyzed using LC-MS.
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Baseline, 45 days, and 90 days
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Change in subjects with Gaucher disease type 1, in concentration of myo-inositol in brain (μmol/g)
Time Frame: At 90 days and at 180 days
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The investigators will measure the concentration of myo-inositol in brains of subjects with Gaucher disease type 1 at 90 days after enrollment, which is the baseline measure.
It will again be measured at 180 days after enrollment.
These measures will be obtained using MRS.
The MRS study will take place over approximately 1.0 hour and will generate measurements of myo-inositol levels from 2-3 brain regions.
Scanning may be done in multiple sessions if needed, but will not exceed 1.5 total scanning hours.
These measures will be performed concurrently during the MRS scans being performed to measure GSH levels.
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At 90 days and at 180 days
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In healthy volunteers, determine the concentration of myo-inositol in brain (μmol/g)
Time Frame: 90 Days After Enrollment
|
The investigators will measure the concentration of myo-inositol in brains of healthy volunteers at 90 days after enrollment.
This measure will be obtained using MRS.
The MRS study will take place over approximately 1.0 hour and will generate measurements of myo-inositol levels from 2-3 brain regions.
Scanning may be done in multiple sessions if needed, but will not exceed 1.5 total scanning hours.
This measure will be performed concurrently during the MRS scan being performed to measure GSH level.
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90 Days After Enrollment
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Change in subjects with Gaucher disease type 1, in concentration of TNF-alpha in plasma (pg/mL)
Time Frame: Baseline, 45 days, 90 days, 120 days, 150 days, 180 days, and 270 days
|
The investigators will measure the concentration of TNF-alpha in blood of subjects with Gaucher disease type 1 at baseline (enrollment), 45 days, 90 days, 120 days, 150 days, 180 days, and 270 days.
Blood samples will be drawn and analyzed using immunoassay for TNF-alpha.
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Baseline, 45 days, 90 days, 120 days, 150 days, 180 days, and 270 days
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Change in healthy volunteers, in concentration of TNF-alpha in plasma (pg/mL)
Time Frame: Baseline, 45 days, and 90 days
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The investigators will measure the concentration of TNF-alpha in blood of healthy volunteers at baseline (enrollment), at 45 days, and at 90 days.
Blood samples will be drawn and analyzed using immunoassay for TNF-alpha.
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Baseline, 45 days, and 90 days
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Change in subjects with Gaucher disease type 1, in concentration of N-acetylcysteine (NAC) in blood (µg/ml)
Time Frame: 120 days, 150 days, and 180 days
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Investigators will measure NAC levels in the blood of subjects with Gaucher disease type 1, at 120 days after enrollment, 150 days, and 180 days.
Blood samples will be drawn and analyzed using LC-MS.
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120 days, 150 days, and 180 days
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Reena V. Kartha, PharmD, University of Minnesota
Publications and helpful links
General Publications
- Holmay MJ, Terpstra M, Coles LD, Mishra U, Ahlskog M, Oz G, Cloyd JC, Tuite PJ. N-Acetylcysteine boosts brain and blood glutathione in Gaucher and Parkinson diseases. Clin Neuropharmacol. 2013 Jul-Aug;36(4):103-6. doi: 10.1097/WNF.0b013e31829ae713.
- Coles LD, Tuite PJ, Oz G, Mishra UR, Kartha RV, Sullivan KM, Cloyd JC, Terpstra M. Repeated-Dose Oral N-Acetylcysteine in Parkinson's Disease: Pharmacokinetics and Effect on Brain Glutathione and Oxidative Stress. J Clin Pharmacol. 2018 Feb;58(2):158-167. doi: 10.1002/jcph.1008. Epub 2017 Sep 22.
- Zhou J, Coles LD, Kartha RV, Nash N, Mishra U, Lund TC, Cloyd JC. Intravenous Administration of Stable-Labeled N-Acetylcysteine Demonstrates an Indirect Mechanism for Boosting Glutathione and Improving Redox Status. J Pharm Sci. 2015 Aug;104(8):2619-26. doi: 10.1002/jps.24482. Epub 2015 Jun 5.
- Radtke KK, Coles LD, Mishra U, Orchard PJ, Holmay M, Cloyd JC. Interaction of N-acetylcysteine and cysteine in human plasma. J Pharm Sci. 2012 Dec;101(12):4653-9. doi: 10.1002/jps.23325. Epub 2012 Sep 27.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
Keywords
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Metabolism, Inborn Errors
- Genetic Diseases, Inborn
- Metabolic Diseases
- Lipid Metabolism Disorders
- Lysosomal Storage Diseases
- Brain Diseases, Metabolic, Inborn
- Brain Diseases, Metabolic
- Lipid Metabolism, Inborn Errors
- Lysosomal Storage Diseases, Nervous System
- Sphingolipidoses
- Lipidoses
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Nutritional and Metabolic Diseases
- Gaucher Disease
- Amino Acids, Peptides, and Proteins
- Sulfur Compounds
- Organic Chemicals
- Amino Acids
- Cysteine
- Amino Acids, Sulfur
- Acetylcysteine
Other Study ID Numbers
Other Study ID Numbers
- 160003
- U54NS065768 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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